My LDL is high — what should I do?
Elevated LDL-C is interpreted alongside ApoB, Lp(a), and absolute cardiovascular risk. Diet, weight, and aerobic training are first-line. Pharmacologic therapy is escalated against risk and patient preference under provider review.
Full answer
LDL-C alone underestimates risk when particle size is small and dense. The full picture pairs LDL-C with ApoB, Lp(a) once in a lifetime, hs-CRP, HbA1c, and family history. Lifestyle change — saturated fat reduction, fiber, weight optimization, aerobic and resistance training — is first-line and often meaningful. Statins, ezetimibe, bempedoic acid, and PCSK9 inhibitors are escalated against absolute 10-year and lifetime risk, age, family history, and patient preference. Hormone optimization, when indicated for other reasons, is monitored against the lipid trajectory.
Educational. Not a substitute for individualized provider review.
- Methodology — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-06-03