THE PROBLEM of what constitutes average, normal, and optimal levels of serum cholesterol and how the results of tests to determine these levels should be applied to clinical practice still bedevils us. High levels of serum cholesterol are associated with an increased incidence of atherosclerosis and death, and a constantly low serum cholesterol level appears protective in this regard. The risk of complications associated with elevated cholesterol levels is increased when other risk factors such as hereditary premature atherosclerosis, hypertension, smoking, and diabetes occur concomitantly. Average levels vary substantially with different ethnic and geographic populations, specific hereditary traits, a number of diseases, and a wide range of dietary habits. This statement is directed to the situation as it exists in the United States today.
Leading investigators are now widely recommending that the uppermost acceptable level should be 240 mg/100 ml, based on the standard Abell-Kendall method. This is consistent with
Wright IS. Correct Levels of Serum Cholesterol: Average vs Normal vs Optimal. JAMA. 1976;236(3):261–262. doi:10.1001/jama.1976.03270030015018
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