Non-HDL cholesterol

Since 2021, heart and vascular disease prevention guidelines recommend additionally assessing Non-HDL-Ch concentration. 

In 2019, the European Society of Cardiology's guidelines for dyslipidemia treatment published a similar recommendation: non-HDL-CH or ApoB should be calculated for patients with hypertriglyceridemia, when very low LDL-Ch concentration is found, as well as for patients with diabetes or obesity who have very low LDL-Ch concentration.

Non-high-density lipoprotein cholesterol is cholesterol present in atherogenic lipoproteins (low-density, very low-density lipoproteins, and lipoprotein a). These lipoproteins are the main factors determining atherosclerosis. Non-HDL-Ch is more significant than low-density cholesterol (LDL) in assessing cardiovascular risk, both for primary and secondary prevention of heart and vascular diseases. It reflects the concentration of apolipoprotein B, and these markers correlate in 85% of individuals.

No additional resources are needed to calculate this indicator (it is calculated from the lipidogram: Non-HDL cholesterol is the difference between B-Ch and HDL-Ch) and it is universally applicable for the prevention of heart and vascular diseases in both adults and children.

Main arguments:

• Non-HDL-Ch includes cholesterol from all atherogenic lipoproteins.
• Non-HDL-Ch is easily calculated from a standard lipidogram.
• Non-HDL-Ch  reflects the concentration of pro-atherogenic apolipoprotein B (ApoB).
• When assessing cardiovascular risk, it is recommended to determine non-HDL-Ch concentration.
• Non-HDL-Ch can be used as a target for dyslipidemia treatment.