In previous entries I discussed why total cholesterol levels aren't very useful and how to set and reach your target for HDL and triglycerides. LDL is bit more complicated, but is one of the most important risk factors for heart attack and stroke.
The first step in establishing your LDL goal is to add up your risk factors. How many of these apply to you?
- High blood pressure
- Family history of heart attack or stroke
- Current or former user of any tobacco product
- Age over 55 (men) or 65 (women)
- Overweight or obese
- Sedentary lifestyle
- History of radiation to the left side of the chest (usually for breast cancer or lymphoma)
If you're fortunate enough to have a protectively high HDL level (more than 65 mg/dL), you can subtract 1 from your total number of risk factors.
Two other factors are considered much more significant, and automatically place you in the highest risk group, regardless of anything else. Everyone with diabetes mellitus ("sugar diabetes") eventually develops atherosclerosis, and people who have had a heart attack (and most people who have had a stroke) already have atherosclerosis.
The second step is to choose an LDL target, depending on how many risk factors you have and how aggressive you want to be. There is no difference between men and women, except in adding up the risk factors above. Use the table below to figure out your ideal LDL level.
Number of Risk Factors | Less Aggressive LDL Goal | Aggressive LDL Goal |
0 or 1 risk factor | 160 mg/dl or below | 130 mg/dl or below |
2 or more risk factors | 130 mg/dl or below | 100 mg/dl or below |
Diabetes or known heart disease/stroke | 100 mg/dl or below | 70 mg/dl or below |