Atp 3

High Blood Cholesterol

National Cholesterol Education Program

ATP III Guidelines At-A-Glance Quick Desk Reference
Step 1

1

Determine lipoprotein levels–obtain complete lipoproteinprofile after 9- to 12-hour fast.
ATP III Classification of LDL, Total, and HDL Cholesterol (mg/dL)
LDL Cholesterol – Primary Target of Therapy 190 Very high Total Cholesterol 240 HDL Cholesterol 60Desirable Borderline high High

Step 2

2 3

Low High

Identify presence of clinical atherosclerotic disease that confers high risk for coronary heart disease (CHD) events (CHD risk equivalent):s s s s

Clinical CHD Symptomatic carotid artery disease Peripheral arterial disease Abdominal aortic aneurysm.

Step 3

Determine presence of major risk factors (other than LDL):
Major RiskFactors (Exclusive of LDL Cholesterol) That Modify LDL Goals
Cigarette smoking Hypertension (BP >140/90 mmHg or on antihypertensive medication) Low HDL cholesterol (60 mg/dL counts as a “negative”risk factor; its presence removes one risk factor from the total count.

s

Note: in ATP III, diabetes is regarded as a CHD risk equivalent.

N A T I O N A L
N A T I O N A L

I N S T I T U T ES
L U N G , A N D

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B L O O D

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I N S T I T U T E

H E A R T ,

Step 4

4 5

If 2+ risk factors (other than LDL) are present without CHD or CHD risk equivalent, assess10-year (short-term) CHD risk (see Framingham tables). Three levels of 10-year risk:
s s s

>20% — CHD risk equivalent 10-20% 100 mg/dL

Risk Category CHD or CHD Risk Equivalents (10-year risk>20%)

LDL Goal 130 mg/dL (100-129 mg/dL: drug optional)* 10-year risk 10-20%: >130 mg/dL 10-year risk 160 mg/dL

2+ Risk Factors (10-year risk 190 mg/dL (160-189 mg/dL: LDL-lowering drug optional)* Some authorities recommend use of LDL-lowering drugs in this category if an LDL cholesterol 40 in) >88 cm (>35 in) >150 mg/dL

85 mmHg >110 mg/dL

* Overweight and obesity are associated with...