Friedewald equation verification and cardiovascular risk assessment
Leave blank to use Friedewald calculation
Usually calculated as TG/5
Isolated elevation of LDL cholesterol (≥130 mg/dL) with normal triglycerides (<150 mg/dL). Often genetic (familial hypercholesterolemia if LDL ≥190 mg/dL). First-line treatment is statin therapy targeting LDL reduction.
Combined elevation of both LDL (≥130 mg/dL) and triglycerides (≥150 mg/dL). Common in metabolic syndrome, diabetes, and obesity. Treatment typically requires statin plus lifestyle modifications; consider adding fibrate or omega-3s if TG remain elevated.
Isolated elevation of triglycerides (≥150 mg/dL) with normal LDL. Causes include obesity, diabetes, excessive alcohol, and certain medications. Severe elevation (≥500 mg/dL) increases acute pancreatitis risk and requires urgent treatment with fibrates or omega-3 fatty acids.
HDL <40 mg/dL (men) or <50 mg/dL (women) represents a major cardiovascular risk factor independent of LDL levels. Associated with sedentary lifestyle, obesity, and smoking. Treatment focuses on exercise, weight loss, and smoking cessation rather than medications.
Genetic disorder causing severe LDL elevation (typically ≥190 mg/dL in adults, ≥160 mg/dL in children). Presents early with tendon xanthomas and premature cardiovascular disease. Requires aggressive statin therapy, often with ezetimibe or PCSK9 inhibitors. Screen first-degree relatives.
General dyslipidemia not fitting specific patterns above, or when complete lipid panel unavailable. Use when total cholesterol is elevated (≥240 mg/dL) but specific dyslipidemia subtype cannot be determined. Requires full fasting lipid panel for proper classification and treatment planning.
The Friedewald equation is a formula used to estimate LDL cholesterol from Total Cholesterol, HDL, and Triglycerides (LDL = TC - HDL - TG/5). It is the standard method used by most labs but becomes inaccurate when triglycerides are >400 mg/dL.
Non-HDL cholesterol is calculated by subtracting HDL from Total Cholesterol. It represents all atherogenic (plaque-forming) particles, including LDL, VLDL, and IDL. It is often considered a better predictor of cardiovascular risk than LDL alone.
Modern guidelines often allow for non-fasting lipid panels for initial screening. However, if triglycerides are elevated (>400 mg/dL) or if calculating precise LDL is critical, a fasting repeat test (9-12 hours) is usually recommended.