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Commonly used cholesterol calculation underestimates heart disease danger for many
Date:3/26/2013

In what promises to be an eye-opener for many doctors and patients who routinely depend on cholesterol testing, a study led by researchers at the Johns Hopkins University School of Medicine found that the standard formula used for decades to calculate low-density lipoprotein (LDL) cholesterol levels is often inaccurate. Of most concern, the researchers say, is their finding that the widely used formula underestimates LDL where accuracy matters most in the range considered desirable for high-risk patients. Results of the study are published in an online article, ahead of print, in the Journal of the American College of Cardiology.

LDL is known as the "bad" cholesterol, with higher numbers signaling greater risk of plaque accumulating in heart arteries and having a heart attack. Since 1972, a formula called the Friedewald equation has been used to gauge LDL cholesterol. It is an estimate rather than an exact measurement. However, physicians use the number to assess their patients' risk and determine the best course of treatment.

"In our study, we compared samples assessed using the Friedewald equation with a direct calculation of the LDL cholesterol. We found that in nearly one out of four samples in the 'desirable' range for people with a higher heart disease risk, the Friedewald equation had it wrong," says Seth Martin, M.D., a clinical fellow at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease. "As a result, many patients may think they achieved their LDL cholesterol target when, in fact, they may need more aggressive treatment to reduce their heart disease risk," says Martin, who is the lead author of the study.

"In patients with heart disease, we want to get their LDL level below 70 that is the typical goal," says Steven Jones, M.D., director of inpatient cardiology at The Johns Hopkins Hospital and a faculty member at the Ciccarone Center who is the senior author of the study. Jones says based on
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Contact: Ellen Beth Levitt
eblevitt@jhmi.edu
410-955-5307
Johns Hopkins Medicine
Source:Eurekalert

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