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Lower LDL-C is better?
According to relevant statistics, the overall prevalence of dyslipidemia among adults in my country is as high as 40.40%, and with the continuous improvement of economic level, this proportion is still increasing. As we all know, long-term hyperlipidemia will increase the risk of cardiovascular and cerebrovascular diseases. Therefore, I always urge everyone to actively improve their living habits, have regular physical examinations, and take lipid-lowering drugs when necessary.
In recent years, people are paying more and more attention to their health. Whenever the physical examination finds abnormal indicators, they will try their best to meet the standards. What’s interesting is that some people work very hard, but don’t see positive results; there are a small number of people who “overshoot” and fall below the normal target… What’s going on? what to do? Let’s take low-density lipoprotein cholesterol (LDL-C) as an example and analyze it in detail.
Measures of LDL-C vary from person to person
Cholesterol is one of the important components of blood lipids and plays an important physiological function. However, there are also good and bad cholesterol in the human body. For example, LDL-C is “bad cholesterol” – “hyperlipidemia” caused by excessive LDL-C is the most common clinical condition. The specific indicators are as follows:
1. Healthy adults do not have any potential risks such as cardiovascular and cerebrovascular diseases, hypertension and diabetes. It is recommended to control LDL-C below 3.4mmol/L;
2. If the patient has diabetes, the LDL-C should be reduced to below 2.6mmol/L; if the duration of diabetes is more than 10 years, the LDL-C should be reduced to below 1.8mmol/L;
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3. For those with concurrent diabetes and cardiovascular and cerebrovascular diseases; for those with target organ damage such as kidneys and retinas; for those with simple diabetes for more than 20 years; for those with at least 3 risk factors ( age, hypertension, dyslipidemia, smoking, obesity), etc., it is best to reduce LDL-C to below 1.4mmol/L.
4. If the patient has at least 2 adverse cardiovascular events (such as myocardial infarction) within 2 years, LDL-C should be reduced to below 1.0mmol/L.
What should I do if my LDL-C doesn’t go down?
Many friends of patients diagnosed with hyperlipidemia told me: Doctor, I have been taking lipid-lowering drugs as prescribed by the doctor, but for several months, the blood test for LDL-C still exceeds the standard. What is this? What’s the matter?
First of all, it should be emphasized that hyperlipidemia is not a difficult disease. If all aspects are noticed, there is basically no “can’t lower” situation. Generally, it is because of negligence in this way that the lipid-lowering effect is not good, such as the following situations:
1. Lack of life management. Dyslipidemia is closely related to diet and lifestyle. Regardless of whether you choose lipid-lowering drugs, you should insist on controlling diet and improving living habits. However, some people think that taking lipid-lowering drugs can be ignored, such as eating too much meat, smoking and drinking, not exercising, staying up all night, etc. Little do they know that these bad living habits will largely offset the efficacy of lipid-lowering drugs.
2. Improper medication. Regarding blood lipid lowering, many people are obsessed with “activating blood circulation and removing blood stasis”. It is not that such drugs or health care products are ineffective, but their safety and effectiveness are discounted compared with statins; It is a drug that is three-point poisonous”, and it is impossible to insist on taking the medicine according to the amount, especially for some patients who need combined medication, there is always a situation of “sneakly reducing the medicine”. In either case, it is not conducive to maintaining a lasting effect.
It turns out that positive results can only be achieved when medication is combined with improving lifestyle habits.
Lower LDL-C is better?
Since LDL-C is “bad cholesterol”, the lower the better, so we have set different standards for different groups. The lower the defined level of coronary heart disease, the safer it is for patients with coronary heart disease.
Clinically, there will be a very small number of patients who continue to reduce blood lipids after reaching the target. For example, patients with coronary heart disease need to be reduced to 1.4mmol/L nominally, and the LDL-C of individual patients can continue to be reduced to 1.2mmol/L /L is even lower. At this point, the patient may wonder if LDL-C lowering too much is counterproductive. In fact, it is still safe to reduce LDL-C to 1.0mmol/L, so generally there is no need to worry.
However, cholesterol is an important component of human cell membranes and hormones, and chronically low levels may affect the normal function of cells and hormones. I see research data showing that if LDL-C is so low that it is almost undetectable, it will also cause low immunity to a certain extent and increase the possibility of depression in patients.
Source of this article: Wang Fangxin’s vision
Editor in charge: Yuan Xueqing, Zhang Li
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