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 treatments.
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 appropriately."
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 says