Given the imprecision in risk estimates, eliciting patients’ values and preferences regarding the potential benefits and harms of statins and other lipid-lowering agents remains essential to treatment decisions. The general guidelines for adults in the United States are: Less than 100 milligrams per deciliter (mg/dL): Optimal 100-129 mg/dL: Near or above optimal 130-159 mg/dL: Borderline high 160-189. As a guide, health authorities recommend cholesterol levels should be no higher than 5.5 mmol per litre if there are no other risk factors present, or LDL levels less than 2 mmol/l for those who smoke, have high blood pressure or pre-existing heart disease. In healthy adults, the following ranges are regarded as 'good' levels: Total cholesterol: Levels below 200 mg/dL (5. Finally, the ACC/AHA did not update the Pooled Cohort Equations risk assessment tool, despite widespread recognition that it can significantly overestimate 10-year risk of myocardial infarction and stroke. The treatment goal for individuals with heart disease or blood vessel disease is to reach an LDL of less than 1.8 mmol/L (70 mg/dL). It encourages the expanded use of CAC scoring to guide the decision to start statin therapy, even though no studies have shown that risk stratification based on CAC score reduces cardiovascular morbidity or mortality more than traditional risk factors alone. Also, it may be beneficial to treat patients 20 to 75 years of age who have an LDL-C level of 190 mg per dL or greater with ezetimibe if they have not been able to achieve a 50 reduction in LDL-C. You may not need more cholesterol tests if your cholesterol is in this normal range. For example, the guideline recommends periodic lipid monitoring in patients receiving therapy, even though randomized trials generally prescribed fixed statin doses rather than titrating to LDL-C percentage reductions or threshold levels. A total cholesterol of 180 to 200 mg/dL (10 to 11.1 mmol/l) or less is considered best. LDL-cholesterol less than 2.0 mmol/L HDL-cholesterol greater than 1.0 mmol/L Triglycerides less than 1.7 mmol/L Total cholesterol less than 4.0 mmol/. Editor’s Note: Similar to the 2013 ACC/AHA cholesterol guideline, this guideline has some utility for family physicians but is limited by several recommendations that will be challenging to implement and lack patient-oriented evidence.
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