If you are like most people, you know that it is important to keep your cholesterol at healthy levels. According Centers for Disease Control and Prevention (CDC), this means less than 100 mg / dL of low density lipoprotein (LDL), more than 60 mg / dL of high density lipoprotein (HDL) and less than 150 mg / dL of triglycerides.
But in addition to simply knowing whether your cholesterol is too high or not, understanding the role of cholesterol in promoting and preventing disease can help keep you healthy, says Deirdre Mattina, MD, preventive cardiologist at Cleveland Clinic. “Knowing more about your cholesterol will help you have a more informed conversation with your doctor. This can help your healthcare team to identify the risk of heart disease early and develop a treatment plan that will help you live longer with a lot of vitality, ”she says.
So, what should you know about cholesterol to prevent heart disease, stroke and more? Read.
1. Total cholesterol is only part of the picture.
When you receive the results of your blood tests, there is a good chance that you will focus on total cholesterol, focusing on that number. However, Dr. Mattina says that what is more important than total cholesterol is understanding each of the different components that make up that score. “You really have to break down the different types of cholesterol to get a complete picture,” says Dr. Mattina. A typical cholesterol test will measure the following:
- LDL: This is considered “bad” cholesterol because it leads to the buildup of plaque in the arteries and increases the risk of heart attack and stroke. (The greater the accumulation, the stiffer and narrower the arteries and the more difficult it will be 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’ve already been diagnosed with heart disease, you’ll want your LDL to be less than 70 – and possibly even lower, he adds Randal Thomas, MD, medical director of the Cardiac Rehabilitation Program at the Mayo Clinic.
- HDL: This is considered “good” cholesterol because carries LDL cholesterol away from arteries and back to the liver, where it is broken down and eliminated from the body. For men, the ideal range is between 40 and 100 HDL; for women, 50 to 100 is ideal, says Dr. Thomas
- Triglycerides: This 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 above 1,000 it is dangerously high. The combination of high triglycerides with low “good” HDL cholesterol or high “bad” LDL cholesterol can increase the risk of heart attack and stroke.
To get a more accurate picture of how cholesterol may be putting you at risk for heart disease, add all three components of cholesterol and subtract the HDL number. “what The number tells us how many particles of cholesterol are circulating and which put you at risk, ”says Dr. Mattina. (Per CDC guidelines, you want this number to be 250 mg / dL or less.)
2. Even if you have normal cholesterol levels, you can still have a heart attack.
For women, in particular, the new thinking is that it’s not just the cholesterol particles that carry the risk of heart disease, but how that cholesterol behaves, says Dr. Mattina. “Many people with normal cholesterol levels have heart attacks, probably because cholesterol behaves in an inflammatory way,” she says.
The best way to find out if you have inflammatory cholesterol particles in your blood is to order a high-sensitivity C-reactive protein (CRP) test, says Dr. Mattina. “This is not seen in a typical cholesterol panel and is not specific for heart disease, but it will give your doctor a general feeling of inflammation in your body,” which will help guide your treatment plan. (CRP is a by-product of inflammation, and experts agrees that he is as good at predicting heart disease as measuring LDL.)
If your C-reactive protein is elevated, your doctor may also order a coronary calcium score to better understand the risk of heart disease. This test involves a low-dose radiation scan of the heart to look for hardened cholesterol in the arteries, says Dr. Mattina. “If you have a high calcium index, it tells us that there is some hardened cholesterol in the arteries around the heart,” she says. “That’s when we’re going to consider cholesterol-lowering medication as a treatment option to prevent heart attacks.”
3. Eating well can improve your cholesterol score, but you may still need to meds.
There is no doubt that certain harmful habits will increase your triglycerides and LDL cholesterol and cause your HDL levels to plummet. According American Heart Association, eating a diet rich in saturated fats and simple carbohydrates, smoking, not exercising enough and being overweight or obese have all had a negative impact on cholesterol and increase the risk of heart disease. On the other hand, improving your diet by choosing healthier fats and increasing fiber intake, exercising more and quitting smoking can go a long way in keeping cholesterol under control.
That said, even if you’re making all the right choices in an effort to improve your cholesterol profile, medication may still be necessary – 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 when we need to dramatically lower LDL cholesterol,” she says. “However, if you make major changes in your habits, it could affect the total dose or amount of cholesterol medications you will receive for maintenance.”
4. Preventive cardiologists can help you control cholesterol and heart health.
Whereas heart disease is the leading cause of death in this country, most of us live with high cholesterol, says dr. Mattina – and the longer the cholesterol remains in the bloodstream, the more likely it is to accumulate in the blood vessels and cause plaque buildup and increased inflammation. Furthermore, there is little data to show 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. “Which means that prevention is essential. And the sooner you start, the better. “
If you have a relative who has had a heart attack in their 30s or 40s, your doctor may suggest that you see a cardiologist when you are in your 20s, says Dr. Mattina. “I also like to see women of childbearing potential, no matter what their family history, because we are seeing the risk of heart disease increase when women experience problems like gestational diabetes and pre-eclampsia during pregnancy.” Chronic conditions that cause chronic inflammation, such as autoimmune diseases like lupus and rheumatoid arthritis, can also increase the risk of heart disease – even if your cholesterol is not high, adds Dr. Mattina. Ask your doctor what he thinks is right for you, given your health history.
If you want to be proactive, make an appointment with a preventive cardiologist, no matter your age or what your risk factors are, says Dr. Mattina. “This type of specialist will be able to assess your cholesterol and the overall risk of heart disease and help you develop a long-term health plan,” she says. “When it comes to heart disease, the sooner you identify the risk and treat it, if necessary, the better.”
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