For decades, doctors have warned patients to watch their cholesterol. Now, leading U.S. heart experts say the effort to prevent heart disease may need to begin earlier in life and be tailored more closely to each patient’s risk.
New cholesterol guidelines from the American College of Cardiology and the American Heart Association update the major recommendations last issued in 2018. The guidance urges clinicians to screen for high cholesterol earlier, use more personalized tools to assess the risk of heart attacks and strokes, and consider medication sooner for some patients.
Cholesterol is a waxy substance the body needs to build cells and make hormones. But too much LDL cholesterol — often called “bad” cholesterol — can contribute to plaque buildup in the arteries. Over time, that can raise the risk of heart attack, stroke and other cardiovascular disease. HDL, often called “good” cholesterol, helps carry excess cholesterol away from the bloodstream.
The new guidelines place a stronger emphasis on prevention, particularly for people with a family history of heart disease or high cholesterol.
The basic advice remains familiar: eat a heart-healthy diet, exercise regularly, maintain a healthy weight, get enough sleep and avoid smoking.
But the guidelines make clear that lifestyle changes may not be enough for everyone. For some patients, cholesterol-lowering medications including statins or newer therapies may be needed to bring risk down.
Cardiologists behind the update say the goal is to prevent more heart disease before it starts. Cardiovascular disease remains a leading cause of death, but experts say much of it is preventable.
The new guidance reflects a shift in thinking: high cholesterol is not only a problem of middle age. It can begin shaping heart health much earlier and doctors now say earlier detection and treatment could help protect patients for decades.
Guest:
Dr. Robert Chilton is a clinical professor of medicine and interventional cardiologist at UT Health San Antonio, serving as director of the Cardiac Catheterization Laboratory. Dr. Chilton is board certified in cardiovascular disease and electrophysiology, with extensive experience in clinical care, research and medical education.
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