Canadian Cardiovascular Society medication guidelines for high cholesterol
The Canadian Cardiovascular Society's recommendations for treatment with medicine are based on cholesterol levels and the number of risk factors you have for heart attack.1 The guidelines provide a good starting point for treatment. Individual risk assessment is important to determine whether starting medicine to lower your cholesterol is appropriate for you.
If you have any risk for heart disease, therapeutic lifestyle changes (losing weight, exercising, and eating a diet that is low in saturated fat) are recommended, whether or not you are taking medicine.
Risk factors for heart disease include:
- Smoking cigarettes.
- Having high blood pressure or taking blood pressure medicine.
- Diabetes.
- Low HDL cholesterol (below 1.0 mmol/L).
- Having a first-degree male relative, such as a father or brother, who had heart disease before he was 55 years old; or having a first-degree female relative, such as a mother or sister, who had heart disease before she was 65 years old.
- Age. People over 65 are more likely to have coronary artery disease (CAD).
Use this Interactive Tool: Are You at Risk for a Heart Attack?
Low risk
People who are at low risk do not have coronary artery disease (CAD) and have a 10% or lower chance of having a heart attack in 10 years. Consider starting medicine when:
- LDL is 5.0 mmol/L or higher. The goal of medication is to lower LDL by 40% or more.
Intermediate risk
People who are at intermediate risk for CAD have a 10% to 19% risk of having a heart attack in 10 years.
Consider starting medicine when:
- LDL is 3.5 mmol/L or higher. The goal of treatment with medicine is to lower LDL by 40% or more.
High risk
People who are at high risk for CAD have more than a 20% chance of having a heart attack in 10 years and have CAD, have had a heart attack, have stable or unstable angina, or have had angioplasty or bypass surgery. This category also includes people who have diseases or conditions that are considered equally as serious as CAD, such as peripheral arterial disease, abdominal aortic aneurysm, transient ischemic stroke or ischemic stroke, chronic kidney disease, and diabetes.
It is recommended that people at high risk for CAD consider taking medicine to control LDL cholesterol levels. The goal of treatment for people at high risk is to reduce LDL levels to a level of 2.0 mmol/L (80 mg/dL) or less, or a reduction of 50% or more.
| Author: | Douglas Dana Robin Parks, MS | Last Updated: September 21, 2007 |
| Medical Review: | Anne C. Poinier, MD - Internal Medicine Caroline S. Rhoads, MD - Internal Medicine Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology Robert A. Kloner, MD, PhD - Cardiology Ruth Schneider, MPH, RD - Diet and Nutrition | |
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