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➤ Diagnosis
• Dyslipidemia is diagnosed by interpreting lipid panel results in the
context of cardiovascular risk.
• Adult LDL-C and non-HDL-C goals:
▶ Very high-risk ASCVD: LDL-C <55 mg/dL and non-HDL-C
<85 mg/dL (not <70 mg/dL )
▶ ASCVD not at very high risk: LDL-C <70 mg/dL and
non-HDL-C <100 mg/dL
▶ High primary prevention risk (≥10% 10-year risk):
LDL-C <70 mg/dL and non-HDL-C <100 mg/dL
• Children and adolescents:
▶ Elevated levels are: TG >100 mg/dl if <10 yrs, >130 mg/dL if ≥10 yrs;
HDL <40 mg/dL; total cholesterol
>200 mg/dL; non HDL cholesterol ≥145 mg/dl; LDL cholesterol
>130 mg/dL.
➤ According to the 2026 ACC/AHA Dyslipidemia Guidelines,
cardiovascular risk is determined by 10-year ASCVD risk
estimation using the PREVENT-ASCVD equations, categorizing
individuals as low-risk (3%), borderline-risk (3% to 5%),
intermediate-risk (5% to 10%), or high-risk (≥10%). Risk-enhancing
factors that may indicate higher individual risk include: Lp(a) ≥125
nmol/L (≥50 mg/dL), LDL-C persistently 160-189 mg/dL, non-
HDL-C 190-219 mg/dL, apoB ≥120 mg/dL, triglycerides persistently
≥175 mg/dL (nonfasting) or ≥150 mg/dL (fasting), hsCRP ≥2 mg/L,
chronic inflammatory diseases, cardiovascular-kidney-metabolic
(CKM) syndrome, family history of premature ASCVD, and
reproductive risk markers.
➤ The 2026 ACC/AHA Guideline on the Management of Dyslipidemia
recommends measuring Lp(a) at least once to identify individuals
at higher risk of ASCVD. Lp(a) ≥125 nmol/L (≥50 mg/dL) is
considered a risk-enhancing factor associated with approximately
1.4-fold increased ASCVD risk, and values ≥250 nmol/L (≥100 mg/
dL) are associated with ≥2-fold higher estimated risk.
