How is treatment determined?

Treatment is based on the overall risk of coronary heart disease. A target LDL level is identified and if your LDL is above the target value, you will be treated. Target LDL values are:

• LDL less than 2.6 mmol/L if you have heart disease or diabetes.
• LDL less than 3.4 mmol/L if you have 2 or more risk factors.
• LDL less than 4.2 mmol/L if you have 0 or 1 risk factor.

The first step in treating high LDL is targeted at changes in lifestyle – specifically adopting a diet low in saturated fat (the fat in dairy produce and meat) and participating in moderate exercise. You may be referred to a dietician for advice in making dietary changes.

If low-fat diets and exercise are not effective in lowering LDL-cholesterol to the target value, drug therapy would be the next step. There are several classes of drugs that are effective in lowering LDL. Your LDL will be checked at regular intervals to check that the drug is working. If the drug does not result in reaching your target LDL-cholesterol, your doctor may increase the amount of drug or possibly add a second drug.