What are the Accepted Cholesterol Guidelines?

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  • Written By: Karyn Maier
  • Edited By: Bronwyn Harris
  • Last Modified Date: 24 December 2018
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Ever since the medical community first raised the alarm about the health hazards of cholesterol, it’s almost come to be known as a “dirty” word. However, we can’t live without it. In fact, cholesterol is found in virtually every cell of the body, where it is used to regulate hormone production, to initiate digestion, and to manufacture vitamin D. On the other hand, too much of this substance in circulation in the blood can lead to serious problems, like heart attack or stroke. To help reduce this risk, and clear up confusion about healthy cholesterol ratios, national cholesterol guidelines have been established in the U.S.

These guidelines are in accordance with the recommendations of The National Cholesterol Education Program (NCEP). Aside from providing specific numbers representing desirable levels of “good” and “bad” cholesterol, the agency also offers clinical guidelines in the testing and management of cholesterol. Periodically, these guidelines undergo review and update, with the most recent being made in 2004. The current version, entitled Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), is in development for a new release.


The new cholesterol guidelines are expected to address recent findings that previous recommendations may have been insufficient. The basis for this stems from a national study that revealed that almost 75 percent of heart attack patients surveyed did not exhibit cholesterol levels that would put them at risk for heart disease per the national cholesterol guidelines. In fact, approximately half of these patients had LDL levels, the “bad” kind of cholesterol, at or below guideline recommendations.

Cholesterol is measured via blood tests, with results being calculated to reflect serum levels of high density lipoproteins (HDL), low density lipoproteins (LDL), and triglycerides. In addition, total cholesterol is also considered. According to the current cholesterol guidelines, the optimum amount of circulating LDL cholesterol is 100 mg/dL or less, with 160 mg/dL being too high. The desirable level of HDL cholesterol is 45 mg/dL for men and 55 mg/dL for women. Ideally, triglycerides should remain below 150 mg/dL and total cholesterol under 200 mg/dL.

In order to adhere to these guidelines, the American Heart Association recommends a dietary cholesterol intake of 200 to 300 mg daily. The lower number is directed toward persons at higher risk for heart disease from factors such as obesity, smoking, or a family history of stroke or heart attack. Additional recommendations include regular exercise and stress management, which have been shown to help reduce LDL cholesterol levels while improving HDL cholesterol levels.



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