What strategies can increase his HDL cholesterol level?
Summary and Recommendations A low level of HDL cholesterol is an independent risk factor for future cardiovascular events. A comprehensive approach to achieving optimal HDL cholesterol levels (40 mg per deciliter or more in men and 50 mg per deciliter or more in women) should include lifestyle modifications, followed by the consideration of pharmacotherapy in high-risk patients. The patient in the vignette has established coronary heart disease and a low level of HDL cholesterol. His plasma LDL cholesterol level is appropriate given that he is taking a statin, but his triglyceride level is elevated, and he is obese. Lifestyle changes should be recommended as the first approach to raise HDL cholesterol levels, which would lead to other cardiovascular benefits. We would initially recommend a program of regular aerobic exercise (a gradual increase to 30 minutes of brisk aerobic activity five days per week), weight loss (1 lb per week, with a target body-mass index of less than 25), and th
