title: Optimal lipid targets for the new era of cardiovascular prevention.
abstract: Optimal lipid targets (OLT) should be the goal for all individuals treated in the new era of cardiovascular (CV) disease prevention. Evidence supports that average LDL cholesterol (LDL-C) values in Westernized populations are not optimal. Lessons from nature and science support a physiologic LDL-C target of <70 mg/dL. Clinical trial evidence further supports optimal LDL-C targets, although several critical questions remain unanswered. Using a calculated LDL-C may have limitations in clinical practice. Non-HDL-C cholesterol may be a better predictor of outcomes, and should therefore be provided on all laboratory reports. Specific HDL cholesterol (HDL-C) targets are significantly more complicated. Although a low HDL-C predicts a less favorable outcome independent of LDL-C level, an HDL-C level > 50 mg/dL is associated with lower CV risk. Clinical trials on HDL-C have thus far been disappointing. OLT should be the goal for all individuals as an important part of addressing global CV risk.
authors.affiliation: J. Willis Hurst Internal Medicine Residency, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Vimal
authors.initials: V
authors.lastname: Ramjee
authors.affiliation: Department of Medicine, Section of Preventive Cardiology, Emory University, Atlanta, Georgia.
authors.forename: Danny J
authors.initials: DJ
authors.lastname: Eapen
authors.affiliation: Department of Medicine, Section of Preventive Cardiology, Emory University, Atlanta, Georgia.
authors.forename: Laurence S
authors.initials: LS
authors.lastname: Sperling
mesh_terms: D002318:Cardiovascular Diseases / Q000097:blood* / Q000188:drug therapy / Q000517:prevention & control*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008055:Lipids / Q000097:blood*; D008297:Male; D017410:Practice Guidelines as Topic; D012307:Risk Factors
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D008055:Lipids