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Cholesterol Guidelines

New Cholesterol Level Guidelines Could Put You at Risk

If you thought your cholesterol level was within an acceptable range the last time you had it checked, it might not be after all. As a result of new data recently released from several clinical trials, the medical community is toughening old guidelines and rethinking how Americans have traditionally evaluated cholesterol levels and their relationship to heart disease. The recommendations were published in the journal Circulation and are endorsed by the National Heart, Lung and Blood Institute, the American Heart Association and the American College of Cardiology.

LDL versus HDL
The new recommendations focus on levels of LDL, rather than total cholesterol levels, because LDL appears to play a significant role in increasing one's risk of experiencing a cardiac event. In the past, a total cholesterol of 200 or below was considered good. Now physicians are looking more closely at anyone with cholesterol levels above 150. In these individuals, it is important to look at the breakdown between HDL and LDL levels," says Scott Shurmur, M.D., cardiologist with The Nebraska Medical Center. "Traditionally, we thought an LDL of 100 to 130 was an acceptable target. Now we'd like to see that number drop to 70 or below for people at highest risk."

New Target Levels
Anyone with a total cholesterol level above 150 and has the following risk factors should aim for the LDL levels listed below to reduce your risk of a cardiac event.

High risk: LDL below 70
* Existing heart disease in addition to any of the following risk factors:

  • Smoking
  • Prediabetes
  • Diabetes
  • Acute coronary event
  • Moderate to high risk: LDL of 100 or below
  • Existing diabetes or coronary artery disease
  • Low risk: LDL of 130 or below
  • No existing diabetes or coronary heart disease
  • Two risk factors such as age, smoking or high blood pressure

Dr. Shurmur notes that these guidelines are preliminary and the results of studies in progress will help better define these numbers.

Cholesterol-Lowering Statins
The use of powerful cholesterol-reducing drugs called statins is the recommended therapy to reduce LDL levels. "The use of statins has been shown to dramatically reduce the rates of heart attack, stroke and even mortality," notes Dr. Shurmur. "Within six weeks, statins can reduce an individual's LDL by 25 to 60 percent."
The use of statins is required for life in order to benefit from its cholesterol-reducing benefits. Once off statins, your risk for cardiac events goes up. Statins produce little or no side effects. Less than 5 percent of individuals will experience muscle pain with use and approximately one out of every 10,000 individuals will experience severe muscle pain. Women of child-bearing age should not take statins.

Lifestyle Changes
Making healthy changes in your lifestyle can also have an affect on your cholesterol levels and risk for coronary artery disease.

  • Diet - A diet low in cholesterol and saturated fats can help lower your total cholesterol levels by 10 to 15 percent.
  • Exercise - Regular exercise can produce a multitude of health benefits, including a stronger heart and a reduction in mortality. Its role in reducing cholesterol levels has seen variable results, however, HDL levels - the good cholesterol, do tend to go up.