Diet and drugs
High cholesterol is usually treated with healthy diet changes, exercise, and medications. For people at a high risk of heart disease, medications are started right away, in combination with a healthy diet and exercise. For people at lower risk of heart disease, the doctor may recommend trying diet and exercise changes alone for 3 to 6 months, and adding medications if this does not reduce cholesterol to the desired levels.
What should your cholesterol levels be? Your doctor will choose cholesterol target levels based on your risk of heart disease. Factors that increase your risk of heart disease include your age, gender, blood pressure, whether you smoke, and whether you have medical conditions such as diabetes, peripheral arterial disease, chronic kidney disease, or a history of stroke. Your doctor will consider these factors and calculate your risk of heart disease in the next 10 years.
In general, your cholesterol targets should be as follows:
|Risk of heart disease
||10% or less
||less than 130
||less than 200
||11% to 19%
||between 130 and 159
||between 200 and 239
||20% or greater
*LDL = low density lipoprotein (the "bad" cholesterol)
HDL = high density lipoprotein (the "good" cholesterol)
Total cholesterol: HDL ratio = total cholesterol divided by HDL
Surgical treatment for lowering cholesterol
An operation called ileal bypass lowers the level of blood cholesterol by decreasing the amount of cholesterol and bile acids taken up from the intestines. Your doctor will not likely consider such a procedure except in extreme cases and where other methods of lowering cholesterol have been unsuccessful.