TARGET LEVELS FOR PLASMA CHOLESTEROL AND LDL CHOLESTEROL

 

Global risk mildly increased

pretreatment cholesterol 5.2-7.8 mmol/l (200-300 mg/dl) NO non-lipid risk factors Plasma cholesterol: HDL cholesterol ratio 4.5-5.0

• Targets:
  • Reduce plasma cholesterol to:
    • 5-6 mmol/l
    • 195-230 mg/dl
  • Reduce LDL cholesterol to:
    • 4-4.5 mmol/l
    • 155-175 mg/dl

Global risk moderately increased

pretreatment cholesterol 5.2-7.8 mmol/l (200-300 mg/dl) PLUS one non-lipid risk factor or PLUS HDL cholesterol: 1 mmol/l (39 mg/dl)

• Targets:
  • Reduce plasma cholesterol to:
    • 5 mmol/l
    • 195 mg/dl
  • Reduce LDL cholesterol to:
    • 3,5-4 mmol/l
    • 135-155 mg/dl

Global risk high

presence of coronary or peripheral vascular disease or presence of familial hypercholesterolaemia or plasma cholesterol 7.8 mmol/l (300 mg/dl) or plasma cholesterol 5.2-7.8 mmol/l (200-300 mg/dl) PLUS two non-lipid risk factors or plasma cholesterol 5.2-7.8 mmol/l (200-300 mg/dl) PLUS one severe non-lipid risk factor

• Targets:
  • Reduce plasma cholesterol to:
    • 4.5-5 mmol/l
    • 175-195 mg/dl
  • Reduce LDL cholesterol to:
    • 3-3.5 mmol/l
    • 115-135 mg/dl
      

    Some authorities advise an LDL cholesterol target of 2.5-300 mmol/l (95-115 mg/dl) in patients with coronary heart disease

(Note: Triglyceride target level not yet determined: suggested value 2.3 mmol/l [200 mg/dl])

• The goals for lipid-lowering therapy depend on an assessment of the patient’s global risk. For example, vigorous treatment of hyperlipidaemia is appropriate in patients with cardiovascular disease or multiple risk factors, while a lipid-lowering diet may be the only treatment required for a patient with mild hypercholesterolaemia and no non-lipid risk factors.

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