Americans as young as 30 should be taking action on their cholesterol, according to updated guidelines from the country’s leading cardiologists.
An estimated 25 percent of American adults have high levels of the fat-like substance, LDL cholesterol, which raises the chance they will develop heart disease – the cause of 900,000 deaths in the U.S. each year. High levels can also lead to other life-threatening issues like heart attack or stroke.
The guidelines, updated every 5-8 years by the American College of Cardiology, aim to reduce heart disease deaths – the fourth highest in the world per capita – and help Americans live longer. The recommendations were last updated in 2018.
People should have cholesterol screening at younger ages, the doctors wrote. They also recommended that more people take cholesterol-lowering medication as only about half the individuals eligible are currently doing so.
By age 10, all children should be tested for high levels of LDL cholesterol, to identify who has a genetic risk and who needs cholesterol-lowering medication, the group said. Screening should then be repeated every five years – and more often for people with high cholesterol or risk factors like diabetes and obesity.
In a departure from their last guidelines, the American College of Cardiology also gave specific instructions, depending on your risk factors for heart attack or stroke.
People above age 30 – whose doctors have determined they have at least a 10 percent risk of having a heart attack or stroke in the next decade – should get their LDL cholesterol levels below 70 milligrams per deciliter and those who have already had a cardiac event or peripheral artery disease should lower it below 55mg per deciliter.
High cholesterol levels are at or above 240 milligrams of cholesterol per deciliter of blood, according to the Centers for Disease Control and Prevention, while healthy levels are at or around 100 milligrams per deciliter.
If the new guidelines are widely followed, especially by younger people, heart disease would “go down markedly,” Dr. Roger Blumenthal, director of the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease who worked on the new guidelines, told The New York Times.
“We think we could cut heart attack and stroke rates down by half,” he said.
LDL cholesterol isn’t bad in itself but too much can lead to a build up of plaque in the arteries, causing them to harden and narrow and restricting blood flow.
This leaves people at risk for deadly cardiac events, although there’s no data showing how many deaths are specifically traced to high LDL levels in the U.S. annually. Worldwide, that tally is over 4.4 million, according to the World Heart Federation.
Eating a saturated fat-heavy diet, being overweight, smoking or chewing tobacco, not getting enough exercise and a genetic history of high cholesterol can leave people vulnerable to high LDL cholesterol levels, the American Heart Association says.
More than 1 in 3 American adults – roughly 42 percent – are living with obesity and the rate of childhood obesity has reached its highest rate ever recorded, jumping from 5.2 percent in the early 1970s to more than 21 percent in 2021-2023, a Harvard T.H. Chan School of Public Health report found.
Maintaining a healthy weight, exercising regularly, not smoking, sleeping well and taking cholesterol-lowering medication can all help to fight elevated LDL cholesterol levels.
Just 30 minutes of brisk walking or another moderate fitness routine can do the trick, according to the Mayo Clinic, as well as increasing the amount of healthy fats in your daily diet, such as salmon and avocado. Lean sources of protein are better for your heart health, dietitians say, instead of red meats.
Once plaque builds in the arteries, you can’t make it disappear, according to Harvard Health. But, lifestyle changes and medication can shrink and stabilize the amount of plaque you have.
Most American adults who are eligible for cholesterol medication aren’t on the drugs, a Johns Hopkins University study found last year. Among 5,000 U.S. adults who had never had a major cardiovascular event, 47 percent were eligible for cholesterol-lowering drugs but only 23 percent were taking them.
