The Importance of Reaching Your Target Cholesterol Levels
It could have life-saving effects.

When your doctor tells you that your cholesterol levels are too high, you might think, “Well, I feel fine.” That’s because high cholesterol on its own doesn’t necessarily cause symptoms. However, reaching target cholesterol levels is an investment in your long-term health. After all, high cholesterol can take a toll on your health.
The Health Risks of High Cholesterol
High cholesterol is a significant risk factor for heart disease, particularly a subtype called atherosclerotic cardiovascular disease (ASCVD). This can then increase your risk for heart attacks and strokes.
When you have too much LDL (“bad”) cholesterol in your body, it builds up in your blood vessels. Here, it hardens and forms plaque, which narrows and hardens the arteries. This process is known as atherosclerosis. It can partially or completely block blood flow to the heart (a heart attack) or the brain (a stroke).
“When we think about atherosclerotic heart disease, we're specifically looking at the blood vessels that are supplying blood to the heart muscle,” says Lawrence Phillips, MD, cardiologist at NYU Langone Health. “The reason that's important is because when you have narrowing in those blood vessels, you're at an increased risk of having symptoms like chest pain or shortness of breath, but also of having problems, such as heart attack.”
Keep in mind that heart disease is the leading cause of death in the United States, and stroke is the fifth leading cause of death. That means managing your cholesterol levels may be an important tool in mitigating your risk of these common problems.
Understanding Target Levels
“It's important to reduce your cholesterol when you're at high risk because it's going to decrease your risk of having a stroke or a heart attack,” says Dr. Phillips. “We need to make sure that when people are looking at their high cholesterol, that they're learning the risks over the long term and seeing the benefit that comes from aggressively treating it early on.”
There is not a defined “perfect” cholesterol level, but in general, your total cholesterol level should be less than 200 mg/dL (milligrams per deciliter). More specifically, your LDL level should be at or below 100 mg/dL.
If your doctor is concerned about your cholesterol profile, you have many ways to reach your target cholesterol levels. This may start with heart-healthy lifestyle changes, such as:
- Reducing intake of saturated fat
- Eliminating intake of trans fats
- Exercising regularly
Additionally, there are many effective medicines that can help lower LDL cholesterol. The most common treatment for high cholesterol is statin therapy.
“A statin medication impacts the way that cholesterol is produced by the liver, and can be beneficial by reducing your cholesterol almost 50 percent,” says Dr. Phillips. Your doctor may recommend statins or other medicines if lifestyle changes aren’t enough to reach your target cholesterol levels.
“We have lots of medications that can be used with different classes that will impact and lower your cholesterol, [and] it's a teamwork between me, their physician, and them as the patient, to come up with a plan that works best for them,” says Dr. Phillips.
Lawrence Phillips, MD, is a cardiologist at NYU Langone Health. Dr. Phillips is the assistant professor of the Department of Medicine at NYU Grossman School of Medicine, the assistant clinical director for strategic affairs at Leon H. Charney Division of Cardiology, the director of the Nuclear Cardiology Laboratory, the medical director for Outpatient Clinical Cardiology, and the associate director of the Cardiovascular Disease Fellowship Program.
00:00:00.000 --> 00:00:01.999
(upbeat electronic music)
00:00:02.000 --> 00:00:05.966
There are some hard, fast rules
when it comes to cholesterol,
00:00:05.967 --> 00:00:08.332
where you really want someone to have lower numbers.
00:00:08.333 --> 00:00:11.666
Ideally, you want the total cholesterol
00:00:11.667 --> 00:00:14.232
to be below 200 to 240,
00:00:14.233 --> 00:00:16.532
and their LDL, their 'bad' cholesterol,
00:00:16.533 --> 00:00:18.666
to be less than 160.
00:00:18.667 --> 00:00:21.466
However, the aggressiveness we're going to use
and the decision
00:00:21.467 --> 00:00:25.966
to use medications versus
just lifestyle modifications alone
00:00:25.967 --> 00:00:28.799
will be dependent on other factors as well.
00:00:28.800 --> 00:00:33.666
(upbeat electronic music)
00:00:33.667 --> 00:00:36.966
It's important to reduce your cholesterol
if you're at higher risk
00:00:36.967 --> 00:00:39.332
because it's gonna decrease your risk of having
00:00:39.333 --> 00:00:41.199
a stroke or a heart attack.
00:00:41.200 --> 00:00:43.699
For most people who don't have other medical problems,
00:00:43.700 --> 00:00:45.132
it's a very difficult concept
00:00:45.133 --> 00:00:48.266
because they're not used to taking medications.
00:00:48.267 --> 00:00:50.832
However, we need to make sure
00:00:50.833 --> 00:00:53.266
that when people are looking at their high cholesterol,
00:00:53.267 --> 00:00:56.566
that they're learning the risks over the long term
00:00:56.567 --> 00:00:58.366
and seeing the benefit that comes
00:00:58.367 --> 00:01:00.666
from aggressively treating it early on.
00:01:00.667 --> 00:01:02.166
So to lower your cholesterol,
00:01:02.167 --> 00:01:04.666
we first start with lifestyle modifications,
00:01:04.667 --> 00:01:08.399
and that includes increasing exercise programs
00:01:08.400 --> 00:01:10.966
so that you're decreasing your sedentary lifestyle.
00:01:10.967 --> 00:01:15.399
It includes changing your diet to decrease fats,
00:01:15.400 --> 00:01:17.232
decrease fried foods,
00:01:17.233 --> 00:01:19.599
decrease some of your cheese intake,
00:01:19.600 --> 00:01:21.566
and increase your vegetable.
00:01:21.567 --> 00:01:24.999
If you're a smoker, it's a great opportunity
to stop smoking
00:01:25.000 --> 00:01:27.399
because we know that smoking increases your risk
00:01:27.400 --> 00:01:29.232
of developing narrowing your blood vessels,
00:01:29.233 --> 00:01:31.932
but also increases the risk of rupturing a plaque,
00:01:31.933 --> 00:01:34.132
which causes a heart attack or a stroke.
00:01:34.133 --> 00:01:37.432
Once we go beyond the lifestyle modifications,
00:01:37.433 --> 00:01:39.566
we think about medications.
00:01:39.567 --> 00:01:43.832
Medications, the first-line for cholesterol is a statin.
00:01:43.833 --> 00:01:47.332
A statin medication impacts the way that cholesterol
00:01:47.333 --> 00:01:50.532
is produced by the liver, and can be beneficial
00:01:50.533 --> 00:01:53.966
by reducing your cholesterol almost 50 percent.
00:01:53.967 --> 00:01:55.732
When I see patients who are struggling
00:01:55.733 --> 00:01:59.199
to reach their target cholesterol levels,
00:01:59.200 --> 00:02:02.066
I tell them, first, it's very common.
00:02:02.067 --> 00:02:03.966
We have lots of tools in our tool belt.
00:02:03.967 --> 00:02:06.232
We have lots of medications that can be used
00:02:06.233 --> 00:02:07.866
with different classes
00:02:07.867 --> 00:02:10.999
that will impact and lower your cholesterol.
00:02:11.000 --> 00:02:13.766
I also tell patients that when they get frustrated
00:02:13.767 --> 00:02:16.332
we're looking at a longitudinal result.
00:02:16.333 --> 00:02:19.632
We're looking to reduce their cholesterol over years,
00:02:19.633 --> 00:02:22.066
not just over a couple days,
00:02:22.067 --> 00:02:24.932
and that if it takes extra work, that's okay.
00:02:24.933 --> 00:02:26.067
(electronic music fades)
- High cholesterol facts. Atlanta, GA: Centers for Disease Control and Prevention. (Accessed on September 16, 2020)
- LDL and HDL cholesterol: “bad” and “good” cholesterol. Atlanta, GA: Centers for Disease Control and prevention, 2020. (Accessed on September 16, 2020)
- Patient education: high cholesterol and lipid treatment options (beyond the basics). Waltham, MA: UpToDate, 2020. (Accessed on September 16, 2020)