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what are the guideline levels for cholestrol?


LDL Goals
High and Very High Risk People: For high-risk patients, the overall goal is an LDL level of less than 100 mg/dL. But for very high-risk patients whose LDL levels are already below 100 mg/dL, there is an option to use drug therapy to go below 70 mg/dL goal.

High-risk people are those who have coronary heart disease or disease of the blood vessels to the brain or extremities, or diabetes, or multiple (2 or more) risk factors (e.g., smoking, hypertension) that give them a greater than 20 percent chance of having a heart attack within 10 years.

Very high-risk people are those who have cardiovascular disease together with either multiple risk factors (especially diabetes), or severe and poorly controlled risk factors (such as continued smoking), or metabolic syndrome (a constellation of risk factors associated with obesity including high triglycerides and low HDL). Patients hospitalized for acute coronary syndromes such as heart attack are also at very high risk.

Moderately High-Risk People: For moderately high-risk patients, the goal is an LDL under 130 mg/dL, but there is a therapeutic option to set a lower LDL goal of under 100 mg/dL and to use drug therapy at LDL levels of 100 - 129 mg/dL to reach this lower goal.

Moderately high-risk patients are those who have multiple (2 or more) risk factors for coronary heart disease together with a 10 to 20 percent risk of heart attack within 10 years.

For high-risk or moderately high-risk patients, the report advises that the intensity of LDL-lowering drug therapy be sufficient to achieve at least a 30 to 40 percent reduction in LDL levels. This can be accomplished by taking statins or by combining lower doses of statins with other drugs (bile acid resins, nicotinic acid, or ezetimibe) or with food products containing plant stanol/sterols.

Lower/Moderate Risk People: Lifestyle changes (good nutrition, physical activity, and weight control) continue to be very important in cholesterol management. Lifestyle changes also have the potential to reduce cardiovascular risks through several mechanisms beyond the lowering of LDL cholesterol.

HDL Goals
An HDL of greater than 40 is desired

Total Cholesterol
Total cholesterol of less than 200 is desireable