Don’t Lose Track of the Dangers of Cholesterol

Opinion

By QUINN PACK, MD

Cholesterol has its good and bad qualities, and it’s the bad you want to avoid.

Cholesterol is a waxy substance used in making the walls that surround cells and in making a number of hormones used in human metabolism. Cholesterol is manufactured in the liver and is found in every cell in the human body. It travels through the bloodstream with the aid of lipoproteins, which can deposit cholesterol in the blood vessels, forming plaque and increasing one’s risk of heart attack and stroke. This is what we consider bad cholesterol, which is clinically referred to as low-density lipoprotein cholesterol (LDL-C).

The National Cholesterol Education Program currently recommends that adults age 20 and older have their cholesterol checked every five years. Cholesterol levels increase as people age and can change significantly depending on dietary habits, so even if your cholesterol levels were normal in the past, it’s still a good idea to get your cholesterol checked every five years. Menopause also can worsen LDL levels.

In addition to LDL, doctors are also concerned with high-density lipoprotein HDL, referred to as good cholesterol, with 40-59 md/dL considered acceptable, but 60 mg/dL and higher even better and considered to be protective against heart disease.

Many risk factors contribute to having high or low cholesterol, including diet, lack of exercise, excess weight, age, sex, race (African-Americans and Hispanics are at greater risk for developing high cholesterol), alcohol, and stress levels. For some, high cholesterol is inherited, but many times, it is the result of eating too many saturated fats and dietary cholesterol from animal products. Some risk factors can be reduced by following a heart-healthy lifestyle, while others are beyond your control.

Although very low levels of LDL have been shown to reduce risk for heart disease the most, it is important to remember that any amount of cholesterol lowering reduces risk of heart disease. For example, if you have very high cholesterol levels (LDL level above 190 mg/dL), reducing your LDL to less than 100 mg/dL will substantially reduce your risk for a heart attack, even if your cholesterol levels don’t get into the 30-70 mg/dL range.

For a patient who has had a heart attack, even if he or she has had average cholesterol levels, we still generally recommend taking a statin or other cholesterol medicine because these medicines reduce a person’s risk of having a second heart attack. For patients without prior heart disease, but with moderate to extreme levels of cholesterol, they should always be on statins, regardless of their risk factors and even if they lead a pristine lifestyle with plenty of exercise and a healthy diet.

Cholesterol can be a confusing health topic for a lot of people, but understanding and managing high blood cholesterol is an important step in taking control of your heart health. Get to know the basics of cholesterol, your risk factors, and your numbers, and team up with your healthcare provider to manage your cholesterol.

Dr. Quinn Pack is a preventive cardiologist in the Heart & Vascular Program at Baystate Health. For more information on the Heart & Vascular Program at Baystate Health, visit baystatehealth.org/heart.

Dr. Quinn Pack is a preventive cardiologist in the Heart & Vascular Program at Baystate Health. For more information on the Heart & Vascular Program at Baystate Health, visit baystatehealth.org/heart.