Finding Your Optimal Lipid Levels

Finding Your Optimal Lipid Levels

The National Cholesterol Education Program (NCEP)
released new goals for lipid levels in May 2001.

"Report of the Expert Panel on Detection, Evaluation,
and Treatment of High Blood Cholesterol in Adults"

(Adult Treatment Panel III)

The National Cholesterol Education Program is part of the National Heart, Lung and Blood Institute and the National Institutes of Health.

To determine your optimal lipid levels, first you must asses your cardiovascular heart disease (CHD) risk.These are the minimum guidelines for lipid levels and treatment. Some doctors may want your LDL levels to be lower than what is indicated here. They often make this decision depending on other risk factors or information, such as type of family history, C-Reactive Protein values or EBCT (heart scan) score.

Highest Risk:

Anyone with known Coronary Heart Disease (CHD) - Or any of the following:
Diabetes
Symptomatic carotid artery disease
Peripheral arterial disease
Abdominal aortic aneurysm
a 10-year risk of CHD greater than 20% (click here)

Moderate Risk:

a 10-year risk of CHD between 10-20% (click here) - Or -
the presence of 2 or more of the following major risk factors:

Cigarette smoking
High Blood Pressure (140/90 mmHg or on BP medication)
Low HDL cholesterol (40 mg/dl or less)
Family history of premature CHD (father or brother age 55 or less; mother or sister age 65 or less)
Age (men 45 years; women 55 years)

(HDL of 60 mg/dL or higher counts as a "negative" risk factor; its presence removes one risk factor from the total count)

Low Risk:

0 or 1 of the major risk factors listed above

Lipid Goals and Optimal Levels

You need to meet all the goals for LDL, HDL, Triglycerides and Cholesterol

If you are at High Risk your goals are:
LDL less than 100 ("less than 70 is a therapeutic option on the basis of recent trial evidence" - 7/12/04
HDL above 40 (60 or higher is optimal)
Triglycerides less than 150
Total Cholesterol less than 200

If you are at Moderate Risk your goals are:
LDL less than 130 ("less than 100 is a therapeutic option on the basis of recent trial evidence" - 7/12/04
HDL above 40 (60 or higher is optimal)
Triglycerides less than 150
Total Cholesterol less than 200

If you are at Low Risk your goals are:
LDL less than 160
HDL above 40 (60 or higher is optimal)
Triglycerides less than 150
Total Cholesterol less than 240

When LDL-lowering drug therapy is employed in high-risk or moderately high-risk persons, it is advised that intensity of therapy be sufficient to achieve at least a 30% to 40% reduction in LDL levels.

Non-HDL Cholesterol is the total cholesterol minus the HDL. Elevated non-HDL is believed by the ATP III panel to be a risk factor for atherosclerotic disease. The non-HDL is made of very low-density lipoprotein (VLDL) and remnant particles, and contains a lot of triglycerides. The goal for the non-HDL is 30 mg/dL above the LDL goal.

If you are in the "Low Risk" category but your one risk factor is very significant, you may need to try for an LDL of 130 or less. A very significant risk factor may be - a heavy smoking history, or strong family history of CHD (parents and siblings had CHD in their 30's or 40's).