•     Known coronary artery disease

•     Other known signs of atherosclerosis such as peripheral artery disease (eg. Intermittent claudication), blocked carotid arteries (which lead to the brain), or aortic aneurysms.

•     Diabetes mellitus

•     Chronic kidney failure, or kidney transplantation

•     Aboriginal or Torres Strait Islander

•     Familial hypercholesterolemia (a genetic disorder)

•     Familial combined hyperlipidaemia (another kind of genetic disorder)

•     If your total cholesterol is >6mmol/L or LDL is >4mmol/L, and you have any 2 or more of the following risk factors:

•     HDL<1.0mmol/L

• Significant family history of heart disease

•     High blood pressure (hypertension)

• Overweight or obesity

• Smoking

• Impaired fasting glucose (blood sugar level between 6.1 and 6.9mmol/L)

•     Age >45 years

•     Below normal levels of albumin in the blood and/or impaired kidney function.

If you fall into this category, the target levels recommended for you by the Heart Foundation are as follows:

Total cholesterol:         < 4.0mmol/L

HDL cholesterol:         > l.0mmol/L

LDL cholesterol:         <2.5mmol/L

Triglycerides:         < 2.0mmol/L

If your blood test results do not match up to these standards, your doctor is supposed to ask you to follow a cholesterol lowering diet (this usually means a low fat diet) for six weeks and then retest your lipid levels. Almost everyone will not be able to achieve the low levels of blood fats recommended; nor is it necessarily healthy. With a cholesterol level that low you will probably be feeling ill in other ways. The next step then is to put the patient on cholesterol lowering drugs.

It is very easy to fall into this “high risk” category; all you need to be is over 45 years of age and overweight, with a total cholesterol level above 6.0mmol/L and you qualify for drug treatment. No wonder such a high proportion of the population are making the drug companies richer at the expense of their health. Studies have shown that the cholesterol lowering drugs statins and fibrates may increase the risk of cancer, and thus should be restricted to only the most urgent cases. These studies seem to have been forgotten.

*14/53/5*