Determine lipoprotein levels–obtain complete lipoprotein profile after
9- to 12-hour fast.
ATP III Classification of LDL, Total, and HDL Cholesterol (mg/dL)
Identify presence of clinical atherosclerotic disease that confers high risk
for coronary heart disease (CHD) events (CHD risk equivalent):
■ Clinical CHD
■ Symptomatic carotid artery disease
■ Peripheral arterial disease
■ Abdominal aortic aneurysm.
Determine presence of major risk factors (other than LDL):
Major Risk Factors (Exclusive of LDL Cholesterol) That Modify LDL Goals
■ Note: in ATP III, diabetes is regarded as a CHD risk equivalent.
Hypertension (BP >140/90 mmHg or on antihypertensive medication)
Low HDL cholesterol (<40 mg/dL)*
Family history of premature CHD (CHD in male first degree relative <55 years;
CHD in female first degree relative <65 years)
Age (men >45 years; women >55 years)
* HDL cholesterol >60 mg/dL counts as a “negative” risk factor; its presence removes one
risk factor from the total count.
N A T I O N A L
I N S T I T U T E S O F H E A L T H
N A T I O N A L H E A R T ,
L U N G , A N D B L O O D
I N S T I T U T E
National Cholesterol Education Program
High Blood CholesterolATP III Guidelines At-A-Glance
Quick Desk Reference
LDL Cholesterol – Primary Target of Therapy
Near optimal/above optimal
If 2+ risk factors (other than LDL) are present without CHD or CHD risk equivalent, assess
10-year (short-term) CHD risk (see Framingham tables).
Three levels of 10-year risk:
■ >20% — CHD risk equivalent
Determine risk category:
■ Establish LDL goal of therapy
■ Determine need for therapeutic lifestyle changes (TLC)
■ Determine level for drug consideration
LDL Cholesterol Goals and Cutpoints for Therapeutic Lifestyle Changes (TLC) and Drug Therapy in Different