cholesterol lab

practice practial exam

what is lipid testing

• fasting lipid panel (FLP) recommended every 5 years in adults >20 years

• preferred fasting for 9-12 hours before test (preferably in morning)

• includes total cholesterol, LDL, HDL, and TG

• LDL is calculated, others measured directly

what conditions have the same risk level as CHD

• clinical CHD

• symptomatic carotid artery disease

• peripheral arterial disease

• abdominal aortic aneurysm

• diabetes

what are major risk factors that affect cholesterol levels

• cigarette smoking

• hypertension (>140/90 mmHg or on therapy)

• low hdl (<40 mg/dL)

• family history of premature CHD

• age

• hdl > 60 mg/dL is a negative risk factor and subtracts one from total

what makes someone lower risk

0-1 risk factors

what makes someone intermediate risk

2+ risk factors

what makes someone high risk

CHD or CHD equivalent high risk

risk calculators estimate 10-year CHD risk

• 20% = high risk

• 10-20% = moderate risk

• <10% = low risk

what is the optimal LDL goal

<100 mg/dL

what is near/above optimal LDL goal

100-129 mg/dL

what is borderline high LDL goal

130-159 mg/dL

what is high LDL goal

160-189 mg/dL

what is very high LDL goal

>190 mg/dL

what is desirable total cholesterol goal

<200 mg/dL

what is borderline total cholesterol goal

200-239 mg/dL

what is high total cholesterol goal

>240 mg/dL

what are low HDL goals

• <40 mg/dL for men

• <50 mg/dL for women

what are high/desirable HDL goals

>60 mg/dL

lipid panel calculations

LDL + HDL +TG/5 = total cholesterol

what is the purpose of risk calculators

• determine need for TLC or statin therapy

• higher risk = more aggressive management

• used to guide intensity of lipid treatment

treatment for cholesterol 4S

• Scandinavian simvastatin survival study (4S)

• demonstrated that statin therapy reduces risk of heart attacks and mortality in CHD patients

• established statins as foundational treatment for high cholesterol

therapeutic lifestyle changes (TLC)

• diet

  • dec saturated fat intake, inc soluble fiber intake, eliminate trans fat, favor monounsaturated fats, include omega 3 fatty acids

• excersise

• weight management

• smoking cessation

• moderate alcohol intake if consumed