Risk enhancers
| Family history of premature atherosclerotic cardiovascular disease (in men age < 55 or in women age < 65) |
| Primary hypercholesterolemia Low-density lipoprotein cholesterol 160–180 mg/dL Non-high-density lipoprotein cholesterol 190–219 mg/dL |
| Metabolic syndrome: 3 or more of the following: Increased waist circumference by ethnically appropriate cut points Fasting triglyceride level > 150 mg/dL High blood pressure Elevated glucose Low high-density lipoprotein cholesterol (< 40 mg/dL in men, < 50 mg/dL in women) Chronic kidney disease (estimated glomerular filtration rate 15–59 mL/min/1.73 m2) |
| Chronic inflammatory conditions (eg, psoriasis, rheumatoid arthritis, lupus, human immunodeficiency virus infection, acquired immunodeficiency syndrome) |
| History of premature menopause (age < 40) and history of pregnancy-associated conditions that increase later risk of atherosclerotic cardiovascular disease such as preeclampsia |
| High-risk ethnicity or race (eg, South Asian) |
| Lipids or biomarkers associated with elevated risk Persistently elevated hypertriglyceridemia (≥ 175 mg/dL nonfasting) Elevated high-sensitivity C-reactive protein (≥ 2.0 mg/L) Elevated lipoprotein (a) (≥ 50 mg/dL or ≥ 125 nmol/L) (relative indication for measurement: family history of premature atherosclerotic cardiovascular disease) Elevated apolipoprotein B (≥ 130 mg/dL) (relative indication for measurement: triglycerides ≥ 200 mg/dL) Ankle-brachial index < 0.9 |
Reprinted from Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2019; 73(24):3168–3209. doi:10.1016/j.jacc.2018.11.002, with permission from Elsevier.