How is treatment determined?
Treatment is based on the overall risk of coronary heart disease as accessed after lifestyle modification. The following groups would be considered for treatment.
- Patients with vascular disease
- Type 2 Diabetics with LDL-cholesterol > 2.5 mmol/L or triglycerides > 2.0 mmol/L
- Patients with a family history of high cholesterol
- Aboriginal or Torres Strait Islander people with LDL-cholesterol >2.5 mmol/L
- Others with an elevated risk of cardiovascular disease
Pharmmceutical Benefits Scheme (PBS) Eligibility Criteria For Lipid Lowering Drugs may also be taken into account.
Recent trials support a target LDL-cholesterol of <2.0 mmol/L, a HDL-cholesterol of >1.0 mmol/L and a triglyceride of <1.5 mmol/L in patients being treated.
The first step in treating high LDL is targeted at changes in lifestyle – specifically adopting a diet low in saturated fat (the fat in dairy produce and meat) and participating in moderate exercise. You may be referred to a dietician for advice in making dietary changes.
If low-fat diets and exercise are not effective in lowering LDL-cholesterol to the target value, drug therapy would be the next step. There are several classes of drugs that are effective in lowering LDL. Your lipid profile will be checked at regular intervals to check that the drug is working. If the drug does not result in reaching your target LDL-cholesterol, your doctor may increase the amount of drug or possibly add a second drug.