If you’re like most people, you know how important it is to maintain a healthy cholesterol level. That amounts to less than 150 mg/dL of triglycerides, more than 60 mg/dL of high-density lipoprotein (HDL), and less than 100 mg/dL of low-density lipoprotein (LDL), according to the Centers for Disease Control and Prevention (CDC).
According to Deirdre Mattina, MD, a preventive cardiologist at the Cleveland Clinic, “Understanding the role cholesterol plays in promoting and preventing disease can help keep you healthy.” “But understanding the role cholesterol plays in promoting and preventing disease can help keep you healthy.” You will be able to have a more informed conversation with your doctor if you know more about your cholesterol.” She says this can help your care team determine your early risk of heart disease and develop a treatment plan that will help you live longer and with more energy.
So, to avoid heart disease, stroke, and other conditions, what should you know about cholesterol? Read on.
1. Total cholesterol is only one component of the equation.
When you receive your bloodwork results, you are likely to concentrate on your total cholesterol and narrow your focus to that one number. However, according to Dr. Mattina, understanding each of the various components that make up that score is more important than total cholesterol. To get a complete picture, you really need to break down the various kinds of cholesterol, says Dr. Mattina. The following factors are typically measured by a cholesterol test:
- LDL: Because it increases your risk of heart attack and stroke and causes plaque buildup in your arteries, this cholesterol is referred to as “bad” cholesterol. Your arteries become stiffer and more narrow as buildup builds, making it harder for blood to flow freely to and from the heart.) A score of less than 100 is ideal for the majority of people, and a score of more than 160 is considered high. According to Randal Thomas, MD, medical director of the Mayo Clinic’s Cardiac Rehabilitation Program, however, if you have already been diagnosed with heart disease, you will want your LDL to be lower than 70, and possibly even lower.
- HDL: Because it transports LDL cholesterol back to the liver, where it is broken down and eliminated from the body, this is referred to as the “good” cholesterol. The ideal HDL level for men is between 40 and 100; Dr. Thomas asserts that 50-100 is ideal for women.
- Triglycerides: Your body burns this type of fat for energy in the blood. According to Dr. Thomas, a triglyceride score above 150 is considered high for the majority of people, and a score above 1,000 is dangerous. Triglycerides can raise your risk of heart attack and stroke when combined with low “good” HDL cholesterol or high “bad” LDL cholesterol.
Add all three of these cholesterol components together, then subtract your HDL number, to get a more precise picture of how your cholesterol may be increasing your risk of heart disease. According to Dr. Mattina, “that number tells us how many cholesterol particles are circulating that put you at risk.” You should aim for this level to be 250 mg/dL or lower, as recommended by the CDC.)
2. A heart attack can occur even if your cholesterol levels are normal.
Dr. Mattina states, “The new thinking is that it’s not just cholesterol particles that convey the risk of heart disease, but how cholesterol behaves.” This is especially relevant to women. She says that many people with normal cholesterol levels have heart attacks because their cholesterol behaves in an inflammatory way.
According to Dr. Mattina, requesting a high-sensitivity C-reactive protein (CRP) test is the most effective method for determining whether you have inflammatory cholesterol particles in your blood. Although this is not included in a typical cholesterol panel and is not specific to heart disease, it will provide your physician with an understanding of your body’s overall inflammation, which will assist in directing your treatment plan. Experts concur that CRP, a byproduct of inflammation, is equally effective at predicting heart disease as LDL.)
Your doctor may also order a coronary calcium score to better understand your risk of heart disease if your C-reactive protein level is high. Dr. Mattina says that test involves scanning the heart with low dose radiation to look for cholesterol that has hardened in the arteries. “It tells us that there is some hardened cholesterol in the arteries around the heart if you have an elevated calcium score,” she says. When that happens, we should think about taking medication to lower cholesterol as a way to prevent a heart attack.
3. Eating healthily can help lower your cholesterol, but you may still require medication.
There is no doubt that engaging in certain bad habits will raise your triglycerides and LDL cholesterol levels and lower your HDL levels. It has been demonstrated that smoking, eating a diet high in saturated fats and simple carbohydrates, not getting enough exercise, and being overweight or obese all have a negative impact on cholesterol levels and raise your risk of heart disease, according to the American Heart Association. On the other hand, changing your diet to include healthier fats and more fiber, exercising more, and giving up smoking can all help lower cholesterol levels.
However, even if you make all the right choices to improve your cholesterol profile, medication may still be necessary. Dr. Mattina says it’s important to know that lifestyle changes may not be enough to improve cholesterol. This is especially true if you have had a heart attack and we need to significantly lower your LDL cholesterol, “she says. However, if you make significant lifestyle changes, you may be able to alter your maintenance cholesterol medication dosage.
4. Preventive cardiologists can assist you in managing your cholesterol and heart health.
Considering that heart disease ranks highest, According to Dr. Mattina, the majority of Americans have high cholesterol, which is the nation’s No. 1 killer. The longer cholesterol stays in the bloodstream, the more likely it is to build up in blood vessels, causing plaque to form and inflammation to rise. Additionally, she asserts, there is a dearth of evidence demonstrating that high levels of “bad” cholesterol can be mitigated. According to Dr. Mattina, “the best we can do for the most part is stabilize cholesterol and prevent it from getting worse.” Therefore, prevention is essential.” Furthermore, the sooner you begin, the better.”
Dr. Mattina says that if you have a relative who had a heart attack in their 30s or 40s, your doctor might recommend that you see a cardiologist when you are in your 20s. I also like to see women in their childbearing years, regardless of their family history, because gestational diabetes and pre-eclampsia increase the risk of heart disease in pregnant women. Dr. Mattina adds that even if your cholesterol isn’t high, chronic conditions that cause chronic inflammation, such as autoimmune diseases like lupus and rheumatoid arthritis, can increase your risk of heart disease. Based on your medical history, ask your doctor what she thinks is best for you.
Dr. Mattina advises making an appointment with a preventive cardiologist if you want to be proactive, regardless of your age or risk factors. She adds, “This kind of specialist will be able to evaluate your cholesterol and overall risk of heart disease and assist you in developing a strategy for long-term health.” When it comes to heart disease, the earlier you can determine your risk and, if necessary, treat it, the better.