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Cholesterol Counts for Everyone
Cholesterol Is Important
Cholesterol level can have a lot to do with your chances of getting heart disease. High blood cholesterol is one of the major risk factors for heart disease. Actually, the higher your blood cholesterol level, the greater your risk for developing heart disease or having a heart attack.
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Cholesterol Can Cause Heart Disease
When you have high cholesterol, it builds up in on the walls of your arteries. This buildup causes "hardening of the arteries" so that arteries become narrowed and blood flow to the heart is slowed down or blocked. The blood carries oxygen to the heart, and if enough blood and oxygen cannot reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack!
It important to know that high blood cholesterol itself does not have any symptoms, so it's possible to be unaware that your cholesterol level is too high. It is important to find out what your cholesterol numbers are because lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack or dying of heart disease, even if you already have it. Cholesterol lowering is important for everyone.
What Cholesterol Levels Are OK?
It's recommended that everyone starting at age 20 should have their cholesterol checked at least once every 5 years. It's best to have a blood test called a "lipoprotein profile" to find out your cholesterol numbers.
A "lipoprotein profile" will provide the following information:
- Total cholesterol
- LDL (bad) cholesterol--the main source of cholesterol buildup and blockage in the arteries
- HDL (good) cholesterol--helps keep cholesterol from building up in the arteries
- Triglycerides--another form of fat in your blood
If you have not had a "lipoprotein profile" done, knowing your total cholesterol and HDL cholesterol can give you a general idea about your cholesterol levels. If your total cholesterol is more than "desirable" according to the chart below your should have a "lipoprotein profile" done
| Total Cholesterol Level |
Category |
| Less than 200 mg/dL* |
Desirable |
| 200-239 mg/dL |
Borderline High |
| 240 mg/dL and above |
High |
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* If your HDL is less than 40 mg/dL, you should have a "lipoprotein profile" done.
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HDL (good) cholesterol protects against heart disease, so for HDL, higher numbers are better. A level less than 40 mg/dL is low and is considered a major risk factor because it increases your risk for developing heart disease. HDL levels of 60 mg/dL or more help to lower your risk for heart disease.
| LDL Cholesterol Level |
LDL-Cholesterol Category |
| Less than 100 mg/dL |
Optimal |
| 100-129 mg/dL |
Near optimal/above optimal |
| 130-159 mg/dL |
Borderline high |
| 160-189 mg/dL |
High |
| 190 mg/dL and above |
Very high |
Triglycerides can also raise heart disease risk. Levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more) may need treatment in some people.
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Controlling Cholesterol Levels
Many factors affect cholesterol levels. Here are a few things you can do something about:
- Diet (see below). Saturated fat and cholesterol in the food you eat make your blood cholesterol level go up. Saturated fat should be your main concern, but cholesterol in foods also makes a difference. Reducing the amount of saturated fat and cholesterol in your diet will help lower your blood cholesterol level.
- Physical Activity. Little physically active is a risk factor for heart disease. Regular physical activity can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also helps you lose weight. Thirty minutes of physical activity a day can make a huge difference in your cholesterol levels.
- Weight. Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol. Losing weight can help lower your LDL and total cholesterol levels, as well as raise your HDL and lower your triglyceride levels.
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Diet tips for low saturated fat and cholesterol
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Foods low in saturated fat include fat free or 1% dairy products, lean meats, fish, skinless poultry, whole grain foods, and fruits and vegetables. Look for soft margarines (liquid or tub varieties) that are low in saturated fat and contain little or no trans fat (another type of dietary fat that can raise your cholesterol level). Limit foods high in cholesterol such as liver and other organ meats, egg yolks, and full-fat dairy products.
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Good sources of soluble fiber include oats, certain fruits (such as oranges and pears) and vegetables (such as brussel sprouts and carrots), and dried peas and beans.
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Unfortunately, there are things that affect cholesterol levels you cannot do anything about. Your age and gender are factors. As we age, our cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women's LDL levels tend to rise. Heredity is another. Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.
For men and women
Clinical trials addressing cholesterol lowering and CHD in middle-aged men with and without CHD have shown that men benefit greatly from cholesterol lowering. Recent clinical trials have shown that women benefit from cholesterol lowering as much as men. Because the lifetime risk of developing CHD is high for both men and women even before the age of 40, it is important to begin cholesterol lowering as early as possible. One out of every 2 men aged 40 and younger, and 1 out of every 3 women aged 40 and younger, will develop CHD sometime in their life.
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For Young Adults
It has been shown that atherosclerosis begins during the teen years and early 20s. High cholesterol levels in young adulthood significantly increase the risk for developing CHD later in life. The Framingham Heart Study showed that young adults with lower cholesterol levels have greater longevity and lower cardiovascular mortality. This has recently been confirmed in a very large pooled study. [Citation: Stamler J, Daviglus ML, Garside DB, Dyer AR, Greenland P, Neaton JD. Relationship of baseline serum cholesterol levels in 3 large cohorts of younger men to long-term coronary, cardiovascular, and all-cause mortality and to longevity. JAMA. 2000;284:311-318]. Establishing a healthy eating pattern and other positive habits early in life is an important step in keeping CHD risk low. It is important to measure cholesterol levels in young adults so that life habit changes that decrease the lifetime risk for CHD can be initiated early. Waiting until mid-life to measure and treat cholesterol can be costly. Approximately one-third of first CHD events are fatal, leaving no second chance. Once CHD has become manifest, there is usually a lot of atherosclerosis to treat. Although cholesterol lowering in those with CHD has been shown to be highly beneficial, once CHD is present it is not possible to eliminate all of the excess risk.
For Older Adults
Among older Americans, cholesterol lowering is beneficial for those with CHD as well as those trying to prevent it. As a group, older Americans (over 65 years) have the highest rate of CHD. Up to three-quarters of older individuals have either obvious or subclinical disease. Even among men who reach 70 years of age without obvious CHD, 1 out of every 3 will still develop the disease in his remaining years; among women free of CHD at age 70, 1 out of every 4 will go on to have the disease. Furthermore, clinical trials in people with CHD and in primary prevention demonstrated that older participants reduce their CHD risk with cholesterol lowering as much as middle-aged ones. Of particular interest is that cholesterol lowering also reduced the occurrence of strokes in older persons. In older adults, life habit changes are the foundation of treatment for primary prevention, and a combination of life habit changes and drug therapy will often be needed in those with CHD.
Drug Treatment
Even if you begin drug treatment to lower your cholesterol, you will need to continue your treatment with lifestyle changes. This will keep the dose of medicine as low as possible, and lower your risk in other ways as well. There are several types of drugs available for cholesterol lowering including statins, bile acid sequestrants, nicotinic acid, and fibric acids. Your doctor can help decide which type of drug is best for you. The statin drugs are very effective in lowering LDL levels and are safe for most people. Bile acid sequestrants also lower LDL and can be used alone or in combination with statin drugs. Nicotinic acid lowers LDL and triglycerides and raises HDL. Fibric acids lower LDL somewhat but are used mainly to treat high triglyceride and low HDL levels.
Once your LDL goal has been reached, your doctor may prescribe treatment for high triglycerides and/or a low HDL level, if present. The treatment includes losing weight if needed, increasing physical activity, quitting smoking, and possibly taking a drug.
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| Information and links found on the UT Medical Group, Inc. web site are neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition. If you think you may have a medical emergency call your healthcare provider immediately. |
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