2010年运程

1）确定罹患心血管疾病的高风险人群

最终继续发展为心血管疾病的人通常在患有LDL-C升高多年后才会出现任何症状。因此，测量LDL-C有助于预测心血管疾病的几率，使您可以在它引起任何问题之前对其进行处理。

In fact, in the UK, the first line lipid test to identify people with ‘high cardiovascular risk’ is not LDL-C, but another parameter derived from the lipid profile called the 总胆固醇 : HDL胆固醇比. The LDL-C would almost always be checked at the same time, and does provide additional information to the total cholesterol : HDL cholesterol ratio. For example, if it is very high, this can sometimes indicate specific conditions such as ‘familial hypercholesterolaemia’.

2）在已知罹患心血管疾病的高风险人群中，监测他们对治疗的反应

如果发现您患心脏病的风险增加，通常建议您改善生活方式，例如改善饮食，还可能为您提供可降低LDL-C的治疗药物，例如他汀类药物。在这两种情况下，通常都会对LDL-C进行监测，以了解您对饮食进行的治疗或更改是否有效。

LDL-C，作为脂质分布，通常会在您40岁时由GP进行测试，这是常规心血管健康检查的一部分。

如果您由于其他原因被认为有增加患心血管疾病的风险，可能会在其他时间进行检查。

最后，可能会定期检查是否接受处方治疗以帮助降低LDL-C，例如他汀类药物。

升高的LDL-C浓度会增加您患上发育不良的风险心血管疾病。但是，如上所述，在英国，通常是一个不同的参数，称为总胆固醇 : 高密度脂蛋白胆固醇 ratio ?which is used to identify people at high risk. This is used in conjunction with other factors such as age, gender, smoking, blood pressure, being overweight, to estimate your chances of developing heart disease in the future. If this indicates you might be at high risk, the LDL-C is then used as a ‘target’ for you to aim for. Your doctor would then usually recommend dietary changes and possibly medical treatments to help reduce your LDL-C down to this target.

In the UK, the target LDL-C for people at high risk of cardiovascular disease is usually ‘no more than 2.0 mmol/L’. A fall of 30% from the pre-treatment level is also used as an alternative target. Bear in mind that the lower your LDL-C, the lower your chances of cardiovascular disease, so there are additional (albeit small) benefits to an even lower LDL-C than 2.0 mmol/L. Furthermore, it means that if your LDL-C was very high to start off with (when getting down to 2.0 mmol/L may not be possible), any reduction you get with dietary improvements or medications will be beneficial.

如果您不被认为具有心血管疾病的高风险，则没有LDL-C的官方目标。但是，许多医生认为不超过3.0 mmol / L是可取的。

在称为“家族性高胆固醇血症”的家庭中存在这种情况，其中LDL-C很高-成人通常超过4.9 mmol / L。 LDL-C偏高的一些人（尽管不是全部）患有家族性高胆固醇血症。这是一种遗传病，很重要，要加以恢复，就好像不加以治疗一样，年轻时患心脏病的风险很高。此外，由于继承，其他家庭成员可能会受到影响。任何怀疑患有家族性高胆固醇血症的人都应转诊到专业的血脂诊所。

当一个人健康时，应该测量LDL-C。急性疾病后，LDL-C暂时低心脏病发作，或在压力下（例如由于手术或意外事故）。您应该在任何疾病发生后至少等待六周来测量LDL-C。

在女性中，胆固醇高怀孕。妇女应在婴儿出生后至少等待六周，以进行LDL-C测定。

The first step in treating high LDL-C is adoption of a healthy diet. In particular, people are often advised to reduce saturated fat intake, and increase intake of foods which are known to lower LDL-C, including vegetables, oats, soya, nuts, and some spreads fortified with ‘plant stanols’ or ‘plant sterols’. For advice on how to lower cholesterol through diet and lifestyle, visit the HEART UK网站.

If dietary changes alone do not adequately lower LDL-C, drugs may be prescribed. A class of drug called ‘statins’ is usually used first line. Statins have been around for many years and there is excellent evidence that they are effective in lowering LDL-C, and have a low rate of side effects.?