In November this year, new guidelines for the detection, evaluation and treatment of high cholesterol were released. Up to now, treatment was aimed at reducing cholesterol to a certain level.
The new guidelines focus instead on identifying which patients are at higher risk of cholesterol-related cardiovascular problems – e.g. Diabetics – and tailoring treatment to achieve the best outcome, taking into consideration lifestyle and other health factors of individual patients.
There are now also some changes in cholesterol reporting by laboratories, with more note being taken of the total amount of “non-HDL cholesterol”. In the past, the LDL (“bad cholesterol”) was considered the main focus, and only LDL and HDL (“good cholesterol) were calculated. New statistical analysis reveals that the total amount of “all non-HDL cholesterol” is a more accurate predictor of outcomes, and this is now included in all laboratory lipograms. Fingerprick tests do not have this calculation.
Whilst there are still general guidelines for desirable cholesterol levels in healthy persons, the emphasis now has shifted towards protecting higher-risk patients from negative outcomes. Lifestyle changes must always be the first step, but these do not make enough of a difference, then Statins are still the recommended first choice medication unless there are compelling reasons to not use them. Using a statin does NOT replace lifestyle changes but are an add-on to the changes that should be lifelong.
If you have a high cholesterol or on statins – or suspect that you should be – please consult your doctor for an update on the new approach.