{Equations}

(Open Calc) Low-Density Lipoprotein Cholesterol Goals

1. High Risk: CHD or CHD Risk Equivalents (10-year risk: > 20%)
   • LDL-C Goal: < 100 mg/dL (2.6 mmol/L)(optional goal: < 70 mg/dL (1.8 mmol/L))
   • Initiate TLC: ≥ 100 mg/dL (2.6 mmol/L)(TLC disclaimer)
   • Consider Drug Therapy: ≥ 100 mg/dL (2.6 mmol/L)
2. Moderately High Risk: 2+ Risk Factors (10-year risk: 10-20%)
   • LDL-C Goal: < 130 mg/dL (3.4 mmol/L)
   • Initiate TLC: ≥ 130 mg/dL (3.4 mmol/L),TLC disclaimer
   • Consider Drug Therapy: ≥ 130 mg/dL (3.4 mmol/L)
3. Moderate risk: 2+ Risk Factors (10-year risk: < 10%)
   • LDL-C Goal: < 130 mg/dL (3.4 mmol/L)
   • Initiate TLC: ≥ 130 mg/dL (3.4 mmol/L)
   • Consider Drug Therapy: ≥ 160 mg/dL (4.1 mmol/L)
4. Lower risk: 0–1 Risk Factor
   • LDL-C Goal: < 160 mg/dL (4.1 mmol/L)
   • Initiate TLC: ≥ 160 mg/dL (4.1 mmol/L)
   • Consider Drug Therapy: ≥ 190 mg/dL (4.9 mmol/L)

CHD

• History of myocardial infarction
• Unstable angina
• Stable angina
• Coronary artery procedures (angioplasty or bypass surgery)
• Evidence of clinically significant myocardial ischemia

CHD RISK EQUIVALENTS

• Clinical manifestations of noncoronary forms of atherosclerotic disease (peripheral arterial disease, abdominal aortic aneurysm, and
  carotid artery disease [transient ischemic attacks or stroke of carotid origin or > 50% obstruction of a carotid artery])
• Diabetes
• 2+ risk factors with 10-year risk for hard CHD > 20%

RISK FACTORS

• Cigarette smoking
• Hypertension (BP ≥ 140/90 mm Hg or on antihypertensive medication)
• Low HDL cholesterol (< 40 mg/dL)
• Family history of premature CHD (CHD in male first-degree relative < 55 years of age; CHD in female first-degree relative < 65 years of age)
• Age (men ≥ 45 years; women ≥ 55 years)

TLC DISCLAIMER

• Any person at high risk or moderately high risk who has lifestyle-related risk factors (eg, obesity, physical inactivity, elevated triglyceride, low HDL-C, or metabolic
  syndrome) is a candidate for therapeutic lifestyle changes to modify these risk factors regardless of LDL-C level

Abbreviations

• CHD: coronary heart disease
• TLC: therapeutic lifestyle changes
• HDL-C: high-density lipoprotein cholesterol
• LDL-C: low-density lipoprotein cholesterol