The Management of Hyperlipoproteinemia

To the Editor.— I am a 47-year-old man with a total cholesterol level of 228 mg/dL, a high-density lipoprotein (HDL) cholesterol level of 58 mg/dL, and a triglyceride level of 86 mg/dL. If I used the figures of Hoeg et al1to do my calculations, my low-density lipoprotein (LDL) cholesterol level would be 152.8 mg/dL, which would place me in a moderate-risk category. However, using the LDL cholesterol HDL cholesterol ratio and the total cholesterol/HDL cholesterol ratio (2.63 and 3.8, respectively), my risk category would be between that of Boston marathon runners and average women without coronary heart disease. You will note that using the formula of Hoeg et al, as triglyceride levels increase the calculated LDL cholesterol level decreases. This makes no sense to me; it might imply that increased triglyceride levels are associated with decreased coronary risk. In addition, why do these authors not use the total