Reaching your cholesterol targets

What are cholesterol targets?

Cholesterol targets are specific cholesterol levels that you are trying to reach with your cholesterol treatment plan. Your doctor will recommend cholesterol targets for you. Meeting these targets will help you reduce your risk of developing heart disease.

The most important cholesterol target is LDL-C (low-density lipoprotein cholesterol), the "bad cholesterol" that clogs your arteries and increases your risk of heart attacks and strokes. Regardless of your level of heart disease risk, the goal is to lower your LDL-C by at least 50%. Your doctor can determine what that specific number should be for you.

Once you have met your LDL-C goal, your doctor may suggest other "secondary" targets such as:

  • Total cholesterol to HDL-C ratio (also called your "ratio"): the ratio of total cholesterol to HDL-C (high-density lipoprotein, the "good cholesterol" that helps clean LDL-C out of your arteries). This number is calculated by dividing the level of total cholesterol by the level of HDL-C.
  • Non-HDL-cholesterol (non-HDL-C) measures all types of cholesterol other than HDL-C. It is equal to the total cholesterol (TC) minus the HDL-C. It is a good measure of how much harmful cholesterol a person has in their blood.
  • Triglycerides (TG) are not the same thing as cholesterol. They are another type of fat often found in the body. TG is tested at the same time as cholesterol. TG can increase the risk of heart attack and stroke. TG can also lower the levels of HDL-C.
  • ApoB to ApoAI ratio: the ratio of apoB (which is part of LDL-C and VLDL-C [very low-density lipoprotein cholesterol]) to apo AI (which is part of HDL-C). This number is calculated by dividing the level of apoB by the level of apoAI.

It's important to know your cholesterol levels and to keep your cholesterol in check by following your treatment plan. Effective treatment saves lives. Talk to your doctor to find out what your cholesterol levels are, what they should be, and what you can do to keep your cholesterol under control.

What are your cholesterol targets?

Your doctor will decide on your personal cholesterol targets. Your doctor will estimate your risk of developing heart disease in the next 10 years using calculations based on your age, gender, cholesterol levels, and other risk factors for heart disease.

To calculate your own risk, use our target cholesterol levels and heart disease risk calculator. The higher your risk of developing heart disease, the lower your cholesterol target levels will be.

Table 1 shows the cholesterol targets recommended in the latest Canadian cholesterol guidelines. Your doctor can determine what specific number that should be for you.

Table 1: Cholesterol targets

If your heart disease risk in the next 10 years is…

Then you should start treatment …

And your cholesterol treatment targets are….

Intermediate (10–19%)

  • when LDL-C is equal to or greater than 3.5 mmol/L or
  • when LDL-C is lower than 3.5 mmol/L but apoB is equal to or greater than 1.2 g/L or non-HDL-C is equal to or greater than 4.3 mmol/L
  • LDL-C less than or equal to 2 mmol/L or
  • apoB* less than or equal to 0.8 g/L or
  • non-HDL-C less than or equal to 2.6 mmol/L

High** (20% or greater)

  • immediately
  • LDL-C less than or equal to 2 mmol/L or
  • apoB less than or equal to 0.8 g/L or
  • non-HDL-C less than or equal to 2.6 mmol/L

*apoB = apolipoprotein, a protein that is part of LDL-C and VLDL-C and can cause inflammation in the blood vessels

**The high-risk group also includes people with diabetes or atherosclerosis-related diseases (e.g., heart disease, stroke, peripheral arterial disease)

Your doctor will recommend a simple blood test to measure your cholesterol levels to see if you are meeting your targets.

This will tell you whether your treatment plan is working successfully. Knowing and reaching your targets may help protect you from developing heart disease. If you have any questions about your cholesterol or cholesterol targets, speak to your doctor or pharmacist.

The next time you have a doctor's appointment, talk to your doctor about the progress you've made towards achieving your cholesterol targets.

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