The first major update of the government's guidelines for preventing and managing high cholesterol was released last month. The new recommendations stress better identification of those at risk for a heart attack and more aggressive lipid-lowering treatment. Reflecting new knowledge about the role of LDL cholesterol (the "bad" cholesterol), the new treatment plan is aimed at lowering LDL. Major changes include:

• Treating high cholesterol more aggressively in people with diabetes.
• Using a lipoprotein profile - which measures LDL, total cholesterol, HDL (the "good" cholesterol), and triglycerides - instead of the previous total cholesterol test to identify those at risk.
• Changing the level at which HDL is considered a major risk factor - from 35 mg/dL to 40 mg/dL. HDL levels above 60 mg/dL are considered protective against heart disease.
• A revised "Therapeutic Lifestyle Changes" treatment plan that intensifies the use of nutrition, physical activity, and weight control in treating high blood cholesterol.
• Urging more aggressive treatment for elevated triglycerides, which are linked to increased risk for heart disease.

Classification of Lipid Levels

Lipid Level	Classification
LDL cholesterol   <100   100-129   130-159   160-189   190 or higher	Optimal Near or above optimal Borderline high High Very high
Total cholesterol   <200   200-239   240 or higher	Desirable Borderline high High
HDL cholesterol   >40   60 or higher	Desirable - Less than 40 is considered low Excellent - Protects against heart disease High

We will discuss the changes in greater detail in the coming weeks and will be updating our information on the Lifeclinic site to reflect the new guidelines.

Related information About it - Cholesterol: In your blood, in your diet | Triglycerides | Guidelines for heart-healthy living