The nurse is teaching about risks of cardiovascular disease. Several clients ask the nurse to determine the risk. What client should the nurse identify as having the greatest risk for cardiovascular disease?

• A. A female with LDL 100
• B. A 60-year-old with well-controlled blood pressure
• C. A male with LDL 201
• D. A 25-year-old smoker with normal blood pressure

Answer: (C)

High LDL cholesterol is a major driver of atherosclerotic cardiovascular disease. When LDL is as high as 201 mg/dL, the risk of plaque buildup and related events is substantially elevated, often more than due to age, blood pressure, or smoking alone in younger individuals. This level indicates severe hyperlipidemia, typically requiring aggressive lipid-lowering treatment and lifestyle changes to reduce future cardiovascular risk.

In comparison, a person with LDL 100 mg/dL has near-normal lipid risk. A 60-year-old with well-controlled blood pressure still faces age-associated risk, but controlled BP lowers overall risk substantially. A 25-year-old smoker with normal blood pressure does have increased risk from smoking, but their young age means the cumulative risk over time is not as high as someone with markedly elevated LDL. Therefore, the individual with LDL 201 mg/dL carries the greatest cardiovascular risk.