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ATP III Classification of LDL, Total, and HDL Cholesterol (mg/dL)

LDL Cholesterol Primary Target of Therapy


<100 Optimal
100-129 Near optimal/above optimal
130-159 Borderline high
160-189 High
190 !er" high
Total Cholesterol
<200 #e$irable
200-239 Borderline high
2%0 High
HDL Cholesterol
<%0 &o'
60 High
Identify presence of clinical atherosclerotic disease that confers high ris
for coronary heart disease (CHD) e!ents (CHD ris e"#i!alent)$
$
$
$
(lini)al (H#
*"mptomati) )arotid arter" di$ea$e
+eripheral arterial di$ea$e
%ator risio #tama penyait &ant#ng oroner selain olesterol LDL ( 'olesterol
(ahat ) men#r#t pand#an )C*P ATP III+ adalah$
,*-.'.'
HIP*-T*)/I , -# 1%0/90 mmhg ata. $edang dalam pengobatan hiperten$i /
HDL 0 12mg/dL
-I3A4AT '*L5A-6A ada 0el.arga 0and.ng "ang ter0ena $erangan 1ant.ng di .$ia
m.da 2
13 &a0i-la0i , 4"ah5 0a0a05 adi0 / $ebel.m .$ia 55 tah.n
23 6anita , 7b.5 0a0a05 adi0 / $ebel.m .$ia 65 tah.n
5/IA
13 &a0i-la0i %5 tah.n
23 6anita 55 tah.n
8nt.0 menent.0an target olesterol LDL "ang har.$ di)apai 0ita perl. menghit.ng
fator risio yang lain $
If 78 ris factors (other than LDL) are present 9itho#t CHD or CHD ris e"#i!alent, assess
:2;year (short;term) CHD ris (see %ramingham ta<les)=
Three le!els of :2;year ris$
$ 209 : (H# ri$0 e;.ivalent
$ 10-209
$ <109
Determine ris category$
$ <$tabli$h &#& goal o= therap"
$ #etermine need =or therape.ti) li=e$t"le )hange$ ,-&(/
$ #etermine level =or dr.g )on$ideration
LDL Cholesterol 6oals and C#tpoints for Therape#tic Lifestyle Changes (TLC) and Dr#g Therapy in Different
-is Categories=
LDL Le!el at 3hich
to Initiate Therape#tic LDL Le!el at 3hich to
-is Category LDL 6oal Lifestyle Changes (TLC) Consider Dr#g Therapy
(H# or (H# >i$0 <;.ivalent$ <100 mg/d& 100 mg/d& 130 mg/d&
,10-"ear ri$0 209/ ,100-129 mg/d&2 dr.g optional/?
10-"ear ri$0 10-2092
2@ >i$0 Aa)tor$ <130 mg/d& 130 mg/d&
,10-"ear ri$0 <209/
130 mg/d&
10-"ear ri$0 <1092
160 mg/d&
0-1 >i$0 Aa)tor
B
<160 mg/d& 160 mg/d& 190 mg/d&
,160-189 mg/d&2 &#&-lo'ering
dr.g optional/
* Some authorities recommend use of LDL-lowering drugs in this category if an LDL cholesterol <100 mg/dL ca
nnot be achieved by
therapeutic lifestyle changes !thers prefer use of drugs that primarily modify triglycerides and "DL# eg# nico
tinic acid or fibrate
$linical %udgment also may call for deferring drug therapy in this subcategory
& 'lmost all people with 0-1 ris( factor have a 10-year ris( <10)# thus 10-year ris( assessment in people with 0
-1 ris( factor is
not necessary
Initiate therape#t
ic lifestyle change
s (TLC) if LDL i
s a<o!e goal=
TLC %eat#res
$ -&( #iet2
: *at.rated =at <C9 o= )alorie$5 )hole$terol <200 mg/da"
: (on$ider in)rea$ed vi$)o.$ ,$ol.ble/ =iber ,10-25 g/da"/ and plant $tanol$/$terol$
,2g/da"/ a$ therape.ti) option$ to enhan)e &#& lo'ering
$ 6eight management
$ 7n)rea$ed ph"$i)al a)tivit"3
Consider adding dr#g therapy if LDL e>ceeds le!els sho9n in /tep ? ta<le$
$ (on$ider dr.g $im.ltaneo.$l" 'ith -&( =or (H# and (H# e;.ivalent$
$ (on$ider adding dr.g to -&( a=ter 3 month$ =or other ri$0 )ategorie$3
Dr#gs Affecting Lipoprotein ,eta<olism
Dr#g Class Agents and Lipid/Lipoprotein /ide *ffects Contraindications
Daily Doses *ffects
HDE (o4 red.)ta$e
inhibitor$ ,$tatin$/
Bile a)id $e;.e$tran$
&ova$tatin ,20-80 mg/
+rava$tatin ,20-%0 mg/
*imva$tatin ,20-80 mg
/
Al.va$tatin ,20-80 mg/
4torva$tatin ,10-80 mg
/
(eriva$tatin ,03%-038
mg/
(hole$t"ramine ,%-16
g/
(ole$tipol ,5-20 g/
(ole$evelam ,236-338
g/
&#& F18-559
H#& G5-159
-E FC-309
&#& F15-309
H#& G3-59
-E No )hange
or in)rea$e
D"opath"
7n)rea$ed liver
enH"me$
Ea$trointe$tinal
di$tre$$
(on$tipation
#e)rea$ed ab$orp-
4b$ol.te2
I 4)tive or )hroni)
liver di$ea$e
>elative2
I (on)omitant .$e o=
)ertain dr.g$?
4b$ol.te2
I d"$beta-
lipoproteinemia
I -E %00 mg/d&
tion o= other dr.g$ >elative2
I -E 200 mg/d&
Ni)otini) a)id 7mmediate relea$e
,)r"$talline/ ni)otini)
a)id
,135-3 gm/5 eJtended
relea$e ni)otini) a)id
,Nia$pan
K
/ ,1-2 g/5
$.$tained relea$e
&#& F5-259
H#& G15-359
-E F20-509
Al.$hing
H"pergl")emia
H"per.ri)emia
,or go.t/
8pper E7 di$tre$$
HepatotoJi)it"
4b$ol.te2
I (hroni) liver di$ea$e
I *evere go.t
>elative2
I #iabete$
I H"per.ri)emia
ni)otini) a)id ,1-2 g/ I +epti) .l)er di$ea$e
Aibri) a)id$ Eem=ibroHil
,600 mg B7#/
Aeno=ibrate ,200 mg/
(lo=ibrate
,1000 mg B7#/
&#& F5-209
,ma" be in)rea$ed in
patient$ 'ith high -
E/
H#& G10-209
-E F20-509
#"$pep$ia
Eall$tone$
D"opath"
4b$ol.te2
I *evere renal di$ea$e
I *evere hepati)
di$ea$e
* $yclosporine# macrolide antibiotics# various anti-fungal agents# and cytochrome *-+,0 inhibitors -fibrates and
niacin should be used with
appropriate caution.