Step 5: Risk Category

Determining the risk category allows you to determine the goal for LDL treatment, need for therapeutic lifestyle changes (TLC), and when to consider drug therapy.

LDL Cholesterol Goals and Cutpoints for Therapeutic Lifestyle Changes (TLC) and Drug Therapy in Different Risk Categories
Risk Category	LDL Goal	LDL Level at Which to Initiate Therapeutic Lifestyle Changes (TLC)	LDL Level at Which to Consider Drug Therapy
CHD or CHD Risk Equivalents (10-year risk >20%)	<100 mg/dL	>100 mg/dL	>130 mg/dL (100-129 mg/dL: drug optional)*
2+ Risk Factors (10-year risk 20%)	<130 mg/dL	>130 mg/dL	10-year risk 10-20%: >130 mg/dL
			10-year risk <10%: >160 mg/dL
0-1 Risk Factor	<160 mg/dL	>160 mg/dL	>190 mg/dL (160-189 mg/dL: LDL-lowering drug optional)

*If TLC's alone are not adequate for lowering LDL to the target level, then drug therapy for LDL treatment may be considered within the first category. Drugs that modify HDL levels may also be considered at this time.