Treatment goals - overview
| LDL cholesterol: | |
| Patients with high risk of MI: | <100 mg/dL (<2.59 mmol/L) |
| Intermediate risk of MI: | <130 mg/dL (<3.37 mmol/L) |
| Low risk of MI: | <160 mg/dL (<4.14 mmol/L) |
| HDL cholesterol: | |
| Men: | >40 mg/dL (>1.02 mmol/L) |
| Women: | >50 mg/dL (>1.28 mmol/L) |
| Blood pressure: | |
| Patients with high risk of MI: | <130/85 mmHg |
| Other risk categories: | <140/90 mmHg |
| Fasting triglycerides: | <150 mg/dL (<1.69 mmol/L) |
| Fasting blood glucose: | <110 mg/dL (<6.1 mmol/L) |
Treatment goals for LDL cholesterol
- The treatment goals for LDL cholesterol depend on the level of global risk (Table 1). Patients at low global risk of CHD can tolerate a higher level of LDL cholesterol than patients at an intermediate or high level of risk.
- There has been some recent discussion on whether an LDL cholesterol goal of below 100 mg/dL (2.6 mmol/L) (e.g., 70 mg/dL [1.8 mmol/L]) should be aimed for in patients at particularly high risk (e.g., CHD in a person with poorly controlled diabetes mellitus). While there is some trial evidence to support this view, it cannot be regarded as consensus at the present time.
TABLE 1. Treatment goals for LDL cholesterol.
| Global risk | Risk of coronary event within next 10 years | Treatment goal for LDL cholesterol |
|---|---|---|
| Low | <10% | 160 mg/dL (4.1 mmol/L) |
| Intermediate | 10-20% | 130 mg/dL (3.3 mmol/L) |
| High | >20% | 100 mg/dL (2.6 mmol/L) |
Treatment goals for triglycerides
- The data on the relationship between raised triglycerides and CHD are less extensive than those available for LDL cholesterol. Nevertheless, most experts consider that fasting triglyceride levels should be below 150 mg/dL (1.7 mmol/L).
- Levels above 200 mg/dL (2.3 mmol/L) are thought to increase coronary risk, while levels above 1000 mg/dL (11.3 mmol/L) carry a risk of acute pancreatitis.