High LDL Cholesterol: Best Approach?

I am 59 years old, in excellent physical condition, don’t smoke, and my blood pressure and HDL cholesterol are good. The only problem is my LDL cholesterol level, which is 170. My doctor wants to put me on medication immediately. Is high LDL really that dangerous?

– February 13, 2015

Very high levels of LDL cholesterol can contribute to arterial plaque build-up, but the risk needs to be put into perspective. Since you have no health problems, and assuming you don’t have a strong family history of heart disease, your personal risk is likely relatively low. The new cholesterol guidelines, which have been criticized for overly emphasizing drug therapy, do not recommend cholesterol medication for otherwise healthy individuals until the LDL is raised to 190 or more.

Regardless of whether you start cholesterol medication or not, your goal should be to focus on your diet and lifestyle to maintain optimal heart health, rather than obtain ideal lab results.

One of the most potent strategies is adopting an anti-inflammatory diet. Its principal features are five servings of vegetables and two servings of fruit every day, whole grains instead of products made from flour, more fish and less meat, and olive oil as the main dietary fat. This anti-inflammatory diet has been shown to reduce heart disease and vascular disease by 30% or more.

Regular exercise – as little as 30 minutes of brisk walking daily – can go a long way to keep your heart strong.

The mind/body connection is also key for heart health. Daily meditation has been shown to cut the risk of a heart attack by almost 50 percent. And simple breathing exercises have also been proven to lower blood pressure and reduce stress.

Nutrition, physical activity, and mind/body work are all completely within your control, and give you a lot more power over your heart health than you might realize.

Andrew Weil, M.D.

Stone NJ, Robinson J, Lichtenstein AH, et al. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. November 12, 2013 2013.

Estruch R, Ros E, Salas-Salvadó J, et al. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet. New England Journal of Medicine. 2013;368(14):1279-1290.

Schneider RH, Grim CE, Rainforth MV, et al. Stress Reduction in the Secondary Prevention of Cardiovascular Disease: Randomized, Controlled Trial of Transcendental Meditation and Health Education in Blacks. Circulation: Cardiovascular Quality and Outcomes. November 13, 2012 2012.

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