> Some even say cholestrol is not bad The main change recently has been an update to the ACC/AHA LDL guidelines about LDL targets. Previously, there were hard

> Some even say cholestrol is not bad The main change recently has been an update to the ACC/AHA LDL guidelines about LDL targets. Previously, there were hard targets that the doctor was trying to reach, in particular the 70mg/dl target was considered "optimal" and doctors strived to get their patients down to that. In reality, it's become clear that there is no clinical evidence that an LDL that low is required. Certainly decreasing it from a high level (150+) has been shown to be a good idea (in most cases...it's complicated). But once you've decreased a patients LDL to a lower level, the clinical benefit of hitting 70 is nebulous. So the new recommendations have dropped many of the hard targets, and recommend a more case-by-case evaluation. E.g. if your patient has a high LDL and you put them on a statin, they start exercising, eating better, and levels come down to 80mg/dl ... well, that's probably fine. They are in good shape, monitor and back off the statins. A major reason for the change is because you'd see people on statins and other cholesterol meds for years. These drugs are very safe and low side-effect, and when combined with hard targets, doctors just "leave" patients on statins forever. But despite being safe, you shouldn't be on a chronic medication and there are other risks. So the new guidelines are trying to encourage doctors to use statins more sparingly. Some more reading on the new guidelines: - http://emorymedicinemagazine.emory.edu/issues/2014/spring/features/guidelines-for-treating-cholesterol/index.html http://emorymedicinemagazine.emory.edu/issues/2014/spring/fe... - http://www.medscape.com/viewarticle/814152 http://www.medscape.com/viewarticle/814152