Lower Cholesterol Limits Become the New Standard

Published Online: Monday, November 1, 2004

The National Cholesterol Education Program has lowered the guideline for low-density lipoprotein (LDL) cholesterol level from 100 to 70 mg/dL, a measure meant to help people avoid heart attacks due to higher-than-necessary cholesterol levels. An LDL level of 70 mg/dL already is the guideline for people who have just had a heart attack, for those who have cardiovascular disease plus diabetes, for persistent smokers with high blood pressure, and for people with other multiple risk factors.

The updated recommendations call for drug therapy for high-risk patients with an LDL level >100 mg/dL. For those who are at moderate risk for a heart attack, the new recommended level is between 100 and 129 mg/dL. Moderate risk refers to people with multiple risk factors and those estimated to have a 10% to 20% chance of a heart attack in the next 10 years. No changes in recommendation were made for those in the low-risk category, whose LDL level should not be higher than 160 mg/dL.

The best way to reduce the LDL level is through exercise and a diet low in saturated fat and cholesterol. In more serious cases, drug therapy with statin drugs is used to block the formation of cholesterol. The goal, according to Sidney C. Smith Jr, MD, of the University of North Carolina, is "further reduction of death from heart disease, as well as heart attacks, and the need for expensive revascularization procedures like bypass surgery and coronary angioplasty."

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