American doctors have updated cholesterol guidelines, lowering the threshold for low-density lipoprotein (LDL) cholesterol, commonly known as “bad” cholesterol, when assessing heart disease risk. The revisions, issued by the American College of Cardiology and the American Heart Association, encourage earlier screening and a personalized approach to cardiovascular health.
New LDL Target Levels
For individuals without cardiovascular disease, the recommended LDL level is below 100 mg/dL. Those at intermediate risk of heart attacks or strokes should aim for LDL levels below 70 mg/dL. People who have already experienced a heart attack or stroke should reduce their LDL levels to less than 55 mg/dL.
Earlier Screening with Updated Risk Calculator
The committee also updated the risk calculator for heart attacks and strokes, now estimating risk over 10- and 30-year periods. The previous calculator only predicted 10-year risks for people aged 40 and older. The new tool, called Predicting Risk of Cardiovascular Disease EVENTs (PREVENT), is recommended for people starting at age 30.
One-Time Test for Lipoprotein(a)
The guidelines recommend a one-time screening for levels of Lipoprotein(a), or Lp(a), a genetically linked type of LDL cholesterol. High Lp(a) levels increase the risk of heart attack, stroke, and aortic stenosis.
“We know that lower LDL cholesterol levels are better when it comes to reducing the risk of heart attacks, strokes and congestive heart failure,” said Dr. Roger S. Blumenthal, chair of the guideline writing committee and director of the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease. “We also know that bringing elevated lipids and blood pressure down in young adults supports optimal heart and vascular health throughout a person’s life.”
The updated guidelines were published in the Journal of the American College of Cardiology and Circulation in March.
