Table 2.

LDL cholesterol targets for adults in familial hypercholesterolemia, adapted from Watts 2020 [65••]

Treatment targets	ESC/EAS [4•]	AHA/ACC [5•]	CCS [6]	NLA [7]	JAS [8]	AACE/ACE [9]	NICE [89, 90]
Primary prevention
Primary target: LDL cholesterol
Relative reduction (%)	≥ 50	–	50	≥ 50	≥ 50	–	> 50
Absolute level (mmol/L)	< 1.8a	< 2.6	< 2.5	< 2.6	< 2.6	< 1.8	–
Secondary targets:
Absolute non-HDL cholesterol level (mmol/L)	< 2.6	–	–	< 3.4	–	< 2.6	–
Absolute apoB level (mg/dL)	< 80	–	–	< 90	–	< 80	–
Secondary prevention
Primary target: LDL cholesterol
Relative reduction (%)	≥ 50	–	–	≥ 50	–	–	> 50
Absolute level (mmol/L)	< 1.4	< 1.8	< 2.0	< 1.8	< 1.8	< 1.4	–
Secondary targets
Absolute non-HDL cholesterol level (mmol/L)	< 2.2	< 2.6	< 2.6	< 2.6	–	< 2.1	–
Absolute apoB level (mg/dL)	< 65	–	–	< 80	–	< 70	–

AACE/ACE American Association of Clinical Endocrinologists/American College of Endocrinology, AHA/ACC American Heart Association/American College of Cardiology, ApoB apolipoprotein B-100, CAD coronary artery disease, CCS Canadian Cardiovascular Society, ESC/EAS European Society of Cardiology/European Atherosclerosis Society, HDL high-density lipoprotein, JAS Japan Atherosclerosis Society, LDL low-density lipoprotein, NICE National Institute for Health and Clinical Excellence, NLA National Lipid Association

^aLower target to < 1.4 mmol/L if there is another major risk factor (e.g. smoking, diabetes, hypertension, unequivocal atherosclerotic cardiovascular disease on imaging)