Older Americans should have their total cholesterol tested once every 5 years and, if an accurate measurement is available, their high density lipoprotein (HDL, the "good" cholesterol) -- the same recommendation as for all American adults. The test should be done in a medical setting, so the presence of other CHD risk factors can be checked.

• Those with high cholesterol should take steps to lower it, especially if they also have other CHD risk factors. These include cigarette smoking, high blood pressure, physical inactivity, being overweight, and diabetes.
• For seniors without CHD who need to lower a high cholesterol, the first line of treatment should be the adoption of the healthy life habits noted above -- eating a diet lower in saturated fat, total fat, and cholesterol, being physically active, and maintaining a healthy weight.
• When life habit changes do not sufficiently lower cholesterol and seniors are at high risk for CHD, drug therapy may be advisable. However, physicians should evaluate a patient's overall health status in making that decision.
• For most seniors with CHD, life habit changes and medication should be used together from the start of treatment.
• Postmenopausal women who are judged to need drug treatment to reduce their risk for CHD should consider cholesterol-lowering drugs instead of hormone replacement therapy. A study of women with CHD found that a combination of estrogen and progesterone did not reduce the risk of CHD events. By contrast, studies have shown that postmenopausal women at high risk for CHD benefit greatly from treatment with statin drugs.
• "It is important for older Americans to pay attention to their cholesterol," said NCEP's Cleeman. "Even if you're 70 and feeling fine, you can develop CHD, so you should take action".
• "Whether you are old or young, cholesterol counts -- you can improve your quality of life by caring about your cholesterol," he added.