Individuals who have high cholesterol counts and display other risk factors for heart disease should receive aggressive therapy targeted at the low-density lipoprotein, or "bad" cholesterol, in their bloodstream, a federal panel recommended Tuesday.
Dietary changes, weight loss and exercise are the therapies of choice for lowering cholesterol, the panel said in its report. Drugs should be regarded as a last resort, especially in adults who have high levels of high-density lipoprotein, or "good" cholesterol, and who are otherwise at low risk for heart disease.
In an accompanying report, the National Center for Health Statistics said average blood cholesterol levels in the United States have dropped significantly in the last 12 years. This reflects a trend that began in 1960 and parallels a continuing decline in heart disease.
Both reports appear this week in the Journal of the American Medical Association.
High cholesterol is a risk factor for heart disease, the nation's leading killer of both men and women. About 500,000 Americans die annually from heart disease, and an estimated 52-million have high cholesterol levels.
Cholesterol is a fatty substance found only in animal products. Saturated fats, which can be found in non-animal products, are turned into cholesterol by the body.
The report by the National Cholesterol Education Program, a panel convened by the National Heart, Lung and Blood Institute, is an update of its first set of treatment guidelines released in 1988.
The guidelines are used as a practice standard for the nation's physicians in determining the best form of therapy for patients with high cholesterol levels.