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Do You Know Your Cholesterol Numbers?

Experts Agree That More Aggressive Screening May Lower Heart Disease
By Hong Mautz
WebMD Feature

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

At-Risk Patients

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 care.

"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 patients' risk."

Is This Normal? Get the Facts Fast!

Is Your Cholesterol Level Heart Healthy?
What is your LDL (low-density lipoprotein) level?

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or
Answer:
Desirable
0-199
Borderline
200-239
High
240+

Your level is currently

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is optimal.

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is near optimal.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is borderline high. If your LDL goes higher, your total cholesterol level could become Borderline High. Consider reducing the amount of foods you eat with saturated fats and increasing physical activity. If you get more exercise, your level of "good" HDL cholesterol may increase, which could also help to keep your levels of LDL and total cholesterol in check.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL. The HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is Very High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL because the HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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