High cholesterol is one of the main risk factors for cardiovascular diseases, particularly heart attack and stroke. Tens of millions of adults live with uncontrolled dyslipidemia.
Content
- 1. New aspects that people should take into account when controlling cholesterol.
- 1.1 Cholesterol testing should begin early, even in adolescence.
- 1.2 Application of new tools to evaluate long-term cardiovascular risk
- 1.3 LDL target values are set lower, depending on the level of risk.
- 1.4 It is recommended that Lp(a) testing be performed at least once in a lifetime.
- 1.5 The use of dietary supplements to lower cholesterol is not recommended.
- 2. What can people do to effectively control their cholesterol?
The American Heart Association, along with 10 other leading medical groups, recently released new guidelines on cholesterol control, with several important changes. These recommendations focus not only on treatment, but also emphasize the importance of early detection, long-term risk assessment, and individualized treatment goals.
1. New aspects that people should take into account when controlling cholesterol.
Table of Contents
- 1. New aspects that people should take into account when controlling cholesterol.
- 1.1 Cholesterol testing should begin early, even in adolescence.
- 1.2 Application of new tools to evaluate long-term cardiovascular risk
- 1.3 LDL target values are set lower, depending on the level of risk.
- 1.4 It is recommended that Lp(a) testing be performed at least once in a lifetime.
- 1.5 The use of dietary supplements to lower cholesterol is not recommended.
- 2. What can people do to effectively control their cholesterol?
Here are five important points that people should keep in mind:
1.1 Cholesterol testing should begin early, even in adolescence.
One notable change is the recommendation for cholesterol testing at a younger age. Therefore, children should have their first blood lipid test around age 10. The main goal of early detection is to identify familial hypercholesterolemia, a genetic condition that causes high levels of LDL cholesterol (“bad” cholesterol) from birth. This condition can increase the risk of developing early cardiovascular diseases if it is not detected and treated early.
After adolescence, the tests should be repeated around age 19 and maintained every 5 years in adulthood. People with elevated LDL levels (≥160 mg/dL) or a family history of early cardiovascular disease should be monitored more closely and early treatment should be considered.
The key message is: controlling cholesterol levels from an early age and maintaining them over the long term will help reduce the risk of cardiovascular disease later in life.
Controlling cholesterol levels from an early age and maintaining them in the long term helps reduce the risk of cardiovascular diseases.
1.2 Application of new tools to evaluate long-term cardiovascular risk
The new guidelines introduce an updated cardiovascular risk assessment tool that helps estimate the probability of developing the disease within 10 and 30 years. This tool calculates the risk of atherosclerotic cardiovascular disease based on multiple factors such as age, sex, blood pressure, cholesterol, smoking, and underlying diseases. A key development is long-term risk assessment (30 years), which helps identify young people at high cumulative risk who may not present clear symptoms in the short term.
According to recommendations, if the risk of cardiovascular disease over a 10-year period is 5% or higher, treatment with lipid-lowering drugs such as statins can be considered. Using risk assessment tools not only helps doctors make more accurate treatment decisions, but also allows patients to understand their risks so they can make timely changes to their lifestyle.
1.3 LDL target values are set lower, depending on the level of risk.
LDL cholesterol is the main target in the treatment of dyslipidemia. The new guidelines emphasize reducing LDL to lower levels than before, depending on each person’s cardiovascular risk.
- For people at moderate risk: LDL should be less than 100 mg/dL.
- For people at high risk (≥10% in 10 years): LDL should be less than 70 mg/dL.
- For people with pre-existing cardiovascular disease: LDL cholesterol should be less than 55 mg/dL.
Recent evidence suggests that significant and sustained reductions in LDL can slow the progression of atherosclerotic plaques in the arteries, and even stabilize them. This means that many patients will require more intensive treatment, not only through lifestyle changes, but also with medications when necessary.
1.4 It is recommended that Lp(a) testing be performed at least once in a lifetime.
Another recent recommendation is to test all adults for lipoprotein(a) (Lp(a)) at least once. Lp(a) is a type of lipoprotein similar to LDL, but with a special protein component that increases the likelihood of plaque formation. Lp(a) levels are determined primarily by genetics and vary little over time.
Approximately 20% of the population has elevated levels of Lp(a), which significantly increases the risk of cardiovascular disease and stroke. Currently, there is no specific treatment to reduce Lp(a) in routine clinical practice. However, knowing this index helps doctors identify higher risk groups, allowing treatment strategies to be adjusted, especially through more intensive control of LDL.
1.5 The use of dietary supplements to lower cholesterol is not recommended.
The new guidelines also include a clear warning: dietary supplements should not be relied on to lower cholesterol. Recent studies have shown that many popular products, such as fish oil, garlic, turmeric, cinnamon, plant sterols or red yeast rice, are not significantly effective in lowering LDL cholesterol compared to a placebo.
Meanwhile, statins have been shown to reduce LDL cholesterol by 30% to 50% and decrease the risk of cardiovascular events. Additionally, dietary supplements are often not subject to the same quality control, active ingredient content, and strict safety standards as prescription drugs.
Therefore, patients should not substitute prescribed medication with supplements on their own. The use of any product requires consultation with a doctor.
The use of dietary supplements to lower cholesterol is not recommended.
2. What can people do to effectively control their cholesterol?
In addition to professional updates, the new guidelines continue to emphasize the role of lifestyle in cholesterol control:
- Maintain a diet low in saturated fat and rich in green leafy vegetables and fiber.
- Increase your physical activity to at least 150 minutes per week.
- Maintain a healthy weight. Don’t smoke.
- Follow the treatment plan prescribed by your doctor…
Combining lifestyle changes with medical treatment when necessary is key to reducing the risk of cardiovascular disease.
New guidelines on cholesterol control show a trend toward a more proactive and early approach to cardiovascular disease prevention. Early detection from infancy, long-term risk assessment, lowering target LDL levels, and decreasing dependency on supplements are important changes. For the general population, regular medical checkups, understanding individual risk factors, and following medical advice will help control cholesterol effectively, thereby reducing the risk of dangerous complications in the future.
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