LDL Cholesterol Clinical Calculator
Computes low-density lipoprotein (LDL-C) using the validated Friedewald and Martin-Hopkins equations, with Non-HDL cholesterol, atherogenic ratios, and statin target classification.
Interactive LDL Cholesterol Calculator
Moderate elevation. Review 10-year ASCVD risk score and risk enhancers (family history, coronary artery calcium score).
ACC / AHA 2024 Statin Target & LDL Risk Classification
| LDL-C (mg/dL) | LDL-C (mmol/L) | Risk Tier | Clinical Statin Strategy |
|---|---|---|---|
| < 70 mg/dL | < 1.8 mmol/L | Target for Very High Risk | Goal for established secondary prevention (post-MI, stroke) and multiple major ASCVD events. |
| < 100 mg/dL | < 2.6 mmol/L | Optimal / High Risk Goal | Primary prevention target for patients with diabetes mellitus or 10-year ASCVD risk ≥ 7.5%. |
| 100 – 129 mg/dL | 2.6 – 3.3 mmol/L | Near Optimal / Desirable | Therapeutic lifestyle changes (diet, exercise). Re-evaluate lipid panel in 12 months. |
| 130 – 159 mg/dL | 3.4 – 4.1 mmol/L | Borderline High | Initiate lifestyle therapy; consider moderate-intensity statin if risk enhancers present (CAC > 0). |
| 160 – 189 mg/dL | 4.1 – 4.9 mmol/L | High Elevation | Moderate to high-intensity statin recommended. Target ≥ 50% LDL reduction. |
| ≥ 190 mg/dL | ≥ 4.9 mmol/L | Severe Hypercholesterolemia | Automatic high-intensity statin (Atorvastatin 80mg / Rosuvastatin 40mg). Screen for Familial Hypercholesterolemia. |
Formula Comparison: Friedewald vs. Martin-Hopkins
The 400 mg/dL Limit: The classic Friedewald formula assumes a constant 5:1 ratio of triglycerides to VLDL cholesterol. When serum triglycerides reach or exceed 400 mg/dL (4.52 mmol/L), chylomicrons accumulate, rendering the fixed ratio invalid and underestimating LDL-C. In such cases, an automated direct enzymatic LDL assay is clinically mandated.
Martin-Hopkins Enhancement: For patients with lower LDL levels (< 70 mg/dL) or elevated triglycerides (150–400 mg/dL), the Martin-Hopkins equation utilizes a personalized divisor ranging from 3.1 to 11.9, avoiding premature undertreatment.
Companion Cardiovascular & Metabolic Tools
While non-fasting lipid testing is acceptable for initial screening, the Friedewald calculated LDL is most reliable following a 9 to 12-hour overnight fast. Recent high-fat meals elevate triglyceride levels, spuriously suppressing calculated LDL.