Lipid Panel Quick Reference

Lipid Panel Quick Reference

What Do My Numbers Mean?

LDL-C (Primary Treatment Target)

Treatment goals depend on your cardiovascular risk:
Risk Level
LDL-C Goal
Source
Very high risk
<55 mg/dL
ESC/EAS 2019
Very high risk with recurrent events within 2 years
<40 mg/dL may be considered
ESC/EAS 2019
High risk
<70 mg/dL
ESC/EAS 2019
Moderate risk
<100 mg/dL
ESC/EAS 2019
Low risk
<116 mg/dL
ESC/EAS 2019
The 2025 ESC/EAS focused update reaffirmed these targets without change.

General population categories (ATP III):

LDL-C
Category
<100 mg/dL
Optimal
100–129 mg/dL
Near/above optimal
130–159 mg/dL
Borderline high
160–189 mg/dL
High
≥190 mg/dL
Very high

HDL-C (Risk Marker Not a Treatment Target)

HDL-C
Interpretation
Source
<40 mg/dL
Low
ATP III
40–59 mg/dL
Normal
ATP III
≥60 mg/dL
Historically associated with lower CV risk
ATP III
Note: Very high HDL is not always protective. HDL is not a treatment target in current guidelines.

Triglycerides

Triglycerides
Category
Source
<150 mg/dL
Normal
ATP III
150–199 mg/dL
Borderline high
ATP III
200–499 mg/dL
High
ATP III
≥500 mg/dL
Very high (pancreatitis risk)
ATP III

Non-HDL-C (Secondary Target)

Total cholesterol minus HDL. Goal is 30 mg/dL above your LDL-C goal.
Risk Level
Non-HDL-C Goal
Source
Very high risk
<85 mg/dL
ESC/EAS 2019
High risk
<100 mg/dL
ESC/EAS 2019
Moderate risk
<130 mg/dL
ESC/EAS 2019

Advanced Tests (Not on Standard Panels)

Apolipoprotein B (ApoB)

ESC/EAS 2019 treatment goals:

Risk Level
ApoB Goal
Very high risk
<65 mg/dL
High risk
<80 mg/dL
Moderate risk
<100 mg/dL
Separately, 2018 AHA/ACC identifies ApoB ≥130 mg/dL as a risk-enhancing factor that may favor statin initiation or intensification in clinician–patient risk discussion.

Lipoprotein(a) Lp(a)

Lp(a) Level
Risk
Source
<75 nmol/L (<30 mg/dL)
Low
2024 NLA
75–125 nmol/L (30–50 mg/dL)
Intermediate
2024 NLA
≥125 nmol/L (≥50 mg/dL)
High
2024 NLA
      • Genetically determined measure once in a lifetime
      • Does not change significantly with diet, exercise, or most medications
      • Levels vary by ancestry see our cholesterol articles for details
      • Conversion between mg/dL and nmol/L is assay-dependent and not a fixed ratio

Risk Categories

Your clinician determines your risk category. The following are examples of conditions used in ESC/EAS guidelines not a complete definition:

Very high risk

      • Established cardiovascular disease (heart attack, stroke, PAD)
      • Diabetes with target organ damage or ≥3 major risk factors
      • Severe CKD (eGFR <30)
      • Familial hypercholesterolemia with ASCVD or another major risk factor

High risk

      • Markedly elevated single risk factor (LDL-C >190 mg/dL, BP ≥180/110)
      • Familial hypercholesterolemia without other major risk factors
      • Diabetes >10 years or with other risk factors
      • Moderate CKD (eGFR 30–59)

Moderate risk

      • Younger diabetes without complications
      • Some risk factors present

Low risk

      • No major risk factors

Quick Facts

Question
Answer
Do I need to fast?
Fasting is usually not required; fasting is most useful when triglycerides are elevated or when a prior non-fasting test was abnormal
How often should I test?
Common guideline intervals: every 4–6 years if healthy; 4–12 weeks after starting or changing medication
What about total cholesterol?
Not a treatment target; LDL-C and non-HDL-C are more clinically useful

Guideline Sources

      • ATP III: NCEP Adult Treatment Panel III (2001) population classification thresholds
      • ESC/EAS 2019: European Society of Cardiology / European Atherosclerosis Society Guidelines for the Management of Dyslipidaemias treatment goals
      • ESC/EAS 2025: Focused update reaffirming 2019 targets; added guidance on combination therapy and newer agents
      • 2018 AHA/ACC: American Heart Association / American College of Cardiology Guideline on Management of Blood Cholesterol
      • 2024 NLA: National Lipid Association Focused Update on Lipoprotein(a)
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