Non-HDL Cholesterol

Since 2021, heart and cardiovascular disease prevention guidelines recommend additionally evaluating Non-HDL-C concentration. 

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

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

Calculating this indicator does not require additional resources (it is calculated from the lipid profile: Non-HDL cholesterol is the difference between total cholesterol and HDL cholesterol) and is universally applicable for both adult and pediatric cardiovascular prevention.

Main arguments:

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