From the Guidelines
Normal LDL cholesterol values are generally considered to be less than 100 mg/dL (2.6 mmol/L), which is optimal for most people. Values between 100-129 mg/dL (2.6-3.3 mmol/L) are near optimal, 130-159 mg/dL (3.4-4.1 mmol/L) are borderline high, 160-189 mg/dL (4.1-4.9 mmol/L) are high, and 190 mg/dL (4.9 mmol/L) or above are very high 1. LDL cholesterol is typically calculated using the Friedewald formula, which subtracts HDL cholesterol and triglycerides/5 from total cholesterol. This calculation works well when triglycerides are below 400 mg/dL but may be less accurate with higher triglyceride levels 1. For people with heart disease, diabetes, or high cardiovascular risk, target LDL levels may be even lower, often below 70 mg/dL (1.8 mmol/L) 1. Some key points to consider when evaluating LDL cholesterol levels include:
- The risk category of the individual, with those at higher risk requiring more aggressive LDL lowering 1
- The presence of other risk factors, such as high blood pressure or smoking 1
- The use of therapeutic lifestyle changes, such as dietary modifications and increased physical activity, to manage LDL levels 1 Regular cholesterol testing is recommended every 4-6 years for most adults, with more frequent monitoring for those with elevated levels or on cholesterol-lowering medications. Maintaining normal LDL levels is important because LDL cholesterol contributes to plaque buildup in arteries, increasing the risk of heart disease and stroke. It's also important to note that non-HDL cholesterol, which includes all cholesterol carried by lipoproteins considered to be atherogenic, is also an important target for therapy, with a goal of being 30 mg/dL higher than the corresponding LDL target 1. Overall, managing LDL cholesterol levels is a critical component of cardiovascular disease prevention and treatment.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
LDL Cholesterol Calculated Normal Values
The calculated normal values for LDL cholesterol are not explicitly stated in the provided studies. However, the studies discuss the effects of various treatments on LDL cholesterol levels and the associated cardiovascular risks.
Treatment Effects on LDL Cholesterol
- The use of statins, ezetimibe, and PCSK9 inhibitors can effectively reduce LDL cholesterol levels and cardiovascular risk 2, 3, 4, 5.
- PCSK9 inhibitors can reduce LDL cholesterol levels by 50-60% above that achieved by statin therapy alone 3.
- The percentage LDL-C reduction with statins, ezetimibe, and PCSK9 inhibition is not attenuated in patients starting with lower baseline LDL-C levels 4.
- The use of combination therapy, such as adding ezetimibe to PCSK9 inhibitor and statin, may reduce stroke and MI, but the reduction may not reach the minimal important difference (MID) 5.
Baseline LDL Cholesterol Levels
- The studies suggest that the baseline LDL cholesterol level can affect the percentage reduction in LDL cholesterol levels achieved with treatment 4, 6.
- Patients with lower baseline LDL cholesterol levels may experience a higher percentage reduction in LDL cholesterol levels with PCSK9 inhibitors 4.
- However, some patients may have an inadequate response to PCSK9 inhibitors, regardless of their baseline LDL cholesterol level 6.
Cardiovascular Risk Reduction
- The use of ezetimibe and PCSK9 inhibitors can reduce cardiovascular risk, including non-fatal MI and stroke, in adults at very high or high cardiovascular risk who are receiving maximally tolerated statin therapy or are statin-intolerant 5.
- The effects of these treatments on cardiovascular risk reduction are consistent in statin-intolerant patients 5.
- However, the benefits of these treatments may be limited in patients with moderate and low cardiovascular risk 5.