Current guidelines for lowering cholesterol may not be stringent enough

Lower may be better, perhaps even stopping heart disease in its tracks, they say. A new study looking at the growth of plaque in arteries of heart disease patients came to that conclusion.

But there is just one problem. While it has become increasingly easier and more feasible to lower cholesterol levels, most people whose levels are dangerously high either do not know it or are not doing much about it.

Recent national data from the Centers for Disease Control and Prevention illustrate the problem. Sixty percent of people with high cholesterol levels did not know that they were high. Of those who knew, only 14 percent were taking a cholesterol-lowering drug and only 7 percent were getting their cholesterol within the recommended limits.

The guidelines in question recommend that levels of low density lipoproteins, or L.D.L., which carry cholesterol to the arteries, be below 100 for those at highest risk, below 130 for those of more moderate risk, and below 160 for others. Large clinical trials found that lowering L.D.L. to such levels sharply decreases the risk of heart attacks.

A study sponsored by Pfizer, reported last month, indicated that lower may be better. Plaque growth stopped in heart patients whose L.D.L. levels dropped to about 80 while it slowly continued in those with levels of about 110.

After years of trying "every diet I could think of to lower cholesterol" and taking herbs and supplements, Ms. Hament said, she has finally gotten her cholesterol down with a low-carbohydrate diet and a weight loss of about 15 pounds.