Blood cholesterol LDL and non-HDL treatment goals

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Template:Hypercholesterolemia Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


No recommendations are made for or against specific LDL-C or non-HDL-C goals for the primary prevention or secondary prevention of atherosclerotic cardiovascular disease (ASCVD), given the lack of evidence on the titration of cholesterol-lowering therapy to specific goals.

2018 AHA ACC Guideline on the Management of Blood Cholesterol. Primary Prevention


Class I
"1. Interventions focused on improving adherence to prescribed therapy are recommended for the management of adults with elevated cholesterol levels, including telephone reminders, calendar reminders, integrated multidisciplinary educational activities, and pharmacist-led interventions, such as simplification of the drug regimen to once-daily dosing(Level of Evidence: A) "
"2. Clinicians, health systems, and health plans should identify patients who are not receiving guideline-directed medical therapy and should facilitate the initiation of appropriate guideline-directed medical therapy, using multifaceted strategies to improve guideline implementation (Level of Evidence: B-NR) "
"3. Before therapy is prescribed, a patient-clinician discussion should take place to promote shared decision-making and should include the potential for ASCVD risk-reduction benefit, adverse effects, drug-drug interactions, and patient preferences (Level of Evidence: B-NR) "


2013 ACC AHA guideline on the treatment of blood cholesterol LDL and non-HDL treatment goals

There are few trials that were designed to define the optimal goals for LDL-C or non-HDL-C by titrating cholesterol-lowering therapy. In AIM-HIGH, the additional reduction in non-HDL–C levels with niacin therapy did not further reduce ASCVD risk in individuals treated to LDL–C levels of 40 to 80 mg/dL.[2] Therefore, no recommendations are made for or against specific LDL–C or non-HDL–C goals for the primary or secondary prevention of ASCVD due to the lack of evidence on titration of drug therapy to specific goals.


  1. Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS; et al. (2019). "2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines". J Am Coll Cardiol. 73 (24): 3168–3209. doi:10.1016/j.jacc.2018.11.002. PMID 30423391.
  2. {{Cite journal | last1 = Boden | first1 = WE. | last2 = Probstfield | first2 = JL. | last3 = Anderson | first3 = T. | last4 = Chaitman | first4 = BR. | last5 = Desvignes-Nickens | first5 = P. | last6 = Koprowicz | first6 = K. | last7 = McBride | first7 = R. | last8 = Teo | first8 = K. | last9 = Weintraub | first9 = W. | title = Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. | journal = N Engl J Med | volume = 365 | issue = 24 | pages = 2255-67 | month = Dec | year = 2011 | doi = 10.1056/NEJMoa1107579 | PMID = 22085343 }

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