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After the initial diagnosis of high cholesterol is made, there are other procedures that take place before cholesterol medication is prescribed. Together, the medical history and the lipid profile test assess the patient's risk factors, set the course of treatment, and determine the need for medication.

Medical histories are important in identifying risk factors for CHD (coronary heart disease). If family members have a history of heart disease or diabetes, it raises the risk factor patients with high cholesterol.

Lipid profile

The diagnosis of elevated levels of cholesterol is done by a test that measures the levels of the total cholesterol and individual levels of LDL cholesterol, HDL cholesterol and triglycerides. It is called a lipid profile test.

The lipid profile test consists of a blood draw for which the patient is required to fast for 9 to 12 hours. The blood is drawn either in the doctor's office or in a medical laboratory. It is then sent to the test laboratory and the doctor gets the results within a few days.

Risk Factors and Treatment

0 to 1 risk factors: bring LDL level to 160 mg/dL

A goal is set for bringing the cholesterol levels down to the established level and a strategy planned for meeting the goal. The treatment for this level of risk usually consists of therapeutic lifestyle changes and diet changes. Evaluation to determine if the patient is meeting his set goal is done. If he is not meeting it, the therapy is intensified and he may be referred to a dietitian. Medication is optional.

2 or more risk factors: bring LDL level to 130 mg/dL

When multiple risks (2 or more) are present, the patient benefits from more intensive treatment. Risk factors can include diabetes, history of heart problems and other risk factors from lifestyle. Smoking, hypertension, low HDL and age are also risk factors. At this point, cholesterol medication might be introduced as part of the therapy.

Major Risk factor: bring LDL level to 100 mg/dL

Diabetes is a factor, or the patient has established CHD. Intense therapy is called for and statins and other medication may be introduced to bring LDL levels down. HDL (good) cholesterol levels and triglycerides are evaluated. Other drugs may be introduced to bring triglycerides levels down.

Cholesterol-lowering medication is not a case of one size fits all. Each cholesterol component is evaluated along with the total cholesterol. High levels of LDL are a risk for CHD, but more attention is given to levels of HDL and triclycerides, both of which are a major threat to heart health if left unattended. Treatment is tailored to individual need.

http://Americanheart.org
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