The higher your cholesterol and the more risk factors you have for coronary heart disease, called CHD, the more aggressive your treatment needs to be. To decide on the details of your treatment, your doctor will have to consider your unique situation. For instance, if you have no other risk factors, you may need treatment only if your LDL - known as the bad cholesterol - level is 160 mg/dL or higher. If you smoke and have high blood pressure, you may need treatment if your LDL level is as low as 130 mg/dL. If you already have CHD or diabetes, treatment is recommended if your LDL is any higher than 100 mg/dL.
What Does My Doctor Look at to Decide My Treatment?Here are the four main factors that your doctor will consider in order to decide whether you need only changes to your diet and exercise or whether you need medicine, too.
Whether you have CHD. This applies to you if you have been diagnosed with heart disease or have had one or more of these:
- chest pain, called angina
- bypass surgery
- heart attack
- mini-stroke, called transient ischemic attack, or TIA
- peripheral vascular disease
- Whether you have diabetes. People with diabetes are at greater risk for heart disease. So if you have diabetes, you may need more aggressive treatment to control your cholesterol.
How many CHD risk factors you have.
- What your LDL level is.If you aren't sure, ask your doctor.
What your percentage of risk is for developing CHD or having a heart attack. For people with two or more risk factors, it is necessary to get more information to determine the best treatment for you. As of May 2001, the National Cholesterol Education Program recommends using a special tool to assess your risk of heart attack within the next 10 years. Your doctor will use this tool to calculate points based on your age, total cholesterol, HDL cholesterol, systolic blood pressure, treatment for high blood pressure, and whether you have smoked at all in the last month. You can see a version of this test yourself, by taking the National Cholesterol Education Program's Risk Assessment.
Your doctor will use all this information to recommend the best treatment for you.
What Will My Treatment Be Like?
To find out which treatment may be right for you, find the statement below that applies to you. The treatment recommendations that appear in the following pages are based on the guidelines of the National Cholesterol Education Program and the American Diabetes Association. The specific treatment plan that your doctor suggests for you may differ. If you need to, review Which Risk Factors for High Cholesterol Are Important? If you are not sure which statement applies to you, ask your doctor.
- I don't have CHD or diabetes. My LDL is 160 mg/dL or higher. I have only one or no other risk factors of heart disease.
- I don't have CHD or diabetes. My LDL is 160 mg/dL or higher. I have two or more other risk factors of heart disease. And my risk for heart disease over the next 10 years is less than 10%.
- I don't have CHD or diabetes. My LDL is 130 mg/dL or higher I have two or more other risk factors of heart disease. And my risk for heart disease over the next 10 years is between 10% and 20%.
- I don't have CHD or diabetes. My LDL is 160 to 189 mg/dL. I have only one or no other risk factors of heart disease.
- I have been diagnosed with CHD or have had one or more of these: angina, heart attack, stroke, mini-stroke, peripheral vascular disease, angioplasty, or bypass surgery, and my LDL is higher than 100 mg/dL.
- I have diabetes, and my LDL is higher than 100 mg/dL.