Doctors have known for years that lowering serum cholesterol is indeed good for overall health. Their recommendations though have been changing as to what constitutes an acceptable level for total cholesterol and its individual fractions, and treatment has become much more aggressive.

Lowering high blood cholesterol reduces the incidence of coronary heart disease. For those with known cardiovascular disease (secondary prevention), benefits from cholesterol lowering include a reduction in total mortality in both men and women and in both middle aged and older people.

Measuring total cholesterol doesn't tell the whole story. There is actually "good" cholesterol and "bad" cholesterol. One bad cholesterol fraction is known as LDL. It is believed to be the most atherogenic of the lipoproteins, and studies have shown a direct link between LDL levels and atherogenesis in all age groups. The extent of lowering LDL closely correlates with protection from clinical coronary heart disease events in both primary and secondary studies.

Conversely, HDL is the good fraction of cholesterol. While scientists are still studying the exact mechanism by which this occurs, HDL plays a very important role in preventing atherosclerosis. There is a strong inverse relationship between total HDL cholesterol levels and the risk of coronary heart disease at all age groups, in men and women and even amongst different ethnic groups, and this is even more pronounced for women. Women have HDL levels 10 - 30% higher on the average than men. While LDL is a good predictor of heart disease and atherosclerosis in younger people, HDL cholesterol appears to be a better predictor of coronary heart disease in the elderly.

What are the new recommended levels for cholesterol? According to the National Cholesterol Education Program, LDL levels should be less than 160 mg/dl in average individuals without cardiac risk factors, <130 mg/dl in those with risk factors, and < 100 mg/dl in those with heart disease or diabetes. HDL levels should be over 35 mg/dl at the least, triglycerides under 200 mg/dl, and total cholesterol less than 190mg/dl. This is a marked change to the 220-260 mg/dl levels of total cholesterol that were considered to be normal several years ago.

Treatment for cholesterol is a much more positive than negative factor. Underwriters would much rather see a cholesterol of 155 on treatment than a 255 on no medication. Of course, life-style and dietary changes, weight management and physical activity are mainstays in the treatment of hypercholesterolemia as well.

The information contained on this page is not intended to provide medical advice, which should be obtained directly from your physician.