(March 19, 2008 - Insidermedicine) Analyzing nine genetic polymorphisms known to affect HDL and LDL cholesterol together help predict the risk for cardiovascular events independently of clinical risk factors, according to research published in the New England Journal of Medicine.

Here are the recommendations for LDL treatment targets from the Adult Treatment Panel III (ATP III):

•    High risk patients, defined as those with coronary heart disease or CHD equivalents and a 10-year risk >20%, should be treated to an LDL goal of <100 or even <70 mg/dL.

•    Moderately high risk patients, defined as two or more risk factors and 10-year risk of 10-20%, as well as moderate risk patients, defined as two or more risk factors and a 10-year risk <10%, should be treated to an LDL goal of <130 mg/dL.

•    Lower risk patients, defined as one or no risk factors, should be treated to a goal <160 mg/dL.

In a study involving over 5,000 adults recruited from the cardiovascular cohort of another trial, researchers out of Massachusetts General Hospital investigated the predictive value of nine single nucleotide polymorphisms that had each been individually linked with LDL or HDL cholesterol. They calculated a genotype score based on the number of unfavorable alleles present.

During a median follow-up period of 10.6 years, 238 patients experienced their first cardiovascular event. Genotype score predicted the development of cardiovascular disease independently of established risk factors and baseline lipid levels, but it did not improve risk prediction obtainable by clinical factors alone. Addition of the genetic information did, however, help classify patients' cardiovascular risk more accurately.

Today's research demonstrates that available genetic information on LDL and HDL risk has some independent predictive value for the risk of cardiovascular events.

For Insidermedicine in Depth, I'm Essie Heinrich.