Q:

How has the desirable cholesterol ratio changed over the years?

A:

Quick Answer

Prior to 2004, low-density lipoprotein, or LDL, levels of 130 milligrams were considered healthy, explains Dr. Joseph Mercola in an article on the Huffington Post. However, in 2004, the National Cholesterol Education Program, or NCEP, revised that figure, recommending LDL levels as low as 70 milligrams for some individuals.

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Full Answer

In 1988, the NCEP issued guidelines recommending a target LDL level of 130 milligrams or less for those individuals at the highest risk of getting heart attacks, explains Heidi Ledford on Nature.com. In 1993, the organization retained the recommendation, later lowering it to 100 milligrams in 2002. These changes reflected a growing consensus in the medical community that lowering LDL levels to recommended levels did not necessarily lower the risk of heart disease.

Clinical trials have shown that a group of drugs known as statins significantly reduce the possibility of getting strokes and heart attacks, explains Ledford. However, reducing LDL, colloquially known as bad cholesterol, with other types of drugs does not confer the same benefits. This means that statins reduce the probability of heart attack and stroke by leveraging other mechanisms, such as fighting inflammation, a known risk factor for heart disease.

These revelations partly led to new NCEP guidelines in 2013, explains Dr Reena Pande, an instructor at the Harvard Medical School. Rather than recommending specific LDL targets, the new guidelines set as basis for treatment individual heart risk profiles. Seen from this perspective, a dose of statin structured according to an individual's heart attack and stroke risk is far more effective than lowering LDL levels to a certain level.

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