ALBUQUERQUE, N.M. — In November 2013, the American Heart Association/American College of Cardiology released guidelines labeled “The Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults.” The guidelines outline when medication should and should not be used to treat an individual’s serum cholesterol levels.
The new guidelines are strongly based on randomized clinical trials, whereas in the past, the recommendations derived in large part from expert opinion not always supported by such clinical trials. Now the goal is to treat an individual’s risk for developing coronary artery disease with problems like heart attacks, coronary angioplasty or bypass surgery. Plus, now for the first time the risk of stroke is considered.
The guidelines emphasize that before drug therapy for cholesterol, you try to achieve ideal body weight, exercise regularly and control your blood pressure. If your risk still indicates you would benefit from drug treatment, the guidelines offer advice on how to do that.
When you have a lipid panel, it measures HDL and LDL cholesterol and triglyceride levels. The HDL cholesterol, the good or “Happy” cholesterol, removes the cholesterol from cells in the plaque in the coronary artery and is protective against heart attacks. To date, medication to treat HDL cholesterol has failed to change a person’s outcome as defined by lowering risk for a stroke, heart attack or cardiac death. So, we do not recommend supplements like niacin or omega-3 fatty acids or newer drugs called cholesterol ester transferase inhibitors for that purpose.