Lower Cholesterol Limits Become the New Standard

The National Cholesterol Education Program has lowered theguideline for low-density lipoprotein (LDL) cholesterol level from100 to 70 mg/dL, a measure meant to help people avoid heartattacks due to higher-than-necessary cholesterol levels. An LDLlevel of 70 mg/dL already is the guideline for people who have justhad a heart attack, for those who have cardiovascular diseaseplus 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-riskpatients with an LDL level >100 mg/dL. For those who are atmoderate risk for a heart attack, the new recommended level isbetween 100 and 129 mg/dL. Moderate risk refers to people withmultiple risk factors and those estimated to have a 10% to 20%chance of a heart attack in the next 10 years. No changes in recommendationwere made for those in the low-risk category, whoseLDL level should not be higher than 160 mg/dL.

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