Asessing coronary heart disease risk and managing lipids

Elevated low-density lipoprotein (LDL) and below normal high-density lipoprotein (HDL) cholesterol are risk factors for coronary heart disease (CHD). According to clinical guidelines, LDL cholesterol is the primary target for lipid-altering therapy. Many patients who develop CHD have LDL and HDL cholesterol levels that fall within the desirable or low-risk category; consequently, conventional measurements of plasma lipids may not accurately detect high-risk patients. This article discusses the clinical significance of lipoprotein subclasses and methods of measurement. Assessing lipoprotein subclasses provides a more comprehensive and efficacious therapeutic approach compared with the standard lipid profile.