Cholesterol

The fasting lipid profile assesses total cholesterol and total triglycerides, in addition to the high and low density lipoprotein cholesterol fractions, from which ratios may be derived. A patient's lipid status is an independent modifier of cardiovascular disease pathology. Its subsequent targeting, by pharmacological or dietary means, lowers the risk for developing such diseases.

Family history of cardiovascular or other thrombotic events Diagnosis and monitoring of hyperlipidaemia Monitoring of high-risk groups, eg. hypertensive, obese, diabetics, etc.

See notes below

In primary prevention, lipid results should be assessed in tandem with other risk factors to estimate cardiovascular disease (CVD) risk. NICE recommend using the QRISK2 calculator In primary prevention, lipid results should be assessed in tandem with other risk factors to estimate cardiovascular disease (CVD) risk. NICE recommend using the QRISK2 calculator

https://www.qrisk.org/2017/

When considering treatment for primary prevention of CVD in individuals with ≥10% risk, share the option to have treatment or not before prescribing.

Patient decision aids include:

http://www.jbs3risk.com/JBS3Risk.swf

https://www.nice.org.uk/guidance/cg181/resources/patient-decision-aidpdf-243780159

Non-HDL cholesterol (total chol minus HDL chol) is recommended for CVD risk prediction; fasting samples are not required for this. Non-HDL cholesterol targets for patients treated for CVD risk reduction are:

* 40 % reduction from baseline (NICE CG181, 2014) or

* <2.5 mmol/L (JBS3. Heart 2014;100:ii1)

Once a patient has reached their target level of cholesterol, there is no need to keep measuring it.