What are the AHA guidelines on the treatment of type II hyperlipoproteinemia (HLP)?

Updated: Jun 27, 2019
  • Author: Henry J Rohrs, III, MD; Chief Editor: Stuart Berger, MD  more...
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Guidelines published by the American Heart Association (AHA) in 2006 approach pharmacologic intervention similarly to the NHLBI guidelines by assigning patients to a risk tier based on their disease and also recommending more aggressive targets. [21] The guidelines are as follows:

Tier I (high-risk) factors include the following:

Tier II (moderate-risk) factors include the following:

  • FH

  • Kawasaki disease with regressed coronary aneurysms

  • Type 2 diabetes mellitus

  • Chronic inflammatory disease

Tier III (at-risk) factors:

  • Long-term cancer treatment

  • Congenital heart disease

  • Kawasaki disease without detected aneurysms

If a patient has two additional risk factors (eg, including abnormal fasting lipid profile, smoking, family history of early cardiovascular disease, hypertension, elevated BMI, impaired fasting glucose, sedentary lifestyle), they are moved up one risk category. The LDL-C level goal for tier III is < 160 mg/dL, the tier II goal is < 130 mg/dL, and the tier I goal is < 100 mg/dL. Pharmacologic management is recommended in patients aged 10 years and older to achieve these goals.

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