All about cholesterol

What is cholesterol?

Cholesterol is a natural substance made by your liver or consumed in foods, and is necessary for our health. However, too much cholesterol (and specific types of cholesterol) are associated with an increased risks of heart attack, stroke, and other health issues.

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What is the difference between HDL and LDL cholesterol?

When you get your blood tested for cholesterol, you may hear your doctor talk about different types of results: total cholesterol, LDL, HDL, and triglycerides. 

• LDL cholesterol: also known as the “bad” cholesterol”.  Research has shown a direct correlation between high LDL levels and coronary artery disease, heart attack, and stroke. 
• HDL cholesterol: also known as the “good” cholesterol.  Higher levels of HDL are actually associated with lower risk of heart attack and stroke. 
• Triglycerides are also measured; they are another type of fat which rises in the blood after a meal (this is why your doctor may ask you to get your lipid panel drawn while fasting). High triglycerides may also increase the risk of heart attack and stroke. 

 
What is a good cholesterol number?

In general, people who do not have heart disease or stroke already should aim for these numbers: 

• Total cholesterol less than 200
• LDL less than 130 (or lower if prior history of heart attack or stroke)
• HDL above 60
• Triglycerides below 150

 
What should I do about high cholesterol?

There are plenty of things that can be done about high cholesterol. In addition, just because you have high cholesterol doesn’t mean you are at a very high risk of heart attack or stroke; it is just one risk factor among others that you can modify to live healthier and prevent disease. Some modifiable risk factors include:

• Smoking
• High blood pressure
• Diet: eating a heart healthy diet including fruits, vegetables, fiber and healthy fats (fish and olive oil), and avoiding sugar and unhealthy fats or processed foods.

 
Some non-modifiable risk factors (meaning you can’t change them) include:

• Family history of heart disease at a young age in a first-degree relative (parent or sibling). This is defined as younger than 55 for men and younger than 65 for women.
• Older age 

Should I take medicine for cholesterol?

Not everyone needs to be on medicine for high cholesterol. You and your doctor should take into account your overall risk of heart disease and stroke.  Clear indications that you should start treatment with a cholesterol-lowering medication (usually a statin) include:

• A history of heart attack or stroke in the past
• Heart disease (coronary artery disease)
• Diabetes
• Peripheral artery disease

Can I lower my cholesterol without medicines?

Yes! Some basic things that we should all be striving to do can lower cholesterol!

• Avoid red meat, processed and fried foods, and foods high in saturated fat
• Lose weight if you are overweight
• Increase physical activity (try to exercise at least 30 minutes a day 3-5 times per week)
   

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