For years, the American College of Cardiology (ACC) and the American Heart Association (AHA) have maintained a set of cholesterol guidelines that are used by doctors—and the public—to measure heart health.
In November 2018, the two organizations—working in tandem with 10 other scientific organizations—updated those guidelines. We asked University of Minnesota Health Cardiologist Daniel Duprez, MD, PhD, a cardiovascular disease expert, to help us dig into these changes and understand what they mean for people concerned about their heart health.
Before we get to the guideline changes, let’s first briefly talk about cholesterol:
Cholesterol, which circulates in your blood, plays an important role in the body. It is used to build and rebuild the membranes—or walls—of every cell in the body. Cholesterol is also necessary to make steroid hormones, vitamin D and is crucial for brain health.
We couldn’t live without it. There are several subtypes of cholesterol, but they fall into several broad categories. High-density lipoprotein (HDL) is known as “good” cholesterol, and low-density lipoprotein (LDL), which is known as “bad” cholesterol.
Having bad cholesterol that is too high, good cholesterol that is too low, or both, is an important risk factor for cardiovascular disease, particularly a condition called atherosclerosis. Atherosclerosis is the buildup of fatty plaques and cholesterol in the walls of arteries, which can lead to heart attack, stroke, peripheral artery disease and other serious health problems.
Many factors can affect your heart health and contribute to the development of high cholesterol. In fact, better recognition of that fact is one of the most important changes to the ACC/AHA guidelines, said Duprez, who provides care for patients with lipid disorders through University of Minnesota Health Heart Care and the University of Minnesota Health Rasmussen Center for Cardiovascular Disease Prevention.
“A person’s risk for cardiovascular disease is determined by family history, genetic predisposition, ethnicity and other medical conditions,” Duprez said. “Lifestyle factors like high fatty diet, high sugar intake, lack of exercise and tobacco use are also important cardiovascular risk factors. Using these updated guidelines can help us tailor our care for each person.”
Some highlights of the new ACC/AHA guidelines include:
In order to get a clear picture of your cardiovascular disease risk, Duprez recommends the following steps:
“Most of these guidelines focus on age 40 to 75, because that is when atherosclerosis often becomes problematic. But you don’t need to wait until 40—start to have your lipids checked at age 20, because atherosclerosis build-up can begin much earlier,” Duprez said.