Keeping Your Cholesterol in Check

Many people assume that if they feel good, they must be healthy. But heart attacks and strokes are sneaky, and high cholesterol increases your risk of both.

Adil Karamali, MD, FACC, a cardiologist with ProMedica Physicians, describes cholesterol as a fat-like substance made in the liver that can also be found in foods such as meats, dairy and eggs. “While the human body requires a certain amount of cholesterol for cell building to produce hormones, vitamins and bile acids, too much cholesterol in the body causes buildup, or plaque, within the walls of the arteries,” Dr. Karamali says. This excess cholesterol may compromise blood flow within the artery, affecting the heart and leading to complications.

The good, the bad, and the ugly

Not all cholesterol is bad for you. When cholesterol makes its way through the body, it travels through the blood stream via transport mechanisms called lipoproteins — some which are good, and others that are bad. You may know these better from their classifications: high-density lipoprotein (HDL), low-density lipoprotein (LDL) and very low-density lipoprotein (VLDL). These categories refer to the cholesterol’s protein content compared to the amount of fat content. Dr. Karamali clarifies:

  • HDL: This is called the “good” cholesterol. HDL helps the body get rid of excess cholesterol. High HDL levels correspond with lower risk of cardiovascular disease.
  • LDL: This is the bad cholesterol, causing the most buildup within the arteries. The higher your level of LDL, the greater your risk of cardiovascular disease.
  • VLDL: Similar to LDL, VLDL carries a fat called triglyceride (TG), creating excess calories. Alcohol and sugar are two major contributors to high TG levels.

The American Heart Association recommends cholesterol testing for adults 20 and older once every five years. This is simply a fasting blood test that will measure all the components of a lipid profile, including your HDL, LDL, VLDL, and TG. If a non-fasting test is performed, you will receive your total cholesterol and HDL levels, as the amount of TG in your system may not be accurate soon after a meal. The optimal cholesterol levels for a healthy person are less than 200 mg/dL for total cholesterol, 60 mg/DL or above for HDL, and 100 mg/dL or less for LDL. Consult your doctor if you have a family history of heart disease or other risk factors.

Controlling cholesterol levels

While cardiovascular disease is not always preventable, it’s important to know the contributing factors that can influence your cholesterol levels. Dr. Karamali recommends paying special attention to:

  • Diet: Stay clear of high saturated fats and high cholesterol containing foods.
  • Weight: Obesity is a risk for heart disease. Losing weight reduces cholesterol, especially LDL, and helps in increasing HDL levels.
  • Exercise: Regular exercise is the only established way to increase HDL levels.
  • Age/Gender: Cholesterol levels rise with age. Women have increasing LDL levels after menopause.
  • Diabetes: All diabetics are treated as though they have established heart disease. Poor sugar control increases LDL levels.
  • Genetics: “Bad” hereditary traits are not alterable and elevated LDL levels are often genetic, thus making it imperative to control other factors.

Who’s at risk?

New guidelines from the American College of Cardiology and the American Heart Association identify four groups who need to pay attention to their lipid levels, making extra efforts with their prescribed medications and therapies, diets and exercise routines. These groups include:

  1. Individuals with established cardiovascular disease.
  2. Individuals with baseline LDL of > 190 mg/dl. These are mostly those with a genetic predisposition.
  3. Individuals with diabetes age 40-75 with LDL 70-189 mg/dl and without established cardiovascular disease.
  4. Individuals without diabetes or cardiovascular disease who have LDL levels 70-189 mg/dl and a 10 year risk of cardiovascular disease > 7.5%.

Learn more about the importance of getting your cholesterol checked regularly in our 24/7 Cardiology campaign.

Sign up for our Heart and Vascular newsletter or read similar articles.