A list of suggested interventions based on the results of total cholesterol
and HDL levels. These numbers are guidelines to decisions and are not precise
cut-offs for decisions.
Description
Cholesterol levels
Suggested action
Desirable
Total cholesterol below 5 mmol/l;
HDL more than 0,9 mmol/l
- 35 % of heart attacks in this range
- If HDL is more than 0,9 mmol/l: not significant risk if no other risk
factors
- Then re-test in 5 years
- Further evaluation if smoking, hypertension, or any other risk factors
for heart disease or stroke
- If HDL is below 0,9 mmol/l, then analyse triglyceride levels
- Advocate healthy lifestyle
Borderline to High
Total cholesterol 5 -7,5 mmol/l;
- If HDL is higher than 0,9 mmol/l, and no other risk
factors, the risk for a heart attack within 10 years is probably lower
than 20%. Then follow-up visits every 6 -12 months. Probably no drugs
needed.
- Change lifestyle: excercise, low-fat diet and stop smoking
- If risk is greater that 20 % for heart attack in 10 years, change
lifestyle plus lipid-lowering drug intervention may be required.
- Risk increases with smoking, hypertension and other risk factors.
High Risk
Total cholesterol 7,5 or higher.
- Detailed assessment of blood tests should be done to
characterise the disorder and it's causes
- Drug therapy should be considered, plus lifestyle changes
- Essential to lower cholesterol levels because many people will have
additional risk factors
Suggested interventions based on the results of LDL tests.
The ideal LDL is lower than 3 mmol/l
Description of Risk
LDL levels
Suggested Action
Ideal
LDL lower than 3 mmol/l
This is the ideal level
Borderline to High
LDL: 3 - 5 mmol/l
- Investigate secondary causes of high cholesterol
(underlying disease, diet or drugs)
- Diet and exercise indicated to lower the cholesterol level
- Lipid lowering drugs if the risk of heart disease higher than 20 % for
10 years
High
LDL: higher than 5 mmol/l
- Clinical examination recommended
- Laboratory tests should be done as needed
- Investigate secondary causes of high cholesterol
- Genetic disorders may be indicated
- Drug treatment, combined with diet modification and exercise, may be
recommended
- Once the patient has manifested any form of atherosclerotic vascular
disease, the target LDL cholesterol is always lower than 3 mmol/l
- Treatment decisions should not be based on a single LDL measurement, but
2 measurements, within a 1 to 8 week period. If they differ by more than
0,8 mmol/l a third is recommended. Base treatment on the average.
Bookmark with:
What are social bookmarks?