In determining whether a patient should be treated for hyperlipidemia, a patient's risk factors must be determined. After assessing fasting lipids, specifically LDLs, CHD equivalents must be identified.
These are diabetes, symptomatic carotid artery disease, peripheral artery disease, abdominal aortic aneurysm, and multiple risk factors that confer a 10 year risk of CHD > 20 percent. Major CHD risk factors are elevated LDL cholesterol, cigarette smoking, hypertension, low HDL cholesterol, family history of premature CHD [in male first degree relatives (FDR) < 55 years; female FDR, 65 years], and age (men > 45 years, women > 55 years). Patients with 2 or more risk factors should have a 10 risk assessment performed and treated accordingly.