Finland's national cholesterol guideline (Käypä hoito, the Finnish Current Care guideline) was updated slightly in September 2026. The changes are not dramatic, but a few of them apply to practically every adult, not just to people who already have a diagnosed arterial disease. Here are the five points I think are worth knowing.
A quick word on terms: LDL is the "bad cholesterol" that circulates in the blood and builds up in artery walls. Lipoprotein(a), or Lp(a), is an LDL-like particle whose level is largely inherited.
1. Measure Lp(a) once in your life
According to the guideline, measuring lipoprotein(a) once in a lifetime is generally sufficient. The value refines your individual risk assessment for arterial disease alongside LDL, and it does not need to be repeated.
Another refining measure is ApoB, apolipoprotein B. It could refine risk assessment beyond LDL, but it is not in routine use in Finland, because the evidence on its cost-effectiveness is incomplete. In practice, an ApoB test may be available through occupational or private healthcare.
2. If your values have never been measured, measure them
The guideline says lipids should be measured by the age of 40 at the latest and then at least every five years; measuring earlier is reasonable, especially when there are risk factors. My own recommendation is bolder: if your values have never been measured, get them measured now rather than waiting for your 40th birthday. The reason is in point five.
3. LDL cannot be too low, but the target depends on your risk
The old worry about cholesterol dropping "too low" can be put to rest. An LDL that is too low is not harmful. The target level, however, depends on overall risk: for a low-risk person the LDL target is below 3.0 mmol/l, and the very low target of below 1.4 mmol/l applies only to patients at very high risk, for example those who already have a diagnosed arterial disease.
4. Lifestyle first, then medication if needed
For a low-risk person the target is pursued primarily through lifestyle. The most important measure is managing excess weight, and on top of that, diet will probably bring LDL down quite handily.
The need for medication is decided on overall risk and an individual assessment, not on a single number: the higher the risk, the lower the target and the sooner medication is justified.
5. It is about exposure over a lifetime
LDL that has been elevated for a long time can cause arterial damage in the future, even when other risk factors for arterial disease are few. For example, a person who exercises and does not smoke may still be carrying a cholesterol load built up over many years.
That is what lifetime exposure means: for the arteries, what matters is not only today's value but how high LDL has been and for how long. That is why it pays to know your values while you are still young.
The full guideline is available on the Käypä hoito website (in Finnish): Dyslipidaemias, Current Care guideline.
Call 112 immediately if
Cholesterol is not an emergency matter, but the sudden consequences of arterial disease are.
- you have pressing chest pain that does not ease with rest
- you have symptoms of a stroke: one-sided weakness or numbness in an arm or leg, a drooping corner of the mouth, slurred speech or a sudden visual disturbance
Discuss your values with a doctor
The numbers are only a starting point. Discuss your own values and any need for treatment with a doctor who knows your overall situation. During service hours, Treat's doctors can assess in chat whether you need tests.
This article is general health information and does not replace an individual assessment by a doctor.