Non-high-density lipoprotein cholesterol calculation and goal awareness among physicians-in-training

Smita I. Negi, Lynne Steinberg, Venkateshwar R. Polsani, Saqib A. Gowani, Vijay Nambi, Varinder Kumar, Victor Marinescu, Peter H. Jones, Laura A. Petersen, Christie M. Ballantyne, Salim S. Virani

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)


Background: Non-high density lipoprotein cholesterol (non-HDL-C) goal attainment per Adult Treatment Panel III (ATP III) guidelines remains low. Objective: To understand gaps in knowledge and practices of physicians-in- training (internal medicine, family medicine, cardiology, endocrinology) towards non-HDL-C. Methods: A survey based on a conceptual model to assess the trainee's knowledge, attitudes, and practice regarding non-HDL-C was developed and administered to physicians-in-training (n = 655) at 26 training programs in the United States. Responses of those in internal medicine and family medicine (residents-in-training; n = 418) were compared with those in cardiology and endocrinology (fellows-in-training; n = 124). Results: Response rate was 83.7%. Fifty-three percent of residents and 31% of fellows-in-training had not read the ATP III guidelines (P <.001). Thirty-three percent of the residents and 35% fellows-in-training could not calculate non-HDL-C from a standard lipid panel (P =.7). Sixty-seven percent of the residents and 52% of fellows were not aware of treatment goals for non-HDL-C (P =.004 for comparison between residents and fellows). Both residents and fellows reported infrequent calculation of non-HDL-C levels in patients with elevated triglycerides (≥200 mg/dL; 32.5% vs 35.4%, respectively, P =.6). Lack of familiarity with ATP III guidelines, lack of knowledge regarding importance of non-HDL-C, lack of institutional mandate to calculate non-HDL-C, and lack of emphasis on non-HDL-C by teaching staff were reported as barriers to non-HDL-C use in routine clinical practice. Conclusions: At least one-third of physicians-in-training could not calculate non-HDL-C from a standard lipid panel, and a large number were not aware of ATP III treatment goals pertaining to non-HDL-C. This area represents one for improvement if non-HDL-C is to be retained as a treatment target in the forthcoming ATP-IV guidelines.

Original languageEnglish
Pages (from-to)50-57
Number of pages8
JournalJournal of Clinical Lipidology
Issue number1
Publication statusPublished - Jan 2012
Externally publishedYes


  • Adult Treatment Panel guidelines
  • Non-HDL-C calculation
  • Non-HDL-C goals
  • Physicians-in-training


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