American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the goal level of LDL cholesterol for high-risk patients?

1. Less than 100

2. Less than 80

3. Less than 70

4. Less than 50

The correct answer is: Less than 70

The goal level of LDL cholesterol for high-risk patients is set at less than 70 mg/dL. This target is recommended based on evidence showing that lower levels of LDL cholesterol are associated with a reduced risk of cardiovascular events, particularly in individuals who are at a higher risk due to preexisting conditions such as heart disease, diabetes, or multiple risk factors. The strategy of aiming for such a low threshold is grounded in studies that indicate significant benefits in terms of lowering morbidity and mortality when patients achieve these levels. For very high-risk patients, reaching this target can enhance the benefits of therapeutic lifestyle changes and pharmacological interventions. In contrast, while targets like less than 100 mg/dL or less than 80 mg/dL are appropriate for individuals at lower levels of risk, high-risk patients require more stringent management of LDL cholesterol to further decrease their chances of adverse cardiovascular outcomes. Targeting levels under 50 mg/dL is generally not warranted and is typically not recommended as that could involve excessive treatment and potential side effects without additional demonstrated benefit. Thus, the position of less than 70 mg/dL is a critical guideline used in clinical practice to protect high-risk individuals from cardiovascular disease effectively.