National Cholesterol Education and Guidlines (NCEP)

for LDL Cholesterol

 

How to use these guidlines

Asses the number of risk factors using the tables below. The total number of risk factors for a given individual using Table 1.

Proceed to Table 2 and enter the first column at the appropriate cell based on an individual's profile from Table 1 and determine whether the individual should initiate drug therapy.

 

Table 1. Classification of Coronary Heart Disease Risk Factors other than LDL Cholesterol Levels*

Positive Risk Factors Negative Risk Factors
1) Age

Male greater than 45 yrs or Female greater than 55 yrs or premature menopause without estrogen replacement therapy

2) Family History

definite heart attack or sudden death before age 55 in male first-degree relative (parent, brother, sister, or children) or before age 65 in female first-degree relative)

3) Current cigarette smoking

4) Diabetes mellitus

5) Hypertension (blood pressure greater than 140/90 or using hypertensive medication)

6) Low HDL level less than 35 mg/dl

 1) High HDL Cholesterol Level which is greater than 60 mg/dl

* - If HDL greater than 60 mg/dl, then subtract one of the positive risk factors above when using the table below.

 

Table 2. Guidelines for LDL Cholesterol**

Individual Background Begin Drug Therapy When LDL Cholesterol Level Goal
No coronary heart disease (CHD) and one other heart disease risk factor (see table above) LDL greater than 190 mg/dl after 6 months of diet to be less than 160 mg/dl
No CHD but has 2 or more other heart disease risk factors (see table above) LDL greater than 160 mg/dl after 6 months of diet to be less than 130 mg/dl
Individual with CHD and other atherosclerotic disease (plaque buildup in vessels) LDLgreater than 130 mg/dl after 6-12 weeks of special Step II diet to be less than 100 mg/dl

** - JAMA June 16, 1993, 269 (23): 3015-3023.