Despite the popular saying, what you don’t know can hurt you. That’s especially true when it comes to high cholesterol.
Since it has no symptoms, many people with high cholesterol don’t know they have it and thus aren’t treating or addressing their condition. This puts individuals at increased risk for heart disease and stroke as well as diabetes, peripheral artery disease and high blood pressure.
Nearly 25 million U.S. adults have high cholesterol, according to the Centers for Disease Control and Prevention. Another 86 million have borderline high cholesterol.
“The first step is knowing your cholesterol levels,” says Dr. Abdulmohsin Ahmadjee, a Cardiologist with ThedaCare Cardiovascular Care. “From there, your cardiologist or primary care provider can work with you to manage and treat your high cholesterol.”
Cholesterol 101
When you hear the word cholesterol, you might think of it as something negative. However, your body needs cholesterol to build cells and make vitamins and other hormones.
At a certain threshold, cholesterol can become problematic. When the level of bad, or LDL, cholesterol becomes too high, it can lead to a buildup of plaque in the arteries. This can increase the risk for heart attack, heart disease and stroke.
Cholesterol is made up of two parts:
- LDL (low-density lipoprotein) is known as bad cholesterol because it contributes to fatty buildup in the arteries.
- HDL (high-density lipoprotein) is called good cholesterol because it helps clear out the cholesterol your body doesn’t need.
Triglycerides come into play alongside LDL and HDL. The most common type of fat in the body, triglycerides store excess fat from your diet. Combined with a high LDL and low HDL level, a high triglyceride level can lead to further fatty buildup within the artery walls.
Optimal Levels
In the simplest terms, you want low levels of LDL cholesterol and triglycerides and a high level of HDL cholesterol.
A lipid panel is a common blood test that measures the levels of certain types of fat in your blood. This includes total cholesterol, LDL, HDL and triglycerides.
In general, optimal numbers are as follows:
- Total cholesterol: <200 mg/dl
- LDL cholesterol: <100 mg/dl
- HDL cholesterol: >60 mg/dl
- Triglycerides: <150 mg/dl
“It’s tempting to focus on numbers alone, but it’s not always that simple,” Dr. Ahmadjee says. “Your primary care provider will assess your complete health picture to help determine if your cholesterol levels are of concern.”
Based on your individual risk factors, your primary care provider will also determine at what age you should first have a lipid panel and how often you should complete the blood test. Your age, gender, family history and heart disease risk factors all come into play in decision-making.
“When you stay on top of routine care, your primary care provider can more effectively help you track and manage your cholesterol and other heart health risk factors,” Dr. Ahmadjee says.
Risk Factors
Certain factors can increase your risk for developing high cholesterol. Some of these you can control, and some you cannot.
Risk factors include:
- Type 2 diabetes
- Obesity
- Family history of high cholesterol
- Poor diet
- Sedentary lifestyle
- Smoking
- Age – risk increases as you get older
- Gender – women’s risk increases after menopause
Prevention and Management
Whether you want to reduce your cholesterol or you wish to prevent developing high cholesterol, you can take many positive steps.
These include:
- Eating a healthy, balanced diet
- Limit foods high in saturated fat, sodium and added sugars.
- Choose foods that are naturally high in fiber, including whole grains, beans, fruits and vegetables.
- Consider the Mediterranean diet.
- Maintaining a healthy weight
- Choose healthy foods and incorporate physical activity into your daily routine.
- If you’re struggling to lose or maintain weight, talk with your primary care provider about additional steps you could take.
- Exercising regularly
- Aim to get 30 minutes of moderate-intensity exercise at least five days per week. Examples include brisk walking, cycling and swimming.
- Incorporate strength training at least twice a week.
- Quitting smoking
- Talk with your primary care provider for help with quitting.
- It’s never too late to quit, and you’ll experience health benefits immediately upon giving up smoking.
- Limiting alcohol
- Drink in moderation if at all. The Centers for Disease Control and Prevention recommends men limit their intake to two drinks per day and women to one drink per day.
- Talk with your primary care provider if you’re concerned about your dependency on alcohol.
Treatment Options
Lifestyle modifications alone might not be enough to treat your high cholesterol. Your primary care provider or cardiologist may recommend one or more medications to help manage your cholesterol.
Statins, which block a substance the liver needs to make cholesterol, are common. Other types of drugs include cholesterol absorption inhibitors and medications for high triglycerides.
“Any medication you take will work in concert with healthy lifestyle steps that your doctor recommends,” Dr. Ahmadjee says. “It’s important for you to take medications as directed, as they can help reduce your risk for heart attack and stroke. If you’re experiencing bothersome side effects, talk with your doctor.”
