Question

1. What is the calculated LDL level as calculated using the Friedewald calculation?

2. Which patient, if any, should have his or her LDL measured, rather than calculated? Explain your answer.

3. How many known CHD risk factors does each patient have?

4. Based on what is known, are these patients recommended for lipid therapy (diet or drug?) and, if so, on what basis?

Patient 1: 40 year old male with HTN, who also is a smoker, but has not been previously diagnosed with CHD. His father developed CHD at the age of 53 years. At the time of his lab draw, he is fasting, and his results of his lab results is as follows: Cholesterol 210 mg/dL Triglycerides 150 mg/dL HDL-C 45 mg/dL Glucose 98 mg/dL

Patient 2: 60 year old female with no family history of CHD and who is normotensive and does not smoke. Her lab results are as follows: Cholesterol 220 mg/dL Triglycerides 85 mg/dL HDL-C 80 mg/dL Glucose 85 mg/dL

Patient 3: A 49 year old male with no personal or family history of CHD and who is not hypertensive and does not smoke. His fasting lab results is as follows: Cholesterol 260 mg/dL Triglycerides 505 mg/dL HDL-C 25 mg/dL Glucose 134 mg/dL

Answer 1

FRIEDEWALD FORMULA

LDL=TOTAL CHOLESTROL-(TG/5)-HDL

Calculated values of each patient is given below.

2.

friedewald formula is not applicable if TG value is morethan or equal to 400mg/dl.

3.

4.Guidelines for lipid therapy

For diet and drug are explained in below images.

*the blood cholestrol values of these patients are above normal level.

It may lead to severe heart diseases like CHD.

So based on patients lipid profile, family history , need for avoiding risk factors like smoking , diabetics , the patient may prescribed for lipid therapy.