Expert: Todd Bublitz, RCEP - 7/15/2006

Question
The levels for cholesterol used to be 200 and I have been told that the drug companies got it lowered to sell more of the cholesterol reducing drugs; do you know the story on this?  What is the cholesterol level for a 66 year old man? Thank you

Answer
Brenda,

I have no love for the pharmaceutical companies, but the idea that THEY had the goals for cholesterol levels lowered is ridiculous.

There has been no target level for total cholesterol since 1993.  In 1993 the National Cholesterol Education Program  developed the Adult Treatment Panel guidelines.  These guidelines have goals for LDL (bad cholesterol) levels, not for total cholesterol.  Before these guidelines, the American Heart Association had recommended that a total cholesterol level of 240 or above was "high" and a total cholesterol level of less than 200 was "acceptable".  For the patients I used to treat, when the LDL level was at goal, the total cholesterol level was usually around 120-160 mg/dL.  In 2001, the Adult Treatment Panel guidelines were updated for a third time based on recent clinical trials - and modified again in 2004.  

Go to the National Cholesterol Education Program website and download the Adult Treatment Panel summary (pdf file).  Go to page 5 through 8 and look at all the people, organizations and government agencies that had a hand in developing, writing and reviewing the guidelines.  Here is the website:
http://www.nhlbi.nih.gov/guidelines/cholesterol/atp_iii.htm
http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3xsum.pdf

Less than half of the people in America that should be on a cholesterol lowering medicine are actually taking one.  The pharmaceutical companies don't need to lower the goals to sell more medicine, they just need to raise awareness that most people with high cholesterol are not being treated.  This is why you see so many TV commercials for Lipitor, Crestor and Zocor.

I spent several years treating people with high cholesterol and conducting clinical trials and I can tell you that it would be IMPOSSIBLE for the pharmaceutical companies to influence the policy makers enough to change goal values.  The conspiracy would need to include tens of thousands of government officials, the American Medical Association, the researchers, and independent clinicians.  ALSO, much of the research is done in Europe.  You'd have to include thousands of people in Europe in your conspiracy.  It just could not happen!

If you want to dig into a conspiracy, take a look at the new "Medicare Prescription Drug Improvement & Modernization Act of 2003".  According to the law it is illegal for Medicare to negotiate with the pharmaceutical companies for lower prices.  The Congress and the President made it illegal for Medicare to negotiate with the pharmaceutical companies for lower prices.  The Veterans Administration negotiates with the pharmaceutical companies for lower prices.  The average cost of the most popular prescription drugs is 43% lower in the VA system than in the new Medicare program.  Since the new Medicare drug program went into effect, the wholesale prices of brand-name prescription drugs increased 3.9% in the first quarter of 2006, the largest quarterly increase since 2000.  Our Government and the pharmaceutical companies are engaging in price fixing and the pharmaceutical companies will make BILLIONS of dollars (our tax dollars) from this Medicare Prescription Drug program.  House Democrats recently announced a proposal to modify the program to require the Centers for Medicare & Medicaid Services to negotiate lower drug prices.

"What is the cholesterol level for a 66 year old man?"  I think you are asking "what is a good cholesterol level for a 66 year-old man"...?  It would depend on his overall risk of cardiovascular disease.  You can figure that out at this web page:
http://www.lipid-clinic.com/levels.html

I hope this helps.

Todd