New Guidelines: Be More Aggressive on Cholesterol

Heart doctors want Americans thinking about cholesterol earlier—and driving it lower—than many are used to. New guidance released Friday from the American College of Cardiology, the American Heart Association, and several other medical groups urges people at risk for heart disease to start actively lowering LDL ("bad") cholesterol by about age 30, reports the New York Times and CNN. The guidelines also suggest tests for LDL levels starting around age 10, which could help identify early those with a genetic condition that puts them at risk for dangerously high levels.

• Big quote: "Eighty percent or more of cardiovascular disease is preventable," Dr. Roger Blumenthal, chairman of the guideline writing committee and a cardiologist at Johns Hopkins Medical School, tells the Times. If the new guidelines are followed, "we think we could cut heart attack and stroke rates down by half."
• Targets: The guidelines set specific LDL targets: under 100 for everyone 30 and up; under 70 for those with at least a 10% chance of heart attack or stroke in the next decade; and under 55 for people who've already had one, or have artery disease.
• New test: Doctors also call for everyone to be tested once for Lp(a), a protein that can independently raise heart risk. Few are currently tested.
• Longer picture: Risk will now be calculated over 30 years, not just 10, to capture the dangers facing younger adults.
• The fixes: Lifestyle changes come first, but statins and newer drugs are expected to do much of the heavy lifting. Supplements, the panel says, mostly don't work, and garlic pills may even be harmful.