Just in time for National Cholesterol Education Month in September, federal health officials announced on July 12 that they are sharply reducing the target level of harmful cholesterol for Americans that are at moderate or high risk for heart disease.

The new recommendations urge the use of cholesterol-lowering prescription drugs for people at high risk to lower their LDL cholesterol to less than 100, with a target of 70. Previously, the recommended level was 130.

Officials also recommended serious consideration of drug therapy to similarly reduce levels for individuals at moderate risk of heart disease.

High-risk people include those with established cardiovascular disease, diabetes or other conditions that raise the risk of heart attack to about 20 percent for the next decade. Moderate risk individuals are those with factors such as advancing age, high blood pressure or smoking that suggest a 10 to 20 percent chance of a heart attack in the next ten years.

Under the new recommendations, several million people have been added to those who should take statins, powerful medications that lower LDL cholesterol. Under the old guidelines, 36 million people should have been taking statins, but only about half that number were.

Coming just two and a half years after the previous recommendations were introduced, the call for intensified treatment to further reduce cholesterol surprised some medical professionals. Some noted that getting high-risk patients down to a new goal of 70 will require still larger doses of statins.

Despite the high cost, however – statins run about $100 per month – experts believe the long-term savings in the nation’s health costs will be worth it. Heart disease, a very costly disease, could be reduced by 30 to 40 percent with more drug therapy.

For people with less than moderate risk for heart disease, statins are not recommended. Though doctors may prescribe statins in these cases, they seldom do.

Some experts predict further lowering of the cholesterol goal in the next few years.

“While these recommendations are directed toward individuals with high or moderate risk of heart disease, everyone should pay attention to their risk for a heart attack,” says LHSFNA Health Promotion Division Director Mary Jane MacArthur. “Healthy lifestyles, including a balanced diet and regular exercise, are essential to controlling cholesterol levels and reducing your risk of heart disease.”

Extensive resources on the risk, prevention and treatment of heart disease, including the 2004 National Cholesterol Education Month Kit, are available from the National Institutes of Health.

[Steve Clark]