America's new cholesterol guidelines explained
US cholesterol guidelines have been updated for the first time since 2018, with experts introducing earlier screenings, a new risk calculator, and updated goals to adhere to.
Last week (13 March), the American College of Cardiology (ACC), the American Heart Association (AHA), and nine other leading health authorities issued an update on managing high cholesterol.
The new document, designed to replace the 2018 cholesterol guidelines, represents a major shift in how practitioners assess and help patients manage cholesterol-related problems.
The updated notice came amid worrying statistics, claiming that an estimated one in four adults in the United States has high levels of ‘bad’ cholesterol, increasing their risk of heart attack, stroke, and other concerns.
What is cholesterol?
The National Heart, Lung and Blood Institute categorises cholesterol as a waxy, fat-like substance that your body needs for good health.
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There are two types of Lipoproteins (round particles made of fats and proteins) designed to carry cholesterol in your blood and throughout your body: Low-density lipoprotein (LDL), sometimes known as ‘bad’ cholesterol, and High-density lipoprotein (HDL), referred to as ‘good’ cholesterol.
Too much LDL can cause plaque build up in your arteries, eventually leading to heart attack, stroke, and a myriad of other health issues, the experts stated.
High HDL levels can reduce risk by transporting LDL out of the bloodstream and into the liver for flushing.
Other key benefits include, but are not limited to, reduced inflammation, improved arterial function, prevention of blood clots, and repair of the inner lining of blood vessels, known as the endothelium.
“In general, lower LDL is better, especially for people at increased risk for a heart attack or stroke,” said Pamela B. Morris, director of the Seinsheimer Cardiovascular Health Program at The Medical University of South Carolina.
“Clinical trials have clearly demonstrated significant benefits for reduction in cardiovascular events when LDL-C levels are even lower than recommended in previous guidelines.”
America’s new cholesterol guidelines
Experts from various American institutions have offered denizens a ‘one-stop shop’ approach to managing abnormal levels of one or more types of lipids or lipoproteins in the blood, including cholesterol and triglycerides.
Information is provided on how experts can best assess and treat various blood lipids to ‘effectively lower an individual’s risk of developing atherosclerotic cardiovascular disease’.
Employ change at the source
The document, jointly published in the JACC journal, recommends early intervention through eating well, maintaining a healthy weight, and prioritising sleep hygiene.
It’s also advised that Americans avoid using tobacco products and heed medical experts when cholesterol-lowering medication is offered.
Screening will start earlier
Doctors may begin screening and considering medical intervention for people as young as 30, especially those whose test results reveal persistently high LDL.
High-risk individuals, such as those with a family history of high cholesterol, obesity, or heart disease, are likely to be screened early too, as per the new guidelines.
Cholesterol checks update
Medical professionals have said that biomarkers should be used alongside routine blood tests to accurately report ‘bad’ cholesterol levels.
Blumenthal reasoned that by measuring biomarkers, experts will have a ‘more complete picture’ of their patients’ cardiovascular risk, helping them to understand whether treatments, such as lipid-lowering therapy, are ‘needed sooner rather than later’.
New risk calculator
Predicting Risk of Cardiovascular Disease EVENTs (PREVENT) is a new cardiovascular disease risk calculator.
This new method estimates both 10-year and 30-year cardiovascular risk for adults ages 30 to 79, as per NewsWeek.
In a press release, Roger Blumenthal, chair of the guideline writing committee, said the tool utilises information already obtained during an annual physical assessment.
These may include cholesterol levels, blood pressure readings and other personal information ‘such as age and health habits’.
“[PREVENT will] then further personalise the risk score for each individual by looking at 'risk enhancers,' which can help guide the need for lipid-lowering therapy,” he added.
Updated cholesterol goals
Anyone with ‘some risk’ of high cholesterol should try to keep LDL levels below 100, the ACC and AHA have stated.
Those with a higher risk should aim for under 70, while people already diagnosed with heart disease should keep it under 55.
How to improve ‘bad’ cholesterol levels
People looking to lower their LDL levels are advised to reduce saturated fats and eliminate trans fats from their diet completely, as per the Mayo Clinic.
Whey protein, found in dairy products, may help lower LDL cholesterol, total cholesterol and blood pressure.
Soluble fibre products, such as oatmeal, kidney beans, Brussels sprouts, apples and pears, are also approved.
Outside of your plate, you should try to raise ‘good’ cholesterol by working out for 30 minutes five days per week and drink alcohol in ‘moderation’.
US Dietary Guidelines, which were updated in January, do not stipulate exactly how much alcohol you should be drinkingon a weekly basis.
However, its broad advice is to simply ‘consume less’ for better health.
Ella Scott