How’s your cholesterol?

New recommendations on what’s considered unhealthy levels of cholesterol will likely lead to many more Canadians being advised they have high cholesterol. The recommendations reflect the findings of major clinical trials conducted over the last decade.

The practical result is that many people who tested as borderline high cholesterol in the past may now find their doctors advising them to take drugs to lower their cholesterol, in addition to modifying their diet and exercise habits.

Canadian cholesterol guidelines were put in place in 1988. Studies conducted since then consistently show that lowering LDL-cholesterol results in prompt and significant decrease in major coronary events and deaths.

The new recommendations are contained in a report backed by Health Canada. It will likely prompt doctors to change their approach to the treatment of LDL ("bad") cholesterol.

In Canada, it’s estimated that cardiovascular disease, the leading cause of death, accounts for 36
per cent of total mortality. Just over four million Canadians have unhealthy levels of LDL-cholesterol.

"The tremendous body of clinical evidence available today,oupled with the addition of new therapeutic agents to treat high blood cholesterol, such as statins, has led to this new evaluation of how physicians should diagnose and treat lipids in Canada," said Dr. Paul Oh. He’s director of the Cardiovascular Assessment and Risk Evaluation Clinic at Sunnybrook Hospital in Toronto.

"With such rigorous new treatment target levels outlined in the report, Canada has not only become a world leader in the management of cholesterol, but has also taken an aggressive step forward to improve the health of Canadians."

Lifestyle changes are recommended as first-line treatment for patients with low or moderate cardiovascular risk. The report recommends that patients at high or very high risk should receive prompt intervention with both medication and lifestyle changes. This means that patients with established cardiovascular disease and/or diabetes require an aggressive approach to reduce their LDL cholesterol levels.