Low-density lipoprotein is a cholesterol carrier in the blood. When LDL builds up in the inner walls of the arteries, it can narrow the walls, potentially causing heart attacks or strokes. Having low LDL cholesterol levels is a preventive marker for cardiovascular disease that, along with age, smoking, systolic blood pressure, family history of diabetes and triglycerides, lowers your likelihood of developing cardiovascular disease. Generally, medical professionals consider a LDL level of 177 mg/dL high.
Lowering LDL Cholesterol
LDL is the primary target of cholesterol-lowering therapy. The National Cholesterol Education Program Treatment Guidelines suggest that for every 30mg/dL increase in LDL, your risk for coronary heart disease increases by 30 percent. A second target is the Non-HDL cholesterol in people with elevated triglycerides greater than 200 mg/dL. The non-HDL-C goal is 30mg/dL higher than the LDL-C goal. Therefore, if you have an LDL level of 177 mg/dL, you have a 30 percent higher chance of developing coronary heart disease than if you had an LDL level of 147 mg/dL.
Assessing Risks
If your LDL levels are at 177 mg/dL, you should discuss your specific risk factors with a medical professional. LDL targets vary accordingly to your risk category of cardio-cerebral-vascular events. Your doctor can assess your risk through an evaluation that considers your previous medical history, weight, abdominal circumference, hypertension, dyslipidemia, Type 2 diabetes, smoking and obesity. The evaluation measures blood glucose, total cholesterol, HDL cholesterol and triglycerides after fasting for an average of 10 hours.
LDL Goals
Based on your risk factors, your doctor will give you some goals for reducing your cholesterol. If you have zero or one risk factors, low risk, your doctor may give you a LDL goal of less than 160mg/dL. If you have two or more risk factors, moderate risk, your LDL goal may be less than 130mg/dL. If your have three or more risk factors, putting you in a high-risk group, the doctor will assess a LDL goal of less than 100mg/dL or preferably less than 70mg/dL. High risk means you have a history of heart attacks, acute chest pain, coronary artery procedures or evidence of myocardial ischemia.
Treatment
The first line of treatment your doctor will recommend for high LDL levels are lifestyle changes, such as exercise, diet modifications and quitting smoking. Your doctor will consider, not only your current LDL level of 177 mg/dL, but also your risk category. Based on your risk category, your doctor may start you on medication for high cholesterol. If you're at low risk, the cutoff point is less than 190mg/dL, for moderate risk the cutoff point varies from less than 130mg/dL to less than 160mg/dL and for high risk, the cutoff point is less than 100mg/dL.
References
- "Circulation"; Implications of Recent Clinical Trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines; Scott M. Grundy, et al.; July 2004
- American Heart Association; Good vs. Bad Cholesterol; July 2010
- National Heart Lung and Blood Institute; Detection, Evaluation and Treatment of High Blood Cholesterol in Adults; 2004
