VI. CORONARY ARTERY DISEASE RISK
The total cholesterol to HDL ratio risk for coronary heart disease is as follows:
• <3.5 = below average risk
• 3.5–5 = average risk
• 5–10 = above average risk
• > 10 = much above average risk
The NCEP Adult Treatment Panel III strongly advocates the concept of global risk assessment along with the focus on LDL cholesterol as the primary target of therapy. The panel does not mention total to HDL cholesterol ratio in their 2001 guidelines. The global risk assessment is essential for identifying patients who will most benefit from risk factor modification and drug therapy. This statement does not underestimate the poten¬tial cardioprotective value of high HDL cholesterol levels exceeding 50 mg/dl. Adverse outcomes appear to be associated with HDL cholesterol levels less than 30 mg/dl (0.8 mmol/L), but clinical proof from randomized trials is required to clarify the dangers of very low HDL cholesterol levels.