This document provides guidelines and recommendations for lipid profiles in both adults and children. It includes normal and abnormal ranges for total cholesterol, triglycerides, HDL, LDL, and non-HDL cholesterol. It also outlines treatment goals based on risk categories as well as notes on interpreting results and additional testing.
This document provides guidelines and recommendations for lipid profiles in both adults and children. It includes normal and abnormal ranges for total cholesterol, triglycerides, HDL, LDL, and non-HDL cholesterol. It also outlines treatment goals based on risk categories as well as notes on interpreting results and additional testing.
This document provides guidelines and recommendations for lipid profiles in both adults and children. It includes normal and abnormal ranges for total cholesterol, triglycerides, HDL, LDL, and non-HDL cholesterol. It also outlines treatment goals based on risk categories as well as notes on interpreting results and additional testing.
This document provides guidelines and recommendations for lipid profiles in both adults and children. It includes normal and abnormal ranges for total cholesterol, triglycerides, HDL, LDL, and non-HDL cholesterol. It also outlines treatment goals based on risk categories as well as notes on interpreting results and additional testing.
ASSOCIATION CHOLESTEROL in in mg/dL CHOLESTEROL in CHOLESTEROL RECOMMENDATIONS mg/dL mg/dL in mg/dL (NLA-2014) Optimal <200 <150 <100 <130 Above Optimal - - 100-129 130 - 159 Borderline High 200-239 150-199 130-159 160 - 189 High >=240 200-499 160-189 190 - 219 Very High - >=500 >=190 >=220
Note:
1. Measurements in the same patient can show physiological& analytical variations. Three serial samples 1 week apart are recommended for Total Cholesterol, Triglycerides, HDL& LDL Cholesterol.
2. As per NLA-2014 guidelines, all adults above the age of 20 years should be screened for lipid status. Selective screening of children above the age of 2 years with a family history of premature cardiovascular disease or those with at least one parent with high total cholesterol is recommended.
3. Low HDL levels are associated with increased risk forAtherosclerotic Cardiovascular disease (ASCVD) due to insufficient HDL being available to participate in reverse cholesterol transport, the process by which cholesterol is eliminated from peripheral tissues.
4. NLA-2014identifies Non HDL Cholesterol(an indicator of all atherogeniclipoproteins such as LDL ,
VLDL, IDL, Lpa, Chylomicron remnants)along with LDL-cholesterol as co- primary target for cholesterol lowering therapy. Note that major risk factors can modify treatment goals for LDL &Non HDL.
5. Apolipoprotein B is an optional, secondary lipid target for treatment once LDL & Non HDL goals have been achieved
6. Additional testing for Apolipoprotein B, hsCRP,Lp(a ) & LP-PLA2 should be considered among patients with moderate risk for ASCVD for risk refinement
Treatment Goals as per NLA 2014
RISK CATEGORY NON HDL LDL CHOLESTEROL APOLIPOPROTEIN B
CHLOESTEROL (NON (LDL-C)(mg/dL) (mg/dL) HDL-C) (mg/dL) Low/Moderate/High <130 <100 <90 Very High <100 <70 <80
NCEP TOTAL CHOLESTEROL TRIGLYCERIDE in LDL CHOLESTEROL in
RECOMMENDATIONS in mg/dL mg/dL mg/dL
Optimal <170 <150 <110
Borderline High 171-199 150-199 111-129 High >=200 200-499 >=130 Very High - >=500 -
Note:
1. Measurements in the same patient can show physiological& analytical variations. Three serial samples 1 week apart are recommended for Total Cholesterol, Triglycerides, HDL& LDL Cholesterol. 2. As per NCEP guidelines, all adults above the age of 20 years should be screened for lipid status. Selective screening of children above the age of 2 years with a family history of premature cardiovascular disease or those with at least one parent with high total cholesterol is recommended.
3. NCEP identifies elevated Triglycerides as an independent risk factor for Coronary Heart Disease ( CHD).
4. Low HDL levels are associated with Coronary Heart Disease due to insufficient HDL being available to participate in reverse cholesterol transport, the process by which cholesterol is eliminated from peripheral tissues.
5. ATP III guidelines uses LDL Cholesterol as the primary target for cholesterol lowering therapy. Note that major risk factors can modify LDL goals.
CHD & CHD risk equivalent ( 10 < 100 < 130 year risk for CHD > 20 %) Multiple ( 2+) Risk Factors and < 130 < 160 10 year risk < or = 20% 0-1 Risk factor < 160 <190
Comments
1. ATP III suggested the addition of Non HDL Cholesterol (Total Cholesterol HDL Cholesterol) as an indicator of all atherogenic lipoproteins ( mainly LDL & VLDL). The Non HDL Cholesterol is used as a secondary target of therapy in persons with triglycerides >=200 mg/dL. The goal for Non HDL Cholesterol in those with increased triglyceride is 30 mg/dL above that set for LDL Cholesterol. 2. For calculation of CHD risk, history of smoking, any medication for hypertension & current blood pressure levels are required.
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