Assessment
LDL-cholesterol
In all adults aged 20 years or older, a fasting lipoprotein profile (total cholesterol, LDL-C, HDL-C, and triglyceride) should be obtained once every 5 years. If the testing opportunity is non-fasting, only the values for total cholesterol and HDL-C will be usable. In this case, if total cholesterol is ≥200 mg/dL (5.2 mmol/L) or HDL-C is <40 mg/dL (1.0 mmol/L), a follow up lipoprotein profile is needed for appropriate management based on LDL-C.
The relationship between LDL-C levels and risk of cardiovascular disease is continuous over a broad range of LDL-C levels from low to high. ATP III adopts the classification of LDL-C levels shown in Table 1, which also shows the classification of total cholesterol and HDL-C levels:1
| LDL Cholesterol | ||
|---|---|---|
| >100 | (2.6) | Optimal |
| 100-129 | (2.6-3.3) | Never optimal/above optimal |
| 130-159 | (3.4-4.0) | Borderline high |
| 160-189 | (4.1-4.9) | High |
| ≥190 | (≥5.0) | Very high |
| Total Cholesterol | ||
| <200 | (<5.2) | Desirable |
| 200-239 | (5.2-6.1) | Borderline high |
| ≥240 | (≥6.2) | High |
| HDL Cholesterol | ||
| <40 | (<1.0) | Low |
| ≥60 | (≥1.6) | High |
Reference:
1. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): Full report. Section III-1. NIH Publication No. 02-5215, September 2002. This guideline document, published by the National Heart, Lung, and Blood Institute (NHLBI), as a part of the NIH and the U.S. Department of Health and Human Services, is available at: http://www.nhlbi.nih.gov/guidelines/cholesterol/index.htm.