Highlights

Total Cholesterol Goals

A blood test is used to measure cholesterol levels. A person’s total cholesterol level is determined from measurements of low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides. Standard total cholesterol goals for adults are:

• Less than 200 mg/dL is desirable
• Between 200 - 239 mg/dL is considered borderline
• Over 240 mg/dL is considered high

Lifestyle Changes

The first step to improving cholesterol levels is through lifestyle changes (especially diet and exercise). Even when drug therapy is required, lifestyle changes are also necessary. These include:

• Eat a heart-healthy diet with plenty of fiber-rich fruits and vegetables. Avoid saturated fats (found mostly in animal products) and trans-fatty acids (found in fast foods and commercially baked products). Instead, choose unsaturated fats (particularly omega-3 fatty acids found in fish oils and olive and canola oils).
• Exercise regularly. Studies have shown that regular aerobic exercise can help boost HDL (“good” cholesterol) levels.
• Quit smoking.
• Try to maintain a healthy weight.
• Don't rely on dietary supplements have been shown to improve cholesterol levels.

Drug Therapy

A person’s LDL (“bad” cholesterol) level generally determines if drug therapy is required. Most cholesterol drugs are used to help lower LDL levels. Some drugs are also used to help raise HDL levels. Statins are the drugs most often used in cholesterol treatment. Other drugs include niacin, bile-acid binding resins, fibrates, and ezetimbe.

Rosuvastatin for Primary Prevention

In 2010, the FDA approved the statin drug rosuvastatin (Crestor) for prevention of heart attack and stroke in certain patients who do not have high LDL cholesterol levels but who have a combination of other risk factors that put them at increased risk for heart disease.

New Drug Approval

In 2009, the FDA approved pitavastatin (Livalo), a new statin drug.

Review Date: 04/06/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)