If you are like most people, you know that it is important to keep your cholesterol within a healthy range. According to the Centers for Disease Control and Prevention (CDC), which means less than 100 mg / dL low-density lipoprotein (LDL), more than 60 mg / dL high-density lipoprotein (HDL), and less than 150 mg / dL triglycerides.
But if you only know if your cholesterol is too high or not, you can say the role that cholesterol plays in promoting and preventing disease keeps you healthy, says Deirdre Mattina, Managing Director, a preventative cardiologist at the Cleveland Clinic. Knowing more about your cholesterol will help you have a more informed conversation with your doctor. It can help your care team identify your risk of heart disease early and come up with a treatment plan that will help you live longer with a lot of vitality, ‘she says.
So, what do you need to know about cholesterol to prevent heart disease, stroke and more? Read on.
1. Total cholesterol is only part of the picture.
If you get your blood work results back, chances are you are concentrating on your total cholesterol and utilizing that one number. Dr. However, Mattina says that what is more important than total cholesterol is to understand the different components that make up the score. “You really have to break down the different types of cholesterol to get a complete picture,” says Dr. Mattina. A typical cholesterol test measures the following:
- LDL: This is considered the “bad” cholesterol because it leads to the accumulation of plaque in your veins and increases the risk of a heart attack and stroke. (The more it builds up, the tighter and narrower your arteries become and the harder it is for blood to flow freely to and from the heart.) For the general population, less than 100 is ideal, and a score above 160 is considered high . However, if you have been diagnosed with heart disease, you want your LDL to be lower than 70 – and possibly even lower, it adds Randal Thomas, Managing Director, medical director of the cardiac rehabilitation program of the Mayo Clinic.
- HDL: It is considered the ‘good’ cholesterol because it carries LDL cholesterol away from the veins and back to the liver, where it is broken down and flushed out of the body. For men, the ideal range is between 40 and 100 HDL; For women, 50 to 100 is ideal, says dr. Thomas
- Triglycerides: It is a type of fat in the blood that your body uses for energy. For most people, a triglyceride score above 150 is considered high, says Dr. Thomas, and more than 1,000 are dangerously high. Combining high triglycerides with low “good” HDL cholesterol or high “bad” LDL cholesterol can increase your risk of heart attack and stroke.
To get a more accurate picture of how your cholesterol can put you at risk for heart disease, add all three of these cholesterol components and then subtract your HDL number. ‘That number tells us how many particles of cholesterol are circulating that put you at risk, ”says Dr Mattina. (Per die CDC’s guidelines, you want this number to be 250 mg / dL or lower.)
2. Even if you have normal cholesterol levels, you may have a heart attack.
In particular, for women, the new thinking is that it is not just cholesterol particles that carry the risk of heart disease, but how cholesterol acts, says Dr Mattina. “A lot of people with normal cholesterol levels get heart attacks, and that’s probably because they act on cholesterol in a way that is inflammatory,” she says.
The best way to know if you have inflammatory cholesterol particles in your blood is to ask for a high-sensitivity C-reactive protein (CRP) test, says Dr. Mattina. “It is not checked in a typical cholesterol panel and is not specific to heart disease, but it will give your doctor a feeling of total inflammation in your body,” which will then help you guide your treatment plan. (CRP is a by-product of inflammation, and experts agree, it is just as good at predicting heart disease as measuring LDL.)
If your C-reactive protein has been increased, your doctor may also coronary calcium count to better understand your risk of heart disease. The test involves a low-dose radiation scan of the heart to look for hardened cholesterol in the arteries, says Dr. Mattina. “If you have an elevated calcium count, it tells us that there is a little hardened cholesterol in the arteries around the heart,” she says. “Then we want to consider cholesterol-lowering medicine as a treatment option to prevent a heart attack.”
3. Eating well can improve your cholesterol count, but you still need it meds.
There is no doubt that certain unhealthy habits will cause an increase in triglycerides and LDL cholesterol to lower your HDL levels. According to the American Heart Association, eating a diet high in saturated fats and simple carbohydrates, smoking, not exercising enough, and being overweight or obese has been shown to negatively affect your cholesterol and increase the risk of heart disease. On the other hand, improving your diet by choosing healthier fats can increase your fiber intake, exercise more and quit smoking to keep your cholesterol in check.
That said, even if you make all the right choices in an effort to improve your cholesterol profile, medication may still be needed – and it’s important to understand that you may not be able to improve your cholesterol with lifestyle measures alone, says dr. Mattina. “This is especially true if you have had a heart attack if you need to drastically lower your LDL cholesterol,” she says. “However, if you make major changes to your habits, you could affect the total dose or amount of cholesterol medication you use to maintain.”
4. Preventative cardiologists can help you manage your cholesterol and heart health.
Since heart disease is the biggest killer in this country, the most some of us live with high cholesterol, says Dr Mattina – and the longer cholesterol lingers in the bloodstream, the greater it is that it accumulates in your blood vessels and causes the plaque to build up and increase inflammation. What’s more, there is very little data showing that we can reverse the damage caused by high levels of ‘bad cholesterol’, she says. “For the most part, the best we can do is stabilize cholesterol and prevent it from getting worse,” says Dr. Mattina. ‘What does prevention mean is the key. And the sooner you start, the better. ‘
If you have a family member who had a heart attack in your 30s or 40s, your doctor may suggest that you see a cardiologist when you are in your twenties, says Dr. Mattina. “I would also like to see women in their pregnancies no matter what their family history is, because we are seeing the risk of heart disease increase as women experience things like gestational diabetes and preeclampsia during pregnancy.” Chronic conditions that cause chronic inflammation, such as autoimmune diseases such as lupus and rheumatoid arthritis, can also put you at higher risk for heart disease – even if your cholesterol is not high, Dr Mattina adds. Ask your doctor what she thinks is appropriate, given your health history.
If you want to be proactive, you should make an appointment with a preventative cardiologist, no matter how old you are or what your risk factors are, says Dr. Mattina. “This type of specialist can determine your cholesterol and overall risk for heart disease and help you develop a long-term health plan,” she says. “As far as heart disease is concerned, the sooner you identify your risk and treat it if necessary, the better.”
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