NON-HDL CHOLESTEROL: MEASUREMENT, INTERPRETATION, AND SIGNIFICANCE*

The reduction of cardiovascular risk by lowering low-density lipoprotein cholesterol (LDL-C) levels is well documented, and LDL-C remains the main target of lipid-lowering therapy. However, not all patients with coronary heart disease have elevated LDL-C levels. There is growing recognition that non‐high-density lipoprotein cholesterol (HDL-C) also strongly relates to cardiovascular risk. Non‐HDL-C can be calculated by subtracting HDL-C from total cholesterol, and encompasses all cholesterol present in potentially atherogenic lipoprotein particles (very low density-lipoproteins, remnants, intermediate-density lipoproteins, LDL, and lipoprotein[a]). Non‐HDLC may be a particularly important measure in certain populations, such as patients with diabetes, in whom dyslipidemia is characterized by low HDL-C levels and elevated triglycerides. Non‐HDL-C has been shown to correlate with coronary artery disease severity and progression as well as predict cardiovascular morbidity