Extract from Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2017
Diagnostic criteria for dyslipidemia (fasting blood collection)*
LDL cholesterol
140mg/dL or higher
LDL-hypercholesterolemia
120 – 139mg/dL
Borderline LDL-hypercholesterolemia**
HDL cholesterol
Lower than 40mg/dL
HDL-hypocholesterolemia
Triglyceride
150mg/dL or higher
Hypertriglyceridemia
Non-HDL cholesterol
170mg/dL or higher
Non-HDL-hypercholesterolemia
150 – 169mg/dL
Borderline non-HDL-hypercholesterolemia**
* “ Fasting” means abstinence from food for at least 10 hours. However, zero-calorie water or tea intake is permitted.
** For patients classified as borderline LDL-hyper C, borderline non-HDL-C in the screening,
examine their high-risk clinical conditions and consider the therapeutic potential.
Use the Friedewald method (TC－HDL-C－TG/5) or direct methods to obtain LDL-C levels.
Use non-HDL-C (TC－HDL-C) or LDL-C direct methods for patients with 400mg/dL of TG or higher,
or postprandial blood collection. When assessing the risk, however,
remember that the difference from LDL-C may be smaller than +30mg/dL in patients without hypertriglyceridemia at the screening.
Flow chart for setting LDL cholesterol target values from the perspective of coronary artery disease prevention using Suita score
Note) Refer to Chapter 5“ Familial cholesterolemia” and Chapter 6“ Primary dyslipidemia” instead of using this chart
for patients with diagnosis of familial hypercholesterolemia and familial type III hyperlipidemia, respectively.
Lipid target values by risk segment
Therapeutic principle
Control segment
Lipid target values (mg/dL)
LDL-C
Non HDL-C
TG
HDL-C
Primary prevention
After improving lifestyle, consider drug therapy.
Low risk
＜160
＜190
＜150
≥40
Medium risk
＜140
＜170
High risk
＜120
＜150
Secondary prevention
Consider drug therapy together with improving lifestyle.
History of coronary artery diseases
＜100 (＜70)*
＜130 (＜100)*
* Consider in patients with familial hypercholesterolemia, acute coronary syndromes,
and also diabetes patients with coexisting high-risk clinical conditions
(non-cardiogenic cerebral infarction, peripheral arterial disease (PAD),
chronic kidney disease (CKD), metabolic syndrome, multiple major risk factors, smoking).
In principle, use non-drug therapy to achieve the target values in the primary prevention.
However, for low risk patients with LDL-C levels ≥ 180mg/dL,
consider drug therapy and also the possibility of familial hypercholesterolemia (refer to Chapter 5).
First, achieve the target value of LDL-C and then aim to achieve the target value of non-HDL-C.
These values represent a goal to strive for. Target values can also be an LDL-C reduction rate of 20 ‒ 30%
in the primary prevention (low/medium risk), and 50% or higher in the secondary prevention.
Refer to Chapter 7 for elderly patients (75 years of age or older).
Sources: Edited by Japan Atherosclerosis Society：
Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2017,
Japan Atherosclerosis Society, 2017 (revised)
