New cholesterol guidelines advise more treatment

Citing results from five recent trials of anticholesterol drugs called statins, U.S. health officials recommend that physicians treat people more aggressively for high cholesterol. The new guidelines set the lowest targets so far for blood concentrations of low-density lipoprotein (LDL) cholesterol, or bad cholesterol. They call for statin therapy and other interventions, such as exercise, to reduce LDL by 30 to 40 percent in people who are considered to have moderate-to-high risk of having a heart attack.

Furthermore, people at the top end of that risk category, those with at least a 20 percent estimated chance of having a heart attack within a decade, should reduce their LDL to no more than 100 milligrams per deciliter (mg/dl) and, at their doctors’ discretion, to 70 mg/dl or less. This group includes people who have survived a heart attack or have an LDL concentration of 130 mg/dl or more as well as individuals with multiple heart-health risk factors, such as diabetes and partially obstructed blood vessels.

For people with LDL scores higher than 130 mg/dl and factors that suggest a 10 to 20 percent chance of heart attack within 10 years, the goal of treatment should be to reduce LDL concentrations to 130 mg/dl or, in some cases, 100 mg/dl.

A division of the National Heart, Lung, and Blood Institute in Bethesda, Md., issued the guidelines, which appear in the July 13 Circulation.