New cholesterol guidelines from the American Heart Association emphasize a personalized approach to preventing and treating high cholesterol and cardiovascular disease.
What Cholesterol Is
Cholesterol is a waxy substance that your body makes to build cells. Too much can pose a problem. Extra cholesterol comes from foods including meat, poultry, dairy and tropical oils.
Why Cholesterol Matters
Cholesterol can slowly build up in your arteries and form a thick, hard deposit that narrows them and makes them less flexible. If a blood clot blocks a narrowed artery, a heart attack or stroke can result.
What To Do
Ask your doctor such questions as:
Q. What do cholesterol numbers mean?
A. Studies suggest optimal cholesterol levels are about 150 mg/dL and about 100 mg/dL for low-density lipoprotein cholesterol (LDL-C). Levels in this range are linked to lower rates of heart disease and stroke.
There’s no ideal target for LDL-C but “lower is better.” Assessment with a risk calculator helps your doctor determine your personal risk and treatment options. A coronary artery calcium test may also help with your assessment.
Q. How can I lower my risk for heart disease?
A. A healthy lifestyle is critical. Also, while statins are still the first choice of medication for lowering cholesterol, new drugs are available for people who have had a heart attack or stroke and are at risk for another. Your doctor will monitor your progress.
Q. How do I know if my medicine is working?
A. It may take a few tries to find the right medicine and dose.
“Finding the sweet spot for treatment is highly individualized,” said Donald Lloyd-Jones, M.D., a member of the cholesterol guideline writing committee and chair of the Department of Preventive Medicine at Northwestern University in Chicago. “The latest guidelines strongly encourage patient and doctor to have detailed and personalized discussions about medication.”
Ask your doctor about medicines, foods—such as grapefruit or pomegranate—or supplements that may interact with your cholesterol-lowering medication.
Q. When and how often should I follow up?
A. Have a follow-up visit one to three months after starting cholesterol-lowering medication to check that it’s working, that you’re taking it properly, and to monitor for side effects.
The American Heart Association’s Check.Change.Control.Cholesterol initiative, supported by Sanofi and Regeneron, has information and resources for managing cholesterol and other cardiovascular risk factors. Visit www.heart.org/cholesterol for further facts, and www.heart.org/MyCholesterolGuide to download the free guide.