Heart intertwined with DNA strands symbolizing gender differences in cardiovascular outcomes.

Decoding Cholesterol: Are Your Levels Really a Target?

Kai Mendoza in Health & Wellness December 2025 • 4 min read.

"New research questions established cholesterol targets and reveals surprising sex-based differences in cardiovascular outcomes, challenging conventional wisdom in heart health."

For years, we've been told to aim for specific cholesterol numbers to keep our hearts healthy. But what if those targets aren't as clear-cut as we thought? Recent studies are beginning to question the one-size-fits-all approach, revealing that optimal cholesterol levels can vary significantly, especially between men and women.

This article dives into groundbreaking research presented at the Atherosclerosis 275 conference, which investigated the role of statins in preventing heart events and examined the impact of cholesterol levels on long-term outcomes after coronary intervention. The findings challenge conventional wisdom and suggest a more nuanced understanding of cholesterol management is needed.

We'll explore how these discoveries could change the way we approach heart health, offering insights relevant to anyone concerned about cardiovascular risk, whether you're already managing your cholesterol or simply looking to stay informed.

Challenging the Cholesterol Paradigm: What the Research Reveals?

Heart intertwined with DNA strands symbolizing gender differences in cardiovascular outcomes.

Traditionally, guidelines have set universal cholesterol targets for everyone, regardless of sex or other individual factors. However, the FU-Registry study, presented at Atherosclerosis 275, suggests that these targets may not be equally applicable to men and women.

The study examined patients undergoing percutaneous coronary intervention (PCI) – a procedure to open blocked arteries – and followed them for five years to see how cholesterol levels affected their long-term outcomes. What they found was surprising:

In women, lower levels of high-density lipoprotein cholesterol (HDL-C), often considered "good" cholesterol, at the time of the procedure were associated with a negative trend towards major adverse cardiovascular events (MACEs).
In men, higher levels of low-density lipoprotein cholesterol (LDL-C), or "bad" cholesterol, at the time of the procedure showed a positive trend towards MACEs.
Moreover, in women, the combination of high LDL-C (≥100 mg/dL) and low HDL-C (<40 mg/dL) was strongly linked to MACEs. This relationship was not observed in men.

These findings suggest that the ideal cholesterol balance for preventing future heart problems may differ significantly between men and women, calling into question the universal application of current cholesterol targets.

Beyond the Numbers: A Personalized Approach to Heart Health

The research presented at Atherosclerosis 275 underscores the importance of moving beyond simple cholesterol targets and embracing a more personalized approach to cardiovascular risk management. This means considering individual factors like sex, genetics, lifestyle, and overall health when assessing risk and making treatment decisions.

For women, focusing solely on lowering LDL-C may not be the most effective strategy. Instead, a more comprehensive approach that considers HDL-C levels and other risk factors may be necessary. For men, maintaining healthy LDL-C levels remains crucial, but these findings highlight the need for ongoing research to refine our understanding of optimal targets.

Ultimately, the key takeaway is that heart health is not a one-size-fits-all endeavor. By staying informed about the latest research and working closely with your healthcare provider, you can develop a personalized plan that effectively manages your cardiovascular risk and promotes long-term well-being.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

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Everything You Need To Know

1

What is the main issue with the current cholesterol targets?

The research challenges the conventional, universal cholesterol targets that have been in place. The FU-Registry study, presented at Atherosclerosis 275, suggests that optimal cholesterol levels and their impact on cardiovascular events like MACEs may differ significantly between men and women. It found, for example, that in women, lower levels of HDL-C were associated with adverse outcomes, a contrast to the typical understanding of HDL-C as protective. This suggests that a 'one-size-fits-all' approach to cholesterol management may not be appropriate, and that a more nuanced, personalized approach is needed.

2

What are the key findings regarding cholesterol levels in men and women?

The key findings from the FU-Registry study, presented at Atherosclerosis 275, highlight sex-based differences. In women, low HDL-C was associated with a negative trend towards MACEs, while in men, high LDL-C showed a similar trend. Furthermore, in women, the combination of high LDL-C and low HDL-C was strongly linked to MACEs, a relationship not seen in men. These results suggest that the balance of cholesterol and the specific cholesterol levels considered optimal for heart health might be different for men and women.

3

What are LDL-C and HDL-C, and how do they relate to heart health?

LDL-C, often referred to as "bad" cholesterol, and HDL-C, the "good" cholesterol, are types of lipids that carry cholesterol in the blood. Elevated levels of LDL-C have traditionally been associated with increased cardiovascular risk. The article presents that in men with high LDL-C, a positive trend towards MACEs was found after PCI. HDL-C helps remove LDL-C from the arteries, lowering the risk of heart disease. However, the article found that in women, low HDL-C was associated with an increased risk of MACEs, challenging the traditional protective view of high HDL-C for women.

4

What are the implications of the study's findings?

The implications of these findings are significant. They suggest that current cholesterol management strategies, which often use universal targets for LDL-C and HDL-C, may need to be re-evaluated. The research presented at Atherosclerosis 275 advocates for a more personalized approach to managing cardiovascular risk, taking into account factors like sex, genetics, and overall health. It means that treatment decisions, such as the use of statins or lifestyle recommendations, should be tailored to each individual rather than following a standardized set of guidelines.

5

Why was the FU-Registry study focused on patients undergoing percutaneous coronary intervention (PCI)?

Percutaneous coronary intervention (PCI) is a procedure used to open blocked arteries, restoring blood flow to the heart. The FU-Registry study examined patients undergoing PCI to investigate the long-term impact of cholesterol levels on cardiovascular outcomes. This study looked at the association between cholesterol levels at the time of the procedure and the occurrence of MACEs over a five-year period. The choice of PCI patients allowed researchers to observe the effects of cholesterol levels in a cohort already at risk for heart problems, providing insights into cholesterol management and cardiovascular risk after intervention.