Do You Know Your Cholesterol Numbers?
Experts Agree That More Aggressive Screening May Lower Heart Disease
Many studies show that people with high cholesterol levels should be treated
with cholesterol-lowering drugs, but aren't. And guidelines published last year
have lowered the mark even further, categorizing more people as having high
cholesterol levels making them candidates for cholesterol-lowering
According to the American Heart Association (AHA), more than 100 million
adults in the United States have blood cholesterol levels considered borderline
high (over 200), and close to 40 million adults have levels considered high
(over 240). High cholesterol levels are strongly linked to an increased risk
for heart disease, which is the leading killer of both men and women in the
United States, accounting for about 500,000 deaths each year.
National Cholesterol Education Program (NCEP) guidelines, published in 2001
focus on preventing heart disease by reducing low-density lipoprotein
cholesterol (LDL, the "bad" cholesterol) levels with lifestyle changes
and medication. The old guidelines, issued in 1993, focused on a person's total
cholesterol level, including both LDL and high-density lipoprotein cholesterol
(HDL, the "good" cholesterol).
"New evidence shows without doubt that lowering the low-density
lipoprotein cholesterol is beneficial," says Scott Grundy, MD, chairman of
the Expert Panel on Detection, Evaluation, and Treatment of High Blood
Cholesterol in Adults that developed the guidelines. "These guidelines will
provide confidence for physicians to treat their patients
20 and Older
The guidelines say that everyone age 20 and older should have blood tests to
measure their lipoprotein profile every 5 years. A lipoprotein profile tells
you your LDL and HDL cholesterol levels as well as your triglyceride (another
fat in the blood) level.
If your LDL cholesterol level is 130 or higher, you should start taking
cholesterol-lowering drugs and make lifestyle changes -- like having less
saturated fat and cholesterol in your diet, losing weight, and exercising more
-- to reach an LDL level of less than 100.
Michael Lauer, MD, a cardiologist at the Cleveland Clinic Foundation, in
Cleveland, Ohio says the guidelines reflect a better understanding of how
managing high cholesterol prevents heart disease.
"There is a need to be even more aggressive and vigilant about treating
cholesterol disorders in the population," he says.
Lauer says that people who should be taking cholesterol-lowering drugs
usually aren't. "The problem we have right now is that we have treatment
that works and [preventive methods that work] but are not being used," he
Using these guidelines, Ronald Krauss, MD, chairman of the AHA Council on
Nutrition, Physical Activity and Metabolism, says that doctors now have a
better way to identify people at risk for heart disease and give them the best
"Physicians now have new tools for sharpening up their assessment of
their patients' risk for heart disease or for recurring heart disease,"
says Krauss. "They will have very specific recommendations for using both
diet and medication where needed to achieve targets that are connected to their