How low should my LDL be?
LDL cholesterol, often referred to as “bad cholesterol,” and HDL cholesterol, known as “good cholesterol,” are two of the main types of cholesterol found in the blood. While LDL cholesterol can contribute to the buildup of plaque in the arteries, HDL cholesterol helps to remove excess cholesterol from the body. In recent years, guidelines for healthy levels of LDL and HDL cholesterol have been developed by various medical organizations, including the American College of Cardiology (ACC), the European Society of Cardiology (ESC), and the Cardiac Society of Australia and New Zealand (CSANZ).
According to the ACC, the goal for LDL cholesterol is less than 70 mg/dL for those at highest risk of heart disease, less than 100 mg/dL for those at moderate risk, and less than 130 mg/dL for those at low risk. The ESC recommends a similar goal for LDL cholesterol, but with a slightly higher threshold for those at moderate risk (less than 115 mg/dL). The CSANZ, however, has a slightly different approach, with a recommended target of less than 2.5 mmol/L for all adults.
For HDL cholesterol, the ACC recommends a level of at least 40 mg/dL for men and at least 50 mg/dL for women. The ESC and CSANZ also recommend similar goals for HDL cholesterol, with targets of at least 40 mg/dL and at least 1.03 mmol/L, respectively.
Over the last 50 years, the goals for LDL cholesterol have become increasingly lower as more research has linked lower LDL cholesterol levels with a reduced risk of heart disease. In the 1970s and 1980s, guidelines recommended LDL cholesterol levels of 130-160 mg/dL, but these targets have gradually been lowered over time to the current goals. Similarly, the target for HDL cholesterol has also been increased over time, as research has shown that higher levels of HDL cholesterol are associated with a lower risk of heart disease.
In summary, the American College of Cardiology (ACC), European Society of Cardiology (ESC), and Cardiac Society of Australia and New Zealand (CSANZ) all have similar goals for LDL and HDL cholesterol. However, these goals have changed over the past 50 years as new research has emerged, with the targets for LDL cholesterol becoming increasingly lower, and those for HDL cholesterol becoming increasingly higher.