What Is My LDL Cholesterol Goal if I Have Heart Disease?

Question: What Is My LDL Cholesterol Goal if I Have Heart Disease?

Answer: Having high levels of LDL cholesterol, otherwise known as your bad cholesterol, can place you at risk of having heart disease if left untreated. However, if you already have established heart disease, you have a greater chance of having another cardiac event, compared to someone who does not have established heart disease. Threrefore, your healthcare provider will be a little more aggressive in lowering your LDL cholesterol in order prevent a second cardiac event or even death. Because of this relationship between high LDL cholesterol and heart disease, the National Cholesterol Education Program (NCEP) recommends keeping your LDL cholesterol below a certain level.

If you have established coronary heart disease (CHD), such as a heart attack, your healthcare provider will want your LDL cholesterol goal to be as low as possible. The NCEP recommends that your LDL cholesterol be lower than 100 mg/dL if you have CHD.

Other risk factors can greatly place you at risk of having a heart attack, stroke or dying from heart disease. Referred to as CHD risk equivalents, your healthcare provider will also aim to have your LDL cholesterol goal below 100 mg/dL in order to prevent a future heart attack or stroke. These conditions include:

• A 10-year risk of having heart disease greater than 20% according to the Framingham Cardiac Risk Calculator
• Diabetes
• Other features of atherosclerotic disease, such as carotid artery disease, abdominal aortic aneurysm, or peripheral vascular disease

Reaching Your LDL Goal

If you have one of these conditions mentioned above, and your LDL cholesterol is not below 100 mg/dL, your healthcare provider will recommend certain treatments to help lower your cholesterol. These treatments include lifestyle modifications and drug therapy. Your treatment will depend upon your current, fasting LDL cholesterol level:

• If your LDL cholesterol is already below 100 mg/dL, you are at your goal -- but that doesn't mean you can slack off. You should continue therapeutic lifestyle changes, which would include a cholesterol-lowering diet, exercise, and controlling your weight.
• If your LDL cholesterol is between 100 and 129 mg/dL, your healthcare provider will encourage therapeutic lifestyle changes. Because you are at high risk for having a cardiac event, your healthcare provider may also recommend you begin taking medications to help lower your cholesterol so that you can achieve your LDL goal.
• If your LDL cholesterol is at 130 mg/dL or over, your healthcare provider will recommend cholesterol-lowering medications to help you achieve your LDL goal. Again, lifestyle changes are also encouraged, since diet, being overweight, lack of exercise, or smoking could be causing your LDL cholesterol levels to be too high.

_Source:

Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (PDF), July 2004, The National Institutes of Heath: The National Heart, Lung, and Blood Institute.