The main goal of cholesterol-lowering treatment is to lower your LDL level enough to reduce your risk of having a heart attack or other diseases caused by hardening of the arteries. In general, the higher your LDL level and the more risk factors you have, the greater your chances of developing heart disease or having a heart attack. (A risk factor is a condition that increases your chance of getting a disease.) Some people are at high risk for heart attack because they already have heart disease. Other people are at high risk for developing heart disease because they have diabetes or a combination of risk factors for heart disease. Follow the steps below to find out your risk for getting heart disease.
Check the list to see how many of the risk factors you have. These are the risk factors that affect your LDL goal:
* If your HDL cholesterol is 60 mg/dL or higher, subtract 1 from your total count
Use your medical history, number of risk factors, and risk score to find your risk of developing heart disease or having a heart attack in the table below.
| If you have | You Are in Category | And Your LDL Goal is |
| Heart disease, diabetes or risk score more than 20% | I. Highest Risk | Less than 100 mg/dL |
| 2 or more risk factors and risk score 10 to 20% | II. Next Highest Risk | Less than 130 mg/dL |
| 2 or more risk factors and risk score less than 10% | III. Moderate Risk | Less than 130 mg/dL |
| 0 or 1 risk factor | IV. Low to Moderate Risk | Less than 160 mg/dL |
After following the above steps, you should have an idea about your risk for getting heart disease or having a heart attack. The higher your risk, the lower your LDL goal. There are 2 main ways to lower your cholesterol:
Therapeutic Lifestyle Changes (TLC) –includes a cholesterol-lowering diet (called the TLC Diet), physical activity, and weight management. TLC is for anyone whose LDL is above goal.
Drug Treatment–if cholesterol-lowering drugs are needed, they are used together with TLC treatment to help lower your LDL.
The higher your risk for heart disease, the lower your LDL goal will be. Your doctor will set your LDL goal. Using the following guide, you and your doctor can develop a possible plan for treating your high blood cholesterol.
Category I, Highest Risk, your LDL goal is less than 100 mg/dL.
| Your LDL Level | Treatment |
| If your LDL is 100 or above | You will need to begin the TLC diet together with drug treatment. |
| Even if your LDL is below 100 | You should follow the TLC diet on your own to keep your LDL as low as possible. |
Category II, Next Highest Risk, your LDL goal is less than 130 mg/dL
| Your LDL Level | Treatment |
| If your LDL is 130 or above | You will need to begin the TLC diet |
| If your LDL is 130 or more after 3 months on the TLC diet | You may need drug treatment along with the TLC diet. |
| If your LDL is less than 130 | You will need to follow the heart healthy diet. |
Category III, Moderate risk, your LDL goal is less than 130 mg/dL.
| Your LDL Level | Treatment |
| If your LDL is 130 or above | You will need to begin treatment with the TLC diet |
| If your LDL is 160 or more after you have tried the TLC diet for 3 months | You may need drug treatment along with the TLC diet. |
| If your LDL is less than 130 | You will need to follow the heart healthy diet. |
Category IV, Low to Moderate Risk, your LDL goal is less than 160 mg/dL
| Your LDL Level | Treatment |
| If your LDL is 160 or above | You will need to begin the TLC diet |
| If your LDL is still 160 or more after 3 months on the TLC diet | You may need drug treatment along with the TLC diet. |
| If your LDL is less than 160 mg/dL | You will need to follow the heart healthy diet. |
Lowering Cholesterol with TLC
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