Lipid Panel and Cardiovascular Risk Interpretation
The lipid panel is a risk marker, and its interpretation is anchored to LDL and non-HDL cholesterol.
Core categories (mg/dL)
- Total cholesterol: below 200 desirable; 200-239 borderline high; 240 or above high.
- LDL: below 100 optimal; 100-129 near optimal; 130-159 borderline; 160-189 high; 190 or above very high.
- HDL: below 40 (men) / 50 (women) is low; 60 or above is protective.
- Triglycerides: below 150 normal; 150-199 borderline; 200-499 high; 500 or above very high (pancreatitis risk).
Calculation limits
Friedewald LDL = Total cholesterol - HDL - (TG/5) is valid only when triglycerides are below 400 mg/dL; use direct LDL or an extended equation when triglycerides are higher.
Derived measures
- Non-HDL = total cholesterol - HDL; target of LDL + 30, and less influenced by non-fasting variation.
- TC/HDL ratio above 5 (men) / 4.5 (women) marks elevated risk.
Clinical integration
Absolute ASCVD risk calculators integrate age, diabetes, smoking, and blood pressure with the LDL/non-HDL to set statin intensity. Repeat fasting confirmation is needed before changing therapy when triglycerides are borderline elevated.