How Low Can Cholesterol Go?

Many heart disease experts are feeling confident that reduced cholesterol may be better and that the current guidelines for lowering cholesterol may not be strict enough, based on studies that are under way. This recommendation does not come without problems, however. For example, although it is easier and more feasible to lower cholesterol levels, many individuals whose levels are very high are not aware of it or are not seeking treatment.

Data from the Centers for Disease Control and Prevention (CDC) shed light on this problem. CDC researchers found that 60% of individuals with elevated cholesterol levels did not know that their levels were high. Of those who knew, only 14% were taking a cholesterol-lowering drug, and only 7% were getting their cholesterol within the recommended limits.

Another study, the Minnesota Heart Survey, reached similar conclusions. The survey of >5000 individuals, taken every 5 years in Minneapolis and St. Paul, found that nearly 60% of men with high cholesterol levels were unaware of them or were untreated, compared with >67% of women.

The guidelines raising concern suggest that levels of low-density lipoprotein (LDL) be below 100 for high-risk individuals, below 130 for moderate-risk individuals, and below 160 for others. Large clinical trials support this recommendation because their findings have shown that lowering LDL to such levels dramatically decreases the risk of heart attacks. Also, other studies are questioning whether lower LDL levels lead to fewer heart attacks. Christie Ballantyne, MD, director of the Center for Cardiovascular Disease Prevention at Baylor College of Medicine and the Methodist DeBakey Heart Center, cautioned policy makers to wait for those studies to be completed.