Hyperlipidemia or dyslipidemia, colloquially known as high cholesterol, is characterized by high blood serum levels of low-density lipoprotein (LDL) and triglycerides and low levels of high-density lipoprotein (HDL).1 All of these measurements together are known as total cholesterol (TC).
Table 1. Recommended cholesterol levels for otherwise healthy adults presented in mg/dL1,2
|
LDL
|
|
Ideal
|
<100
|
|
Near optimal
|
100-129
|
|
Borderline high
|
130-159
|
|
High
|
160-189
|
|
Severe
|
≥190
|
|
Triglycerides
|
|
Ideal
|
<150
|
|
Borderline high
|
150-199
|
|
High
|
200-499
|
|
Severe
|
≥500
|
|
TC
|
|
Ideal
|
<200
|
|
Borderline high
|
200-239
|
|
High
|
≥240
|
The 2018 American Heart Association/American College of Cardiology (AHA/ACC) Guideline on the Management of Blood Cholesterol focuses on low-density lipid cholesterol (LDL-C) level, existing atherosclerotic cardiovascular disease (ASCVD), as well as 10-year ASCVD risk when making management decisions.3 Severe hypercholesterolemia is defined as a low-density lipid cholesterol (LDL-C) level of ≥190 mg/dL.3,4 The optimal level of LDL-C is <100 mg/dL for most people. However, the guideline sets a threshold of LDL-C of 70 mg/dL for people with existing ASCVD or diabetes or who have a very high 10-year ASCVD risk.3 The overarching message of the guideline that “lower is better” when it comes to LDL-C levels.
References
- Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. Jun 25 2019;73(24):e285-e350. doi:10.1016/j.jacc.2018.11.003
- 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) final report. Circulation. Dec 17 2002;106(25):3143-421.
- Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol. Circulation. Nov 10 2018:Cir0000000000000625. doi:10.1161/cir.0000000000000625
- Bibbins-Domingo K, Grossman DC, Curry SJ, et al. Statin use for the primary prevention of cardiovascular disease in adults: US Preventive Services Task Force recommendation statement. JAMA. Nov 15 2016;316(19):1997-2007. doi:10.1001/jama.2016.15450
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