EXPEDITED REVIEW
Optimal low-density lipoprotein is 50 to 70 mg/dl
Lower is better and physiologically normal
James H. O'Keefe, Jr, MD*,*,
Loren Cordain, PhD ,
William H. Harris, PhD*,
Richard M. Moe, MD, PhD* and
Robert Vogel, MD
* Mid America Heart Institute, Cardiovascular Consultants, Kansas City, Missouri, USA
Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado, USA
University of Maryland, University of Maryland Hospital, Baltimore, Maryland, USA
Manuscript received March 14, 2004;
accepted March 15, 2004.
* Reprint requests and correspondence: Dr. James H. O'Keefe, Jr., Mid America Heart Institute, Cardiovascular Consultants, 4330 Wornall Road, Suite 2000, Kansas City, Missouri 64111, USA.
jhokeefe{at}cc-pc.com
The normal low-density lipoprotein (LDL) cholesterol range is 50 to 70 mg/dl for native hunter-gatherers, healthy human neonates, free-living primates, and other wild mammals (all of whom do not develop atherosclerosis). Randomized trial data suggest atherosclerosis progression and coronary heart disease events are minimized when LDL is lowered to <70 mg/dl. No major safety concerns have surfaced in studies that lowered LDL to this range of 50 to 70 mg/dl. The current guidelines setting the target LDL at 100 to 115 mg/dl may lead to substantial undertreatment in high-risk individuals.
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Abbreviations and Acronyms
| | CHD | = coronary heart disease | | LDL | = low density lipoprotein | | NCEP-ATP-III | = Natural Cholesterol Education Program-Adult Treatment Panel-III |
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