Setting Goals - Dream Health

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Saturday, 7 April 2012

Setting Goals

You and your doctor will determine your treatment goals set against cholesterol. Clearly defined objectives will assess more easily the success of your treatment.

Your main objectives will be therapeutic to target your target cholesterol levels. The target values
​​determined depend on the level of your baseline and your risk of heart disease. Your doctor will calculate your risk of heart disease, or you can calculate it yourself here. Whatever your level of risk of heart disease and how you treat your high cholesterol, the goal for everyone is to reduce LDL ("bad" cholesterol) at least 50%.

Here are the usual targets of cholesterol:

If your risk of heart disease over the next 10 years is ... You'll need to start treatment ... And your cholesterol targets are ...
Moderate risk (10-19%) For most people:

when LDL-C is greater than 3.5 mmol / L, or

when the ratio CT / HDL-C is greater than 5.

Among men over 50 and women over 60 years:
when hsCRP *** is greater than 2.0 mg / L (regardless of whether the LDL-C is high).
Lowering LDL-C at least 50%, or

Reach a level of LDL-C below 2.0 mmol / L, or

Achieve a rate of apo B * less than 0.8 g / L.
High risk ** (20% or more) Immediately Lowering LDL-C at least 50%, or

Reach a level of LDL-C below 2.0 mmol / L, or

apo B Less than 0.8 g / L
* Apo B = apolipoprotein: protein part of LDL-C and VLDL, which can cause inflammation in blood vessels.

** The high risk group also includes people with diabetes or a disease related to atherosclerosis (eg. Heart disease, stroke, peripheral vascular disease).

*** CRP (CRP) is a protein that produces the liver when there is inflammation in the body. That's why they say it is a marker of inflammation. The C-reactive protein can be measured by assaying the rate of hsCRP (C-reactive protein high sensitivity), also called hsCRP assay.

The targets set out in the table above are only recommendations - your doctor may recommend that you aim for even lower values
​​(eg, a reduction of over 50% in LDL-C). With respect to LDL cholesterol, the general rule is "the higher the rate is lower, the better." For each reduction of 1.0 mmol / L LDL cholesterol, your risk of certain complications associated with heart disease (cardiac death and heart attack) decreases from 20 to 25%.

Although LDL cholesterol is the most important target, your doctor may establish other targets "secondary", especially when you reach your goal LDL-C, for example:

Secondary targets Usual targets
Ratio CT/C-HDL less than 4.0
Triglycerides less than 1.7 mmol / L
hsCRP less than 2.0 mg / L
Non-HDL cholesterol (HDL-C less than CT) less than 3.5 mmol / L
Ratio apo B / apo AI (apo B is part of the LDL-C and VLDL-C and apo AI is part of HDL-C) less than 0.80

Although triglyceride levels be measured during the determination of cholesterol, the Canadian guidelines for the management of cholesterol does recommend more valuable therapeutic target for triglycerides. However, a triglyceride level of 10.0 mmol / L or higher requires treatment because of the increased risk of pancreatitis (inflamed pancreas). Triglyceride levels should ideally be below 1.5 mmol / L.

Your doctor may also recommend other therapeutic purposes, for example:
  •     achieve and maintain a healthy weight;
  •     quit smoking;
  •     control your blood pressure;
  •     control your blood sugar.

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