🩺 ASCVD Risk Stratification & LDL-C Target (China Lipid Guideline 2023)
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.
ASCVD Risk Stratification & LDL-C Target (China Lipid Guideline 2023)
Established ASCVD (CHD / ischaemic stroke / PAD etc.)?
[Secondary] number of severe ASCVD events (ACS < 1 yr / old MI / ischaemic stroke / symptomatic PAD)
[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)
[Primary] meets direct high-risk (LDL ≥ 4.9 or TC ≥ 7.2 / diabetes & age ≥ 40 / CKD stage 3–4 — any)?
[Primary] if not direct high-risk: 10-year ASCVD risk assessment result
When to use
Set an individualised LDL-C goal and lipid-lowering plan once risk stratum is known.
How it works
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.
Key points
- 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.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.