How Lifelong Cholesterol Levels Can Harm or Help Your Heart

The longer you have high levels of “bad” LDL cholesterol, the greater your risk of a heart attack.

They found no increased risk for stroke or heart failure associated with cumulative LDL exposure. The researchers suggest that many factors can contribute to heart failure, and their study had too few cases of stroke to achieve statistical significance.

The study controlled for race and ethnicity, sex, year of birth, body mass index, smoking, high-density lipoprotein (HDL, or “good” cholesterol), blood pressure, Type 2 diabetes and the use of lipid-lowering and blood pressure medicines.

In people under 40, current guidelines recommend treatment with cholesterol-lowering statin drugs only with LDL readings higher than 190, but the researchers found that the increased risk for coronary heart disease may start at a much lower level. (LDL levels below 100 are generally considered normal.)

“Our figures suggest that the risk starts at LDL levels as low as 100,” said the lead author, YiYi Zhang, an assistant professor of medical sciences at Columbia. “That doesn’t necessarily mean that a person under 40 with an LDL of 100 should immediately start treatment. We need more evidence to determine the optimal combination of age and LDL level.”

Dr. Tamara Horwich, a cardiologist and professor of medicine at the University of California, Los Angeles, who was not involved in the study, noted that medical guidelines on choosing who needs statin therapy are heavily weighted toward older people, since advancing age is a major risk factor for complications from heart disease.


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