1. A 45 years old gentleman underwent a routine health evaluation. His physical examination did not reveal any abnormalities. His routine labs showed a fasting blood sugar of 87mg/dL and a fasting lipid profile as below:

Total Cholesterol – 215mg/dL
LDL – 130mg/dL
Triglycerides – 100 mg/dL

Which of the following conditions if present in this patient would not warrant intensive treatment for lipid lowering?

1. Diabetes Mellitus
2. Symptomatic carotid stenosis
3. Peripheral vascular disease
4. Hypertension

Answer: This male patient has an elevated HDL (=/> 60). The ATP III – NCEP identifies Diabetes Mellitus, Symptomatic Carotid stenosis and peripheral vascular diseases as coronary risk equivalents. Therefore these conditions require treatment as if for secondary prevention of coronary artery disease. The only condition not defined as a coronary risk equivalent in the ATP III is Hypertension. Therefore the answer is (d).

2. From the above, I am sure you know how to calculate HDL. If not please make sure you do as this has been tested on.

Use the formula Total cholesterol = LDL+HDL+ 1/5th of triglycerides.

215 = 130+HDL+100/5

215 = 130+HDL+20

215-130-20 = HDL

65 = HDL

Thus the HDL is 65.