Physicians remind that the value of low-density cholesterol LDL-C (also known as bad cholesterol) should not be too high, so as not to increase cardiovascular risk; the picture shows a situational photo.


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[Health Channel/Comprehensive Report] Westernized diet and refined diets such as high sugar and high fat have made cardiovascular diseases tend to be younger. Physicians reminded that strict control of low-density cholesterol LDL-C (also known as bad cholesterol) is very important. , According to past literature, every 1 mmol/L lowering of low-density cholesterol (equivalent to 38.6 mg/dL LDL-C) can reduce major cardiovascular events by 22%. Therefore, patients with diabetes and chronic kidney disease should reduce "bad cholesterol" "(LDL-C) is reduced to below 100mg/dL, and if there is existing cardiovascular disease, it should be considered to be controlled below 70mg/dL.

Chen Jieyu, an attending physician at the Cardiovascular Center of Cathay Pacific Hospital, pointed out that coronary heart disease can be divided into acute and chronic, called "acute coronary heart disease" and "chronic coronary heart disease".

Myocardial infarction and unstable angina pectoris are collectively referred to as acute coronary heart disease, because the atherosclerotic plaques are unstable, and even the rupture of the plaques has caused vascular embolism, and the risk of sudden cardiac death is high, so it must be done urgently. medical treatment, and drug treatment must be more aggressive.

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European and American Heart Associations recommend strict control of LDL-C

For patients with acute coronary heart disease, the American Heart Association recommends lowering “bad cholesterol” (LDL-C) to at least 70 mg/dL, and the European Heart Association even recommends lowering LDL-C to at least 70 mg/dL in all high-risk patients 55mg/dL or less, and if a second cardiovascular event occurs within 2 years, consideration should be given to reducing LDL-C to less than 40mg/dL.

Based on domestic and foreign literature and expert recommendations, the Taiwan Society of Lipid and Arteriosclerosis has formulated guidelines recommending that all patients with coronary heart disease or acute coronary heart disease should reduce their LDL-C to below 70mg/dL. For patients with myocardial infarction, multiple coronary vascular disease or peripheral arterial occlusion, stricter LDL-C control should be considered to below 55 mg/dL; for other peripheral arterial occlusive diseases, ischemic stroke or temporary carotid artery stenosis All patients with acute cerebral ischemia are recommended to reduce LDL-C to below 70 mg/dL; in addition, if more than two of the coronary arteries, carotid arteries, and peripheral arteries are combined, lowering LDL-C to below 55 mg/dL should be considered.

Different risk groups suggest different values

In addition, it also provides control recommendations for the primary prevention of cerebrovascular and cardiovascular complications of abnormal cholesterol. It is recommended that high-risk groups: diabetes, chronic kidney disease (eGFR<60) or those with high basal LDL-C exceeding 190mg/dL, should directly convert LDL -C will be at least 100 mg/dL or less; for those with other cardiovascular disease risk factors, according to the level of risk factors, they should be given under non-drug control, such as: diet, exercise, lifestyle and other adjustments for at least 3 months , if LDL-C is still greater than 115mg/dL (more than two risk factors), 130 mg/dL (one risk factor), 160 mg/dL (no risk factor), then start cholesterol-lowering drug therapy.

Especially in the United States, the primary prevention age is relaxed to the 0-40-year-old group. After adjusting for other risk factors for arteriosclerosis, when LDL-C continues to exceed 190 mg/dL or LDL-C is greater than 160 mg/dL and there is premature arterial In patients with a family history of sclerosis or familial hypercholesterolemia, drug therapy should be considered.

Non-immediate harm Cardiovascular progressive sclerosis, stenosis

Chen Jieyu reminded that although the harm caused by cholesterol is not immediate, it will cause premature aging, hardening and stenosis of the cardiovascular system over time, resulting in related follow-up complications, and even causing myocardial infarction, cerebral apoplexy and death. Therefore, the control of cholesterol and related risk factors is very important.

In response to the raging new crown pneumonia (COVID-19) epidemic, in addition to external epidemic prevention, one should also pay more attention to the internal health of one's own body, in order to live a happy life.

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  • low density cholesterol

  • myocardial infarction　

  • bad cholesterol

  • LDL-C

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