Cholesterol is a waxy, fat-like substance found in your blood that plays a crucial role in building cells, producing hormones, and aiding digestion. Low-density lipoprotein (LDL) is known as “bad” cholesterol and high-density lipoprotein (HDL) is known as “good” cholesterol. LDL & HDL are types of cholesterol that are transported in the blood by lipoproteins. When cholesterol levels become too high, it can lead to the buildup of fatty deposits in your arteries, increasing the risk of heart disease, stroke, and other serious health issues. Understanding cholesterol is essential for maintaining heart health.
A person’s total cholesterol level can be measured any time of day while fasting. Fasting means nothing to eat after midnight on the day of test. Black tea, black coffee or water is allowed the day of the test and medications can be taken as prescribed. A total cholesterol level of 200 to 239 mg/dL (5.17 to 6.18 mmol/L) is borderline high. A total cholesterol level of 240 mg/dL (6.21 mmol/L) or greater is high.
In patients with high serum HDL cholesterol, less than 60 mg/di, (>60 mg/dL [1.6 mmol/L]), the cause may be hereditary or acquired in conditions such as alcohol abuse, hypothyroidism, phenytoin (dilation) treatment, and insulin treatment in type 1 diabetes.
High cholesterol, or having too much cholesterol in your blood, is often caused by unhealthy lifestyle habits:
• Poor Diet: Eating a lot of foods high in saturated and trans fats such as red meat, full-fat dairy, chocolate, and processed foods such as lunch meats, canned fruits and vegetables, or TV dinners.
• Lack of Exercise: Not getting enough physical activity, especially sitting a lot; to have good healthy amounts of exercise one needs to exercise 30 minutes a day most days of the week for a goal of 150 minutes of exercise in a seven day period. Exercises include: brisk walking, biking, swimming, or jogging. The goal of the exercise is to get your heart rate to a healthy rate. A healthy exercise heart rate is usually between 50% and 85% of your maximum heart rate, which is calculated by subtracting your age from 220. For example, if you’re 50 years old, your maximum heart rate is 170 beats per minute (220 -50), and your target heart rate for moderate to vigorous exercise would be 85-145 beats per minute (50-85% of 170).
• Smoking: Lowers HDL cholesterol, especially in women, and raises LDL cholesterol.
Those at risk for developing cardiovascular disease are people with:
• Known atherosclerotic cardiovascular disease
(ASCVD) – a type of heart disease that occurs when plaque builds up in the walls of arteries, limiting blood flow to the vital organs.
• Heart failure
• Diabetes mellitus
• Chronic kidney disease
• Age over 65 years
• Calculated 10-year risk of ASCVD more than or equal to 10%.
If exercise and a healthy diet fail to lower cholesterol, then the cause of high cholesterol can be hereditary. Medications called statins are the recommended prescriptions to lower cholesterol. Statin therapy ranges from low intensity to high intensity. Low intensity statins are lovastatin 20 mg, pravastatin 10mg or 20 mg, simvastatin 10 mg doses. High intensity statins are atorvastatin 40mg or 80 mg or rosuvastatin 20mg to 40 mg, to name a few.
According to the National Heart, Lung and Blood Institute (NHLBI), the general guidelines for cholesterol screening are as follows:
• Ages 9-11 : First screening
• Ages 19 or younger: Repeat screening every five years, or earlier if there is a family history of high cholesterol, stroke, or heart attack
• Ages 20-65: Repeat screening every five years, or more often if you have certain health conditions
• Ages 45-65: Men and women should be screened every one to two years
• Older than 65: Screen annually
Make an appointment with a primary care provider if you would like to discuss your cholesterol and have your cholesterol checked.
