LDL-C Calculation Formulas

Comparison of Formulas

Formula	Status	Accuracy	Best Use Case
Martin/Hopkins	Recommended by 2026-acc-aha-dyslipidemia-guidelines	High	General clinical practice
Sampson/NIH	Recommended by 2026-acc-aha-dyslipidemia-guidelines	High	Alternative when triglycerides are elevated
Friedewald	Legacy / Deprecated	Moderate (underestimates at high TG)	Historical reference only

Why the Shift?

The legacy Friedewald formula becomes increasingly inaccurate as triglyceride levels rise, often underestimating LDL-C. Modern equations account for variations in lipoprotein composition, providing more reliable data for dyslipidemia-management and risk-stratification.

Recommendation

Clinicians should transition to Martin/Hopkins or Sampson/NIH for all routine LDL-C estimation to ensure treatment decisions are based on accurate lipid quantification.