How low should your cholesterol be?

Posted on October 17, 2009. Filed under: 1 | Tags: , , , , |

High blood cholesterol levels increase your risk for a heart attack or stroke. The best information is related to the low-density lipoprotein cholesterol level or the LDL-cholesterols (called the ‘bad guys) and cardiovascular risk. Many experts recommend that everyone should have a LDL-cholesterol value below 130 mg/dl (or a total cholesterol below 200 mg/dl). They recommend that the ideal LDL-cholesterol should be between 70 to 100 mg/dl for persons who do not have coronary heart disease (CHD). If you have CHD or have had a heart attack some experts recommend that your LDL-cholesterol should be below 70 mg/dl (total cholesterol below 140 mg/dl) (1;2). My research leads me to recommend that if you have CHD or have had a heart attack and are less than 70 years old your LDL-cholesterol should be between 60 and 80 mg/dl (total cholesterol of 130 to 150 mg/dl). Lower LDL-cholesterol levels may lead to more rapid loss of brain (cognitive) function as you get older (3). If you are over 70 years old, my research suggests that maintaining your LDL-cholesterol between 80-100 mg/dl (total cholesterol of approximately 150-170 mg/dl) is the prudent thing to do to sustain optimal brain (cognitive) function.
People with LDL-cholesterol values below 110 mg/dl (total cholesterol below 180 mg/dl) appear to have lower brain(cognitive) function than persons with LDL-cholesterol values above 110 mg/dl (3). The evidence that statin drugs decrease risk for heart attack for persons above the age of 70 years old is unclear (4). Some evidence indicates that statin drugs decrease brain (cognitive) function—perhaps by decreasing cholesterol available for to maintain the cholesterol levels required for the brain (4;5).
Reference List
1. Expert Panel. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). J Amer Med Assoc 2001;285:2486-97.
2. Keevil JG, Cullen MW, Gangnon R, McBride PE, Stein JH. Implications of cardiac risk and low-density lipoprotein cholesterol distributions in the United States for the diagnosis and treatment of dyslipidemia: data from National Health and Nutrition Examination Survey 1999 to 2002. Circulation 2007;115:1363-70.
3. Elias PK, Elias MF, D’Agostino RB, Sullivan LM, Wolf PA. Serum cholesterol and cognitive performance in the Framingham Heart Study. Psychosom Med 2005;67:24-30.
4. Golomb BA. Implications of statin adverse effects in the elderly. Expert Opin Drug Saf 2005;4:389-97.
5. Muldoon MF, Ryan CM, Sereika SM, Flory JD, Manuck SB. Randomized trial of the effects of simvastatin on cognitive functioning in hypercholesterolemic adults. Am J Med 2004;117:823-9.


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