5
Evaluation and Diagnosis
3.1. Screening in Children and Adults
COR LOE
Recommendations
1 B-NR
1. In adults, screening with a lipid profile is recommended
beginning at age 19 years and at least every 5 years
thereafter to identify treatable ASCVD risk, with frequent
screening recommended for individuals with additional
ASCVD risk factors.
1 B-NR
2. In children 9 to 11 years of age not previously tested, it
is recommended to screen with a lipid profile to identify
familial hypercholesterolemia (FH) and other significant
lipid disorders.
2a B-NR
3. In individuals with first- or second-degree relatives with
premature ASCVD, severe hypercholesterolemia, or FH,
it is reasonable to perform screening with a single lipid
profile (eg , cascade screening ) starting at ≥2 years of age
to identif y FH.
3.2. Measurement of TC, LDL-C, HDL-C, Triglycerides, and
Non–HDL-C
COR LOE
Recommendations
1 B-NR
1. In adults and children, a standard nonfasting or fasting lipid
profile is recommended to document baseline lipid levels,
estimate ASCVD risk, and guide initiation of LLT.
1 B-NR
2. In adults and children with a family history of dyslipidemia
or premature ASCVD, a personally known or suspected
disorder in TG metabolism, or whose nonfasting lipid profile
reveals a TG level ≥400 mg/dL (≥4.5 mmol/L), a fasting
lipid profile should be performed to more accurately estimate
the LDL-C level.
1 B-NR
3. In adults and children who have undergone a standard lipid
profile, use of either the Martin/Hopkins equation or the
Sampson/National Institutes of Health (NIH) equation
is preferred over calculation by the Friedewald equation to
estimate LDL-C.
1 B-NR
4. In adults and children who have undergone a standard
lipid profile, use of either the Martin/Hopkins equation or
Sampson/NIH equation is preferred over direct LDL-C
measurement (other than by beta-quantification) to
estimate LDL-C.
