The usual treatment options for high cholesterol are healthy lifestyle changes, used alone or in combination with medications.
The usual goal of treatment is to lower your LDL cholesterol ("bad cholesterol") as much as possible - the lower, the better. Each reduction in LDL cholesterol is associated with a large drop in the risk of heart attacks and dying from heart disease. For every 1.0 mmol/L reduction in LDL cholesterol, this risk goes down by 20% to 25%.
Talk to your doctor to find out if your treatment plan is helping you get your cholesterol down low enough.
Do you know your treatment goals? Having clear goals will make it easier to evaluate the success of your treatment.
Your main treatment goals are your cholesterol level targets. These targets depend on how high your cholesterol is to start and on your risk of developing heart disease. Your doctor will calculate your heart disease risk level , or you can calculate it here. Regardless of your heart disease risk level and how you are treating high cholesterol, the target for everyone is lowering LDL cholesterol ("bad" cholesterol) by at least 50%.
Here are the usual cholesterol targets:
|If your heart disease risk in the next 10 years is...||Then you should start treatment...||And your cholesterol treatment targets are...|
|Low (less than 10%)||
when LDL-C is 5 mmol/L or higher
|Moderate (10-19%)||For most people:
For men over 50 and women over 60:
|High** (20% or greater)||
*apoB = apolipoprotein, a protein that is part of LDL-C and VLDL-C and can cause inflammation in the blood vessels
**The high risk group also includes people with diabetes or atherosclerosis-related diseases (e.g., heart disease, stroke, peripheral arterial disease)
*** CRP (C-reactive protein) is a protein that the liver makes when there is inflammation in the body. It's also called a marker of inflammation, and can be measured with an hsCRP (high-sensitivity C-reactive protein) test, also called a CRP test.
The targets listed in the table are just a guideline - your doctor may recommend that you aim for even lower targets. When it comes to LDL cholesterol levels, the general rule is "the lower the better." This means your doctor may recommend going beyond the 50% reduction recommended in the table. For every 1.0 mmol/L reduction in LDL cholesterol, your risk of developing certain complications of heart disease-related death and heart attack goes down by 20% to 25%.
While LDL cholesterol is the most important target, your doctor may also set other "secondary" targets in addition to LDL cholesterol, such as:
|Secondary targets||Usual target level|
|total cholesterol to HDL cholesterol ratio (TC:HDL-C ratio)||less than 4.0|
|triglycerides||less than 1.7 mmol/L|
|hs-CRP||less than 2.0 mg/dL|
|non-HDL-cholesterol (total cholesterol minus HDL-cholesterol)||less than 3.5 mmol/L|
|apoB:apoAI ratio (apoB is part of LDL-C and VLDL-C, and apo AI is part of HDL-C)||less than 0.80|
The key to evaluating the success of your treatment is to track your progress, including:
Use these tools to help you:
Here are a few questions to ask yourself as you use these tools:
Why is it so important that I treat my high cholesterol?
Treating high cholesterol can help reduce your risk of serious cholesterol-related complications, such as:
Effective cholesterol treatment could even save your life. Research shows that the more you lower your cholesterol, the lower your risk of developing certain complications of heart disease (heart attacks and heart disease-related death).
What healthy lifestyle changes can help lower my cholesterol?
The following healthy lifestyle changes can help keep your cholesterol under control:
Learn more about these healthy lifestyle changes.
Medications for high cholesterol include:
Learn more about these medications.
This section deals with some common issues that you may have during medication treatment. To learn more about specific medications, click here.
If you start medication therapy, you and your doctor will work together to set goals for your treatment. Having clear goals will make it easier to evaluate the success of your treatment. The main goal for cholesterol medication treatment is to reach certain target cholesterol levels. In general, the lower your cholesterol levels, the better. The recommended target for everyone at risk of developing heart disease is to reduce LDL cholesterol (the "bad" cholesterol) by at least 50% from their starting cholesterol level.
Talk to your doctor what your cholesterol target levels should be. To learn more, read "Setting goals."
Side effects and concerns about side effects are a common roadblock to successful treatment with cholesterol medications. Fortunately, most side effects can be managed, and there are steps you can take to reduce the impact of side effects you may experience:
It can be hard to stick with your medication, for many reasons:
For tips on how to deal with these issues, read "Staying motivated."
Without proper treatment, high cholesterol can cause serious complications, such as heart disease, heart attacks, strokes, angina (chest pain), circulation problems, and death.
Your doctor can help you set goals for your treatment, evaluate the success of your treatment, and minimize your risk of side effects. There is a link between dosing and side effects: higher doses tend to cause more side effects. Your doctor can help you reduce your side effect risk by making sure you're on the appropriate dose of your medication.
To help you prepare for your visit, print the Doctor discussion guide, fill out as much information as you can, and bring it to your doctor's visit.