From the Research
For a 46-year-old female on statin therapy, the goal cholesterol numbers should include an LDL cholesterol below 70 mg/dL, as this target has been associated with the greatest reduction in cardiovascular risk without a significant increase in adverse events, as supported by the most recent and highest quality study 1. The goal of statin therapy is to reduce the risk of cardiovascular events, and the most effective way to achieve this is by lowering LDL cholesterol levels.
- Total cholesterol should ideally be under 200 mg/dL,
- HDL cholesterol above 50 mg/dL for women, and
- triglycerides below 150 mg/dL. These targets may be adjusted based on her specific risk profile, with more aggressive goals for those with diabetes, existing heart disease, or multiple risk factors. Regular monitoring of cholesterol levels every 3-6 months initially, then annually once stable, is recommended to assess statin effectiveness. Lifestyle modifications including a heart-healthy diet, regular exercise, weight management, and avoiding smoking should complement medication therapy for optimal cholesterol management. The use of ezetimibe in addition to statin therapy may be considered for patients who do not achieve their LDL cholesterol goals with statin therapy alone, as it has been shown to provide additional benefit in reducing cardiovascular risk 2. However, the primary goal should be to achieve an LDL cholesterol level below 70 mg/dL, as this has been shown to be the most effective target for reducing cardiovascular risk 1.