By: Laurie Edwards for Heart1
We’ve heard a lot about “good” and “bad” cholesterol lately, but according to a recent study out of Northwestern University’s Feinberg School of Medicine, the message can’t be taken too lightly: An estimated 63 million Americans have low-density lipoprotein (LDL-C) levels – “bad” cholesterol – higher than those recommended by the National Institutes of Health (the NIH).| Take Action |
Monitor your cholesterol according to your risk
For people at highest risk – those with conditions like hypertension and diabetes – experts at the NIH say that LDL-C levels shouldn’t be higher than 70. For people who face a moderate risk, the suggested level is 100.
Know your risk factors: If you smoke, if you are overweight or if you have a family history of heart disease, you face an increased risk of heart attack or stroke and should monitor your cholesterol closely.
Talk to your doctor: There are medications that can help lower your cholesterol, and he or she can help you map out a diet and exercise regimen that also plays a part in cardiovascular health.
LDL-C is known as “bad” cholesterol because it helps plaque build up in your arteries, while HDL-C is considered “good” cholesterol because it carries plaque away from the arteries.
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LDL-C is known as “bad” cholesterol because it helps plaque build up in your arteries, while HDL-C is considered “good” cholesterol because it carries plaque away from the arteries.
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What do we mean by “bad” cholesterol? LDL-C levels gauge how much plaque builds up in the arteries that feed the heart and the brain. High LDL-C levels put people at increased risk of heart attack and stroke, especially those who already have risk factors for heart problems. Such risk factors include having high blood pressure, diabetes, smoking or a family history of cardiovascular disease.In contrast, high-density lipoprotein (HDL-C) levels – “good” cholesterol – are considered helpful in terms of preventing heart disease since HDL tends to carry excess cholesterol and plaque away from the arteries and to the liver, where the body can get rid of it.
The Northwestern study, published in the February issue of the Journal of General Internal Medicine, compared LDL-C levels from 2001 with newer, more stringent levels suggested by the National Institutes of Health in 2004.
“Nationally, we are far from achieving the 2001 goals, and as new evidence leads the NIH to push optimal goals down further, the gap between what we believe to be ideal goals and what has been achieved gets even wider,” said Dr. Stephen D. Persell, assistant professor of medicine at the Feinberg School of Medicine.
So what is considered an “optimal” LDL-C level? It depends on what level of risk patients face. Originally, the goal for highest risk patients (those with heart disease or conditions like diabetes) was 100, but recent updates now put that optimal level at 70.
For patients who face moderate risk, the recommended level decreased from 130 in 2001 to 100in 2004.
The advantages of lower LDL-C levels are also emphasized in a new study conducted by Dallas researchers, which appeared in a recent issue of the New England Journal of Medicine. It followed patients with a genetic makeup that gave them naturally lower levels of LDL-C since childhood.
The Dallas study found that a group of people with an average LDL-C level of 100 were eight times less likely to suffer a heart attack or develop atherosclerosis (hardening of the arteries) than a group whose average was only 40 points higher.
Experts hope such data will result in people paying attention to their cholesterol levels earlier in life.
“The key message of this is that if you keep your cholesterol low throughout your whole lifetime, your chances of getting heart disease are quite low,” said Scott Grundy, director of the Center for Human Nutrition at the University of Texas Southwestern Medical Center in Dallas. “What we do now is treat people when they get into trouble. But what this does is encourage people to do something about it earlier,” added Grundy, who was not involved in the study.
It’s important to recognize the role of cholesterol-lowering drugs – namely a class of drugs called statins – in achieving the LDL-C levels set forth by the NIH. For instance, 25 percent of the Northwestern study participants were already using medication to help lower their cholesterol.
Many more people would need to use these medications in order to achieve an optimal LDL-C level, but their prohibitive cost means that for many patients, these drugs are not an option. A year’s worth of the generic drug lovastatin, for example, can cost between $450 to $750 at current retail prices. Brand-name drugs put the cost per patient even higher.
In addition, according to Dr. Alan Tall, professor of medicine and physiology at Columbia Medical School, these drugs only help about one-third of patients who are trying to lower their cholesterol.
Being informed is key, so knowing your LDL and HDL cholesterol levels and discussing treatment options with your physician is the first step towards achieving optimal cardiovascular health.
