Cholesterol - The Goals for Lower Cholesterol just got Lower
It seems as though every time we talk about cholesterol experts say your cholesterol should be even lower, and they are saying it again. A panel of experts recently recommended that Americans and their doctors be even more aggressive getting cholesterols down in order to reduce risk of heart attack.
The recommendations are aimed in particular at patients at highest risk for heart attack, which include those patients with established heart disease who also have diabetes, or poorly controlled high blood pressure, or who are still smoking. Those patients should aim for an LDL cholesterol (the so-called 'bad cholesterol') in the 70 range. Previous recommendations were to get that number below 100.
Patients at moderate risk (defined as patients who have a 10-20 percent risk of death from heart disease within the next 10 years) should be even more aggressive getting their LDL cholesterol under 130, and should have cholesterol-lowering medication treatment considered even if their LDL cholesterol is in the 100-129 range, according to the experts.
There has been a lot of controversy about the new recommendations, and for good reason. First, implementing them fully could add another 7 million Americans to the ranks of those on cholesterol-lowering medicines such as Lipitor, medicines which would add billions of dollars in health care costs. Second, several of the experts who made the recommendations have had consulting roles or been supported in their research by the drug industry. That makes at least some people suspicious of their recommendations.
The American Heart Association, the American College of Cardiology (the professional organization of heart specialists), and the National Heart, Lung, and BLood Institute have all endorsed the lower cholesterol recommendations, after studying the cholesterol data and the recommendations themselves.
Bottom line - at this point the data seems to be suggesting that lower is better when it comes to LDL cholesterol for patients who either have heart disease or are at high risk for developing heart disease. Any patient who is at risk for heart attack should be taking responsibility for their own cholesterol and organizing a plan with their doctor to get that LDL cholesterol at least well below 100. If you have not done that, all the advice for experts is not going to help.
Dr. Erik Steele, DO