New recommendations released last month are signaling that Americans should start trying to lower cholesterol levels as early as age 30. The new guidelines were released by the American College of Cardiology in partnership with other medical organizations in the U.S. What do the new recommendations advise, and how can you make sure that you are complying with the advice? Read on for all of the details.

Know Your Numbers

Cholesterol levels impact a number of health risks, notably heart disease and stroke. The longer that these levels are not in check, the greater the threat to your overall health.

The first step in taking control of this facet of your health is to know your numbers. Adults should have their cholesterol checked at least once every five years beginning at age 19. A lipid panel blood draw will screen for several types of cholesterol. Health care professionals generally focus on the low-density lipoprotein (LDL) levels. This is what is known as "bad cholesterol," as it can build up along the artery walls. Doctors have long known that lower LDL levels translate to a lower risk of acute cardiovascular events.

The updated guidelines recommend that all adults check levels of Lipoprotein(a), a genetic form of cholesterol. Lp(a) inherently raises the risk of heart disease, even in the absence of other mitigating factors.

To take it one step further, it is advised to test the lipoprotein known as ApoB. This measurement gives the total number of risky cholesterol particles, including both LDL, Lp(a), and vLDL. Knowing all of these numbers will serve as a guide as you determine what steps to take to protect your health.

Understand Individual Risk

Once you know your key cholesterol numbers, you can talk with your doctor about your personal risk of heart disease. You are never too young to start focusing on good nutrition and exercise habits. Beginning at about age 30, a doctor can also offer a personalized prediction of future risk using a new calculator known as PREVENT. This metric takes into consideration personal risk factors, such as body mass index.

The PREVENT calculator assesses both the 10-year short-term risk and the 30-year long-term risk of a patient. The long-term risk assessment is particularly important for individuals between the ages of 30 and 59.

Patients with a low 10-year risk are not generally advised to begin medication to control the problem. Those at an intermediate risk may be advised to undergo a low-dose CT scan to investigate evidence of potentially dangerous plaque building in the arteries. This coronary arterial calcium (CAC) score then serves to provide doctors with more data to make recommendations. The evidence of plaque buildup often serves as motivation for asymptomatic patients to be more proactive about their health.

Health care providers will consider a variety of different factors when deciding whether or not to start a patient on preventative medication. Factors that naturally raise an individual's risk of heart disease include a diagnosis of diabetes, going through early menopause, being diagnosed with gestational diabetes or pre-eclampsia, or being of South Asian descent. Certain inflammatory conditions, including psoriasis and rheumatoid arthritis, also naturally increase the chances of having high cholesterol.

Make a Plan

Knowledge is power when it comes to being in charge of your health. Knowing your numbers and your individual risks will empower you to make a plan. Individuals who are at an intermediate 10-year risk and have not been diagnosed with heart disease or diabetes should aim for an LDL level below 100 mg/dL.

Individuals with a high 10-year risk, those with CAC scores over 100, or patients who have been diagnosed with Type 2 diabetes should try to keep LDL levels under 70 mg/dL. The goal is even more aggressive for those who have already suffered a stroke or heart attack. These patients should aim to keep LDL numbers below 55 mg/dL for the best outcomes. A dedicated plan to lower LDL levels can actually shrink the plaque in the body, providing long-lasting health benefits.

Your health care provider will be able to recommend the best medication for your needs and goals. Statins are typically the first line of defense, as they are inexpensive and effective. This type of medication works by blocking the liver from producing cholesterol to reduce negative outcomes.

Other medications that doctors lean on for patients with cholesterol concerns include ezetimibe and PCSK9 inhibitors. The takeaway is that if statins lead to too many side effects, there are other medications at your disposal to try. Some patients may need a combination of different medications to see the desired results.  The promising news for those who struggle with high cholesterol levels is that there are more options than ever to help manage high cholesterol.

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