What number of LDL cholesterol should I aim for?

Your goal LDL cholesterol level depends on your heart disease risk factors. For low risk patients, the goal LDL is less than 160. For patients with many heart disease risk factors, the goal LDL is less than 100. These cholesterol goals are set by the National Heart, Lung and Blood Institute, an organization advised by the National Institutes of Health (NIH). At your next visit, ask your doctor about your heart disease risk factors and how they affect your cholesterol goals.

LDL level is only one part of the risk picture, and the “right” LDL (or HDL, or triglyceride) level for you depends on your underlying coronary heart disease risk.  Fortunately, there is more science-grounded knowledge about coronary heart disease risk than  any other chronic disease risk.  Knowledge is power, so to empower yourself, I recommend entering some basic information into a Framingham 10 year risk calculator (http://hp2010.nhlbihin.net/atpiii/calculator.asp?usertype=prof), and/or a Reynolds 10 year risk calculator (http://www.reynoldsriskscore.org/).  

Next, I strongly  recommend you attempt to  personalize your result from the risk calculator to your own unique situation,  using additional information about your diet and lifestyle, physical activity, body weight, diabetes status, family history, and your other medical conditions.  A good primary care physician can help you determine the relative importance of each of these to your personal situation.  

For people without heart symptoms, medical testing beyond the above set of basic information is sometimes indicated and helpful,  often overused, sometimes expensive, and sometimes even physically dangerous.  

Oh, the question was about LDL level, was it? OK then, in a healthy adult, an  LDL >130 mg/dL or presence of any other risk factor for coronary heart disease warrants further discussion and personalized planning with an expert in disease prevention, which your primary physician hopefully is.   Remember, an ounce of prevention is worth a pound of cure.

For people who meet our definition of high risk, a science-supported LDL target is <100 mg/dL.  For those with very high risk, further benefit can be seen at levels  <70 mg/dL.      

We are beginning to learn that some of the beneficial effects of statin drugs come from mechanisms beyond their ability to lower LDL.  This knowledge will continue to refine how and when we recommend statin drugs as part of your well-rounded plan to prevent death from heart disease. 

Your target for harmful low-density lipoprotein (LDL) depends on your cardiovascular health and your odds of having a heart attack in the next 10 years. Targets range from below 70 mg/dL for those at very high risk up to 160 mg/dL for people with the least overall risk.