There are 3 steps to determine the goals of cholesterol therapy
Step-1: Understanding Cholesterol Numbers and Determining your Goal
The lipid profile or cholesterol test mainly includes:
- LDL cholesterol
- Total cholesterol
- HDL cholesterol
Based on emerging evidence, Adult Treatment Panel (ATP) III recommends new guidelines:
- LDL cholesterol should be less than 100 mg/dL. An LDL cholesterol level of 100-129 mg/dL is considered being ‘borderline’, between 130-159 mg/dL to be ‘borderline high’, between 160-189 mg/dL to be ‘high,’ and above 190 mg/dL as very high
- The total cholesterol level should be less than 200 mg/dL. A total cholesterol level of 200-239 mg/dL is borderline, and 240 mg/dL or more is considered to be high risk
- HDL cholesterol is desirable if it is 60 mg/dL or higher and is considered high risk if it is less than 40 mg/dL
Step 2: Identify the occurrence of heart diseases (or equivalent), such as stroke, peripheral arterial disease, or abdominal aortic aneurysm
This step is necessary as the target cholesterol goals are lower (more aggressive) for those who have heart disease or equivalent. For example, the recommended total cholesterol goal is less than 200 mg/dL in low-risk individuals. However, for people suffering from heart disease or a high risk of heart disease, this level should be less than 160 mg/dL.
Step 3: Understanding other risk factors for heart diseases
In addition to high cholesterol levels, serious risk factors for heart disease include:
- Age factor: 45 or older for men, 55 or older for women
- Diabetes
- Family history of heart problems
- HDL cholesterol level lower than 35 mg/dL
- High blood pressure
- Obesity
- Smoking
- Women with early menopause
Goals for Reducing LDL Cholesterol
The cholesterol-lowering treatment is primarily based on the degree of risk for heart disease or heart attack. Adult Treatment Panel (ATP) III stated “recent clinical trials robustly show that LDL cholesterol lowering therapy reduces the risk for CHD or CHD risk factors”. For this reason, ATP III identifies LDL as the primary target for cholesterol-lowering therapy.
Management for LDL cholesterol with CHD or CHD Risk Equivalents
