ASCVD Risk Stratification & LDL-C Target (China Lipid Guideline 2023) — free guideline decision tool

Determine ASCVD risk stratum and the corresponding LDL-C / non-HDL-C targets and initial lipid-lowering strategy, per the 2023 Chinese lipid-management guideline. Instant, browser-side.

LDL-C targets: extreme-high < 1.4, very-high < 1.8, high/intermediate < 2.6, low < 3.4 mmol/L (secondary-prevention strata also require ≥ 50% reduction). Non-HDL-C target = LDL-C target + 0.8 mmol/L.

Set an individualised LDL-C goal and lipid-lowering plan once risk stratum is known.

LDL-C is the primary lipid target; non-HDL-C is the secondary target. Stepwise therapy: moderate-intensity statin → add ezetimibe → add a PCSK9 inhibitor if still not at goal. For hard-to-classify intermediate risk, risk-enhancing factors (high Lp(a), LV hypertrophy, premature family history) favour treating as high risk. Targets are closely aligned with the ESC 2021 dyslipidaemia guideline.

For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.

Inputs: Established ASCVD (CHD / ischaemic stroke / PAD etc.)? Yes (secondary prevention), [Secondary] number of severe ASCVD events (ACS < 1 yr / old MI / ischaemic stroke / symptomatic PAD) 0, [Secondary] number of high-risk factors (premature CHD / FH or LDL ≥ 4.9 / prior CABG-PCI / diabetes / hypertension / CKD 3–4 / smoking / recurrence with LDL ≤ 1.8) 0, [Primary] meets direct high-risk (LDL ≥ 4.9 or TC ≥ 7.2 / diabetes & age ≥ 40 / CKD stage 3–4 — any)? Yes, [Primary] if not direct high-risk: 10-year ASCVD risk assessment result Low → Result: LDL-C target < 1.8 mmol/L（Risk stratum: Very-high risk, Reduction required: ≥ 50% reduction from baseline, Non-HDL-C target: < 2.6 mmol/L）