Is an LDL cholesterol level of 5.35 mmol/L (207 mg/dL) severely elevated?

　　An LDL cholesterol level of 5.35 mmol/L is generally considered severe; however, a comprehensive assessment must be made based on the patient’s specific clinical condition. The normal reference range for LDL cholesterol is <3.4 mmol/L; thus, 5.35 mmol/L is markedly elevated. Chronically elevated LDL cholesterol can damage vascular endothelium, promote atherosclerosis, and significantly increase the risk of cardiovascular and cerebrovascular diseases. Therefore, lower LDL cholesterol levels are more beneficial for overall health.

　　1. If the patient has isolated dyslipidemia (i.e., no other comorbidities), lifestyle modifications—including dietary control and regular physical activity—are recommended to reduce LDL cholesterol to <3.4 mmol/L.

　　2. For patients with concomitant hypertension or diabetes mellitus, the LDL cholesterol target should be <2.6 mmol/L.

　　3. In patients with established coronary artery disease (CAD) or peripheral arterial disease (e.g., carotid or lower-limb arterial stenosis), the LDL cholesterol goal should be <2.1 mmol/L.

　　4. For CAD patients who have undergone coronary stent implantation, the LDL cholesterol target should be <1.8 mmol/L.

　　Adopting a heart-healthy diet constitutes the cornerstone of prevention and management of hyperlipidemia—this principle applies regardless of whether lipid-lowering medications are prescribed. Patients should cultivate sound dietary habits: avoid foods high in saturated fat and cholesterol (e.g., fried foods, fatty meats, and organ meats); use minimal oil and salt during cooking; and consume abundant fresh fruits and vegetables. Additionally, regular physical exercise is essential: engage in activities such as swimming, brisk walking, jogging, hiking, cycling, or yoga for at least 30 minutes per session, ideally several times per week.