Which result is most consistent with a high risk of coronary heart disease?

Which result is most consistent with a high risk of coronary heart disease?

• A. 20 mg/dL HDL-C and 250 mg/dL total cholesterol
• B. 35 mg/dL HDL-C and 200 mg/dL total cholesterol
• C. 50 mg/dL HDL-C and 190 mg/dL total cholesterol
• D. 60 mg/dL HDL-C and 180 mg/dL total cholesterol

Answer: (A)

Low HDL cholesterol removes cholesterol from arteries and is protective, while high total cholesterol reflects a larger burden of atherogenic lipoproteins. The profile with 20 mg/dL HDL-C and 250 mg/dL total cholesterol shows both a very low protective HDL and a very high cholesterol load, which together indicate a high risk of coronary heart disease. The cholesterol ratio underscores this: 250 divided by 20 equals 12.5, a markedly elevated ratio associated with greater risk. By comparison, the other profiles have higher HDL and/or lower total cholesterol (for example, 60 mg/dL HDL with 180 mg/dL total gives a ratio of 3.0, which is more favorable). Hence, the described lipid pattern is the most consistent with high CHD risk.

Low HDL cholesterol removes cholesterol from arteries and is protective, while high total cholesterol reflects a larger burden of atherogenic lipoproteins. The profile with 20 mg/dL HDL-C and 250 mg/dL total cholesterol shows both a very low protective HDL and a very high cholesterol load, which together indicate a high risk of coronary heart disease. The cholesterol ratio underscores this: 250 divided by 20 equals 12.5, a markedly elevated ratio associated with greater risk. By comparison, the other profiles have higher HDL and/or lower total cholesterol (for example, 60 mg/dL HDL with 180 mg/dL total gives a ratio of 3.0, which is more favorable). Hence, the described lipid pattern is the most consistent with high CHD risk.