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Guidelines on Cholesterol Management: What You Need to Know

Guidelines from the American Heart Association and the American College of Cardiology were released on November 12, 2013.

The guidelines recommended that far more people take statin medications even if they have good cholesterol levels and have never had a heart attack or stroke. 

They include:
  • Adults with existing heart disease or prior stroke
  • Adults with LDL “bad” cholesterol levels of 190 or above
  • Adults age 40 to 75 who have diabetes
  • Adults whose age, blood pressure, cholesterol and smoking behavior give them an estimated risk of heart attack or stroke higher than 7.5 percent in the next 10 years (Note: 7.5 percent risk over 10 years is a much lower threshold for statin medication than before)

 Who Should Take Statin Medications

  • 50 percent of all African-American men in their 50s
  • 30 percent of white men in their 50s
  • Almost all men in their 70s
  • 70 percent of African-American women in their 60s
  • 30 percent of white women in their 60s and nearly all white women in their 70s

People with cardiovascular disease who need to lower their low-density lipoprotein (LDL) cholesterol levels are recommended to move to a higher dose or intensity of statin medication rather than take additional drugs along with the statins.

The guidelines still recommend checking cholesterol numbers but they leave it up to the patient and health care provider to decide what to do with the information. It used to be that people should aim to lower their LDL cholesterol level to less than 100. The new guidelines do not specify any targets for LDL levels as long as people are taking an adequate dose of statin medication.

Manage Your Cholesterol

Managing cholesterol is still a key element in reducing your risk of heart attack and stroke.

  • High levels of cholesterol, in particular LDL and triglycerides, can build up as plaque inside of blood vessels and raise the risk of a heart attack or a stroke. 
  • Lifestyle changes are the most important steps to lower cholesterol and therefore lower the risk of heart attack and stroke. Those include a healthy diet (for instance the DASH diet or the Mediterranean diet), regular physical activity, managing your weight and not smoking.