Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA.
Lipoprotein Metabolism Laboratory, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
Expert Rev Mol Diagn. 2024 Jan-Feb;24(1-2):123-133. doi: 10.1080/14737159.2024.2306127. Epub 2024 Jan 22.
Lipid testing for atherosclerotic cardiovascular disease (ASCVD) risk is often performed every 4-6 years, but we hypothesized that the optimum time interval may vary depending on baseline risk.
Using lipid values and other risk factors from the National Health and Nutrition Examination Survey (NHANES) ( = 9,704), we calculated a 10-year risk score with the pooled-cohort equations. Future risk scores were predicted by increasing age and projecting systolic blood pressure (SBP) and lipid changes, using the mean-percentile age group change in NHANES for SBP ( = 17,329) and the Lifelines Cohort study for lipids ( = 133,540). The crossing of high and intermediate-risk thresholds were calculated by time to determine optimum intervals for lipid testing.
Time to crossing risk thresholds depends on baseline risk, but the mean increase in the risk score plateaus at 1% per year for those with a baseline 10-year risk greater than 15%. Based on these findings, we recommend the following maximum time intervals for lipid testing: baseline risk < 15%: 5-years, 16%: 4-years, 17%: 3-years, 18%: 2-years, and 19%: ≤1-year.
Testing patients for lipids who have a higher baseline risk more often could identify high-risk patients sooner, allowing for earlier and more effective therapeutic intervention.
动脉粥样硬化性心血管疾病（ASCVD）风险的血脂检测通常每 4-6 年进行一次，但我们假设最佳时间间隔可能因基线风险而异。
我们使用来自国家健康和营养检查调查（NHANES）的血脂值和其他风险因素（n=9704），使用合并队列方程计算了 10 年风险评分。未来的风险评分通过增加年龄和预测收缩压（SBP）和血脂变化来预测，使用 NHANES 中 SBP 的平均百分位数年龄组变化（n=17329）和 Lifelines 队列研究中的血脂数据（n=133540）。通过时间计算高风险和中风险阈值的交叉来确定血脂检测的最佳间隔。
达到风险阈值的时间取决于基线风险，但对于基线 10 年风险大于 15%的患者，风险评分的平均增长率每年稳定在 1%。基于这些发现，我们建议以下血脂检测的最长时间间隔：基线风险<15%：5 年，16%：4 年，17%：3 年，18%：2 年，19%：≤1 年。
对基线风险较高的患者更频繁地进行血脂检测，可以更早地识别高风险患者，从而更早地进行更有效的治疗干预。
