The lowdown on high cholesterol

Cholesterol is a waxy, fat-like substance that is produced in your liver and also found in foods. While you need a certain level of cholesterol for your body to function normally, too much cholesterol can build up and cause problems. Over time, this buildup can cause your arteries to narrow, which will put you at an increased risk for conditions such as heart disease and stroke.

Normal levels of total cholesterol are <200mg/dL, but according to the Centers for Disease Control and Prevention more than 102 million Americans exceed that number. You may have heard of LDL and HDL when talking about cholesterol, and those are two numbers to better understand.

LDL (low density lipoprotein) is often referred to as the “bad” cholesterol because it makes up the largest part of our body’s cholesterol and can cause buildups that are commonly called “plaques.” Thus, having levels of LDL that are too high will raise your risk for heart disease and stroke due to the reduced blood flow to and from organs in your body.

HDL (high density lipoprotein), or “good” cholesterol, works to absorb cholesterol in the body and carries it back to the liver. Thus, having high levels of HDL is generally considered a good thing. Triglycerides, the most common type of fat in your body, store excess energy from your diet. Having a higher level of triglycerides in combination with high LDL or low HDL cholesterol is linked to an increased risk of building up the plaques in your arteries.

Since high cholesterol alone won’t usually have any symptoms, the only way to know how high your cholesterol is to have it checked. Having your cholesterol checked is done by visiting your primary care physician for a simple blood test.

For adults over the age of 20 who are currently not taking any medications to lower cholesterol, you may or may not have to fast before having your cholesterol checked. Fasting refers to a period of time where you do not consume food or drinks, but your doctor will tell you whether to fast prior to your cholesterol test and for how long.

Once your blood test has been analyzed by a lab, your doctor can determine your cardiovascular risk while also taking into consideration your age, sex, smoking history, and family history. Other health conditions such as diabetes and high blood pressure will also influence your cardiovascular health.

If you have elevated levels of cholesterol, there are several things you can do to help lower them or prevent them from going higher. Non-medication ways to help prevent your cholesterol from rising are to make sure you are eating healthy foods by limiting foods that are high in saturated fat, which can include cheeses, fatty meats, and dairy-based desserts.

Foods naturally high in fiber like oatmeal or various types of beans such as black beans and pinto beans can help prevent or manage elevated levels of LDL cholesterol and triglycerides and can also promote higher levels of our good cholesterol, HDL.

In addition to maintaining a healthy diet, it is recommended that you get 2.5 hours of moderate-intensity exercise weekly. This can include taking a brisk walk with friends, going on a bike ride, or even just taking the stairs instead of an elevator whenever possible. Anything to get more active can surely having a benefit and also help you maintain a healthy weight.

Outside of eating well and exercising regularly, you should quit smoking if you are a current smoker, and if you drink alcohol then you should limit yourself to two drinks per day if you are a man or one drink per day for women.

Despite making lifestyle modifications listed above, some people with high cholesterol will still need to take medications to help. The most common class of medications used for high cholesterol are called “statins.” Examples of these medications are atorvastatin (Lipitor), rosuvastatin (Crestor), simvastatin (Zocor), lovastatin (Mevacor), and pravastatin (Pravachol).

These medications help by blocking the enzyme in your liver that is responsible for making cholesterol. In addition, a new class of medications called PCSK9 inhibitors can be used in patients who do not meet cholesterol treatment goals with dietary modification and other cholesterol medications. Examples of PCSK9 inhibitors include evolocumab (Repatha) and alirocumab (Praluent).

The American Heart Association recommends that all adults over 20 have their cholesterol and other risk factors checked every four to six years. Once you are over 40 years old, your doctor will also use an equation to calculate your 10-year risk of developing cardiovascular disease or stroke.

If you already have cardiovascular disease or are at an increased risk for developing cardiovascular disease, your doctor may want you to have your cholesterol and other risk factors checked more often.

For more information on cholesterol and how it pertains to your health, you can visit the CDC website or American Heart Association website, or talk with a health care provider.