Besides total cholesterol and LDL, should we not also consider non-HDL cholesterol a predictor of future coronary heart disease (CHD), especially with regard to our female patients?
—James L. Steward, MD, Hyattsville, Md.
Non-HDL cholesterol is defined as total serum cholesterol minus HDL and has the same predictive value as LDL. Non-HDL cholesterol is useful when the triglyceride level is elevated and accurate measurement of LDL may not be possible. The target levels for non-HDL cholesterol are 30 mg/dL greater than the LDL goals and can be reached with intensified statin doses, often with addition of niacin and fibrates when the triglyceride levels must also be treated (Circulation. 2005;112:3184-3209).
—Peter F. Cohn, MD (109-4)