LDL cholesterol: the lower the better

Med Clin North Am. 2012 Jan;96(1):13-26. doi: 10.1016/j.mcna.2012.01.009.

Abstract

High cholesterol is often a prerequisite for atherosclerotic plaque. Low-density lipoprotein cholesterol (LDL-C) is the focus of the National Cholesterol Education Program Adult Treatment Panel guidelines. LDL-C ranges from 50 to 70 mg/dL in native hunter-gatherers, healthy human neonates, free-living primates, and other wild mammals, who are notably free of atherosclerotic vascular disease. Multiple statin trials and meta-analyses support a treatment target of LDL-C levels less than 70 mg/dL, as this is associated with improved clinical outcomes and atherosclerosis regression. In fact, no threshold has yet been identified below which patients do not benefit from lowering of LDL-C.

Publication types

  • Review

MeSH terms

  • Adult
  • Age of Onset
  • Animals
  • Atherosclerosis* / drug therapy
  • Atherosclerosis* / epidemiology
  • Atherosclerosis* / etiology
  • Atherosclerosis* / metabolism
  • Cholesterol, LDL / blood*
  • Guidelines as Topic
  • Humans
  • Hypolipidemic Agents / therapeutic use*
  • Infant, Newborn
  • Lipid Metabolism / drug effects
  • Outcome and Process Assessment, Health Care
  • Plaque, Atherosclerotic* / complications
  • Plaque, Atherosclerotic* / metabolism
  • Primary Prevention / methods
  • Proportional Hazards Models
  • Risk Assessment / methods
  • Risk Factors

Substances

  • Cholesterol, LDL
  • Hypolipidemic Agents