If you have risk factors for heart disease, your LDL goal will depend upon how many high cholesterol risk factors you have, as well as your 10-year risk for having heart disease. This is calculated by using the Framingham Cardiac Risk Calculator, which takes into consideration many factors, including your age, your blood pressure, whether or not you smoke, your family history of heart disease, your cholesterol, and your gender. If you have two or more risk factors, your LDL goal will be based upon your 10-year risk for developing heart disease:
- If your 10-year risk is less than 10%, your LDL goal is less than 130 mg/dL.
- If your 10-year risk is between 10 and 20%, your LDL goal is less than 130 mg/dL.
- If your 10-year risk is greater than 20%, your LDL goal is less than 100 mg/dL – which is the same as those individuals who already have established heart disease or a CHD risk equivalent.
Reaching Your LDL Goal
If you have two or more risk factors for heart disease, eliminating the risk factors you can control could lower your LDL cholesterol -- and your risk for developing heart disease.
If you have had your cholesterol checked, and your LDL cholesterol is below 130 mg/dL, you should continue to stick to the positive changes in your lifestyle, such as smoking cessation, a healthy diet, and moderate exercise.
If your LDL cholesterol is over 130 mg/dL, your healthcare provider will recommend certain treatments to help lower your cholesterol. These treatments usually include lifestyle modifications and drug therapy. Reducing other risk factors for heart disease, such as reducing your weight and blood pressure, will also be encouraged, if needed. Your treatment will depend upon your current, fasting LDL cholesterol level:
- If your 10-year risk for developing heart disease is greater than 20%, your healthcare provider may be a little more aggressive in addressing your LDL levels to lower your risk. Your LDL goal is less than 100 mg/dL, and your healthcare provider may use a combination of lifestyle changes and/or medication to help you reach this goal.
- If your 10-year risk for developing heart disease is between 10 and 20%, lifestyle changes are still recommended if your LDL cholesterol is greater than 130 mg/dL. If lifestyle changes do not work, cholesterol-lowering medication may be necessary to lower your LDL cholesterol to goal.
- If your 10-year risk is less than 10%, your healthcare provider will try lifestyle changes if your cholesterol is over 130 mg/dL. If lifestyle changes are not working, and your LDL cholesterol is greater than 160 mg/dL, your healthcare provider may decide to add medications to your cholesterol-lowering regimen.
Sources:
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
