New Cholesterol Guidelines Recommend Earlier Screening
New guidelines encourage earlier intervention for high cholesterol
New guidelines encourage earlier intervention for high cholesterol
It’s estimated that one in four adults in the U.S. have high low-density lipoprotein (LDL) cholesterol — often referred to as the “bad” cholesterol. It’s a condition that’s preventable and treatable; however, it often has no symptoms, so many people are unaware they have it, putting them at higher risk for heart attack or stroke.
A recent update to national guidelines for preventive cholesterol screenings, the first since 2018, aims to change that by screening and intervening earlier, and calculating long-term risk differently.
“We are taking a proactive rather than a reactive approach and are getting more aggressive in terms of preventing disease before it occurs,” says Elizabeth Epstein, MD, a cardiologist at the Scripps Center for Integrative Medicine at Scripps Clinic.
New guidelines recommend earlier cholesterol screening
Included in the guidelines recently adopted by the American College of Cardiology, American Heart Association and other organizations is a recommendation that the baseline age for screening be lowered from 40 to 30. For some people with a high genetic risk or a family history of high cholesterol, testing could start as early as age 9.
The guidance also includes updated threshold levels for LDL cholesterol, as well as other types of lipids based on a person’s individual risk of heart disease. And it emphasizes using risk estimates to create unique cholesterol targets and support shared decision-making between clinicians and patients.
“The changes can be summed up by the alliteration, ‘Sooner, Smarter, Stronger,’” says Dr. Epstein. “We’re doing a risk assessment 10 years sooner. We have a more comprehensive and smarter risk evaluation now and have incorporated leading-edge data, including genetic testing and advanced lipid measures, to adjust that calculation. And stronger refers to treatments — in the last decade we’ve had new and highly effective non-statin medications become available.”
Lifestyle changes can help lower cholesterol
Physicians are also taking proactive steps when it comes to preventive measures like diet and exercise, and are encouraging patients to make meaningful changes to protect themselves from heart attack and stroke years down the road.
“Our aim is to protect you, and we have a chance to make a difference,” says Dr. Epstein. “A diagnosis of high cholesterol is not necessarily bad news — it’s meant to be empowering information.”
Scripps cardiologists use the most advanced assessments and diagnostics to create personalized, effective prevention and treatment plans.
Dr. Epstein and her colleagues are passionate about lowering risk via evidence-based recommendations and personalized prevention and treatment plans. They also employ a “second toolbox” that combines natural and integrative therapies, nutrition counseling, stress reduction techniques, supplements to augment treatment and other approaches for healthy lifestyle changes.
“The expertise here at Scripps is rare to find in the broader cardiology landscape,” she says.
Four ways to lower cholesterol and protect your heart
These four tips from Dr. Epstein can help lower cholesterol and prevent heart attack or stroke in the future.
Eat a Mediterranean diet. Focus on a diet that emphasizes plant-based foods, lean proteins and healthy fats. Prioritize heart-healthy staples, like fruits and vegetables, whole grains, legumes, fish, poultry, nuts and olive oil.
Stay active. Regular aerobic and strength-building exercise is key. Dr. Epstein notes that the more physically fit you are, the longer you typically live.
Lose excess weight. Reducing body fat, especially the visceral fat that surrounds organs, can reduce inflammation and protect the heart.
Advocate for your health. Be proactive and ask your doctor about advanced testing to better understand your long-term risk.
This content appeared in San Diego Health, a publication in partnership between Scripps and San Diego Magazine that celebrates the healthy spirit of San Diego.