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below 70 mg/dL (milligrams per deciliter).

A patient who already has coronary heart disease, diabetes, an abdominal aortic anerysm, atherosclerosis, or peripheral vascular disease, is a high-risk patient. Having two or more risk factors that give a patient a 20 percent or higher chance of having a heart attack in the next ten years also places that patient in the high-risk category. For high-risk patients the NCPE suggests medication be used to reduce LDL cholesterol to below 100 mg/dL.

For patients at moderately high risk (those with two or more risk factors but whose ten year risk of heart attack is 10 to 20 percent), drug treatment is recommended if the patient's LDL cholesterol level is 130 or higher. Doctors are encouraged to consider the option of drug treatment if the levels fall in the 100 to 129 ranges.

Moderate risk is defined as having less than a 10 percent chance of having a heart attack in the next ten years. For those patients the NCPE suggests drug treatment for LDL cholesterol levels over 160 mg/dL.

For those at the lowest risk, treatment with medication is still recommended for those with LDL cholesterol levels over 190 mg/dL.

The decision to treat high LDL cholesterol with medication should be made after careful analysis of the patient's history and risk factors. In the fight against heart disease there is no better weapon than a physician armed with the facts. Communication between doctor and patient is vital to the patient's understanding of his condition and the treatment options available.

For further information about the NCPE guidelines you can visit the National Heart, Lung, and Blood Institute's website at http://www.nhlbi.nih.gov/guide lines/cholesterol/index.htm. The website also has tools to help you calculate your 10 year heart attack risk. Knowing your risk is the first step to reducing it.

Learn more about this author, Roberta Packard.
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