Unless you live in a protective bubble, most of us know that high cholesterol is one of the leading risk factors for heart disease. But, once you get past that fact, how much do you actually know about high cholesterol? For example, do you know what the risk factors are? How it’s prevented? When you should get tested? These are simple questions with equally simple answers but in an informal survey conducted of family and friends, I was surprised to learn that most knew very little about high cholesterol other than the obvious - it is bad for your heart and might lead to a heart attack. Not only did they know little about such a treatable and preventable risk factor for heart disease, but most did not even have a clear picture of the risk factors for developing high cholesterol or how to prevent it from developing. Since knowledge is power, it’s clear that it’s time for a little high cholesterol primer.
What is cholesterol?
Simply put, cholesterol is a waxy substance that’s found in your blood. You need a certain amount of cholesterol to maintain and build healthy cells. However, too much cholesterol causes build-up in your arteries, which blocks or restricts your blood flow leading to atherosclerosis, cardiovascular disease (heart disease), strokes, heart attack and possible death.
Are there different forms of cholesterol?
Cholesterol comes in three different forms:
• Low density lipoprotein (LDL) or “bad” cholesterol: causes buildup in your arteries leading to restricted blood flow as arteries narrow and hardening
• High density lipoprotein (HDL) or “good” cholesterol: delivers extra cholesterol to the liver
• Very low density lipoprotein (VLDL): contains triglycerides; makes LDL cholesterol bigger and may lead to additional damage and narrowing to blood vessels and arteries.
What do the numbers mean? When should I worry?
Depending on the test conducted, you may receive results for LDL, HDL and triglyceride levels individually, a combined score for your total cholesterol levels only, or both individual and combined cholesterol scores. While you should always discuss your results with your doctor, the following general guidelines apply to cholesterol scores:
Total Cholesterol Scores
Good – less than 200 mg/dL
Borderline (high) – 200 – 239 mg/dL
High – 240 mg/dL
LDL or “bad” Cholesterol Levels
Good (optimal) – less than 100 mg/dL
Above optimal – 100-129 mg/dL
Borderline high – 130-159 mg/dL
High – 160-189 mg/dL
Very high – above 190 mg/dL
HDL or “good” Cholesterol Levels
Good – above 60mg/dL (protective benefits against heart disease)
Better – 40-59 mg/dL
Bad – less than 40 mg/dL (considered major risk factor for heart disease)
What are the risk factors for high cholesterol?
As with heart disease, risk factors for high cholesterol come in two forms – those risk factors you can’t change, such as family history, age, and sex, and those you can change. Risk factors you can change include smoking, obesity, diet, limited physical activity, high blood pressure, and diabetes.
What are the symptoms of high cholesterol?
There are no early warning signs for high cholesterol. Unless you get tested, you may not know you have high cholesterol until atherosclerosis has developed and your blood vessels and arteries have been damaged. Once this occurs, you may experience chest pain, heart attack, or stroke.
When should I get my cholesterol levels tested?
Because there are no early warning signs for high cholesterol, it’s important to get tested and know whether or not you are at risk. According to the National Heart Lung and Blood Association, you should get your cholesterol tested at age 20 and every five years thereafter (or more often if your doctor recommends it depending on your history and risk factors).
What can I do to prevent high cholesterol from developing?
High cholesterol can be prevented by lifestyle changes that address each of the various risk factors. For example, if you smoke – stop. If you don’t get enough exercise, add 30 minutes of moderate exercise per day to your routine. Improve your diet by eliminating transfats, limiting your daily intake of cholesterol, adding whole grains, fresh fruits and vegetables, and foods rich in omega-3 fatty acids. Maintain a healthy weight or lose weight if you are overweight.
How is high cholesterol treated?
High cholesterol can be treated with the following:
• lifestyle changes such as those discussed above
• medications such as statins (Lipitor, Lescol, Altoprev, Mevacor, Pravachol, Crestor, or Zocor), bile-acid-binding resins (Prevalite, Questran, Welchol, and Colestid), cholesterol absorption inhibitors (Zetia), or combination cholesterol absorption inhibitor and statins (Vytorin)
• medications for triglycerides such as fibrates (Lofibra, TriCor, Lopid), Naicin, omega-3 fatty acid supplements (over the counter or Lovaza)
• supplements such as omega-3 or fish oil, artichoke, barley, garlic, beta-sitosterol, oat bran (oatmeal, whole oats), blond psyllium, and sitostanol.
Sources:
What is Cholesterol, National Heart Lung and Blood Institute, Sept. 2008, http://www.nhlbi.nih.gov/health/dci/Diseases/Hbc/HBC_WhatIs.html
High Cholesterol, The Mayo Clinic, 24 Jun 2010, http://www.mayoclinic.com/health/high-blood-cholesterol/DS00178