Heart disease remains one of the leading causes of death in adults. Of the known risk factors for heart disease or coronary artery disease, elevated cholesterol is one of the most important. In fact, having elevated cholesterol puts you at risk not only for coronary artery disease, but also strokes, poor circulation, blindness, kidney disease and erectile dysfunction.
If elevated cholesterol is so important, then what is an acceptable cholesterol level and how often should it be checked?
Cholesterol is a complex collection of many different fats. It largely comes from two sources; the food we eat and from production by our own body. Some cholesterol is actually good and crucial for a healthy body, while other types of cholesterol are extremely bad and associated with heart disease.
The good cholesterol is called HDL or high density lipoprotein. HDL circulates in the body and collects some of the bad cholesterol and removes it from circulation before it can cause damage. The bad cholesterol is called LDL or low density lipoprotein and causes blockages. Just remember, you want your HDL to be high, and your LDL to be low.
There are a couple of numbers that all adults should remember about their own cholesterol. Your total cholesterol is actually a composite score of HDL, LDL and another type of fat called triglycerides. The total cholesterol is nice to know, as it is one number and easy to remember. Your goal total cholesterol should be less than 200. If it is higher, your risk of heart disease unsafely increases. In fact, if it is greater than 240, then you are twice as likely to develop heart disease as those with cholesterol less than 200.
However, as this total cholesterol takes into account both good and bad cholesterol, it is important to know how your total cholesterol breaks down. This is particularly important if you have heart disease or currently take a cholesterol lowering medication. In this case, your physician should check a fasting lipid profile, which will allow your total cholesterol to be broken down into the three major components: HDL, LDL and triglycerides.
Additionally, what is defined as acceptable is markedly affected by whether you already have heart disease or you have significant risk factors for developing it? Such as the more risk factors you have, the lower your cholesterol should be. While if you already have heart disease, the goal should be as low as possible.
HDL is the good cholesterol, and the higher the HDL the better. Low HDL is defined as less than 40 in men less than 50 in women. Low HDL is associated with heart disease and stroke. While an HDL greater than 60 is protective and actually reduces your risk of heart disease.
LDL is the bad cholesterol and constitutes the majority of your total cholesterol value. In patients with no known history of heart disease or strokes, the target LDL should be less than 100. If it is 160 or greater, this is too high. As mentioned previously, much more stringent LDL levels apply to those with many risk factors or those with established heart disease. Regardless of your LDL, diet and exercise will lower your LDL and risk of developing heart disease.
Triglycerides are also a type of fat that can cause damage. Elevated triglycerides seem to be associated with obesity, sedentary lifestyles, diabetes, high carbohydrate diets, excess alcohol and tobacco. All raise triglycerides and further increase risk of heart disease. The good news is that addressing the above can sometimes rapidly lower triglycerides to target. The goal triglyceride level should be 150 or less.
So when should you have your physician check your cholesterol? It seems that a baseline sample as a young adult is appropriate, especially those with a known family history of early heart disease and stroke. Certainly every adult should have his or her cholesterol checked at least once.
If your cholesterol is at target, most physicians and the American Heart Association recommend follow up cholesterol checks every five years. If you have heart disease or are taking cholesterol-reducing medications, your physician will want frequent samples until the strategy of lifestyle modification and medications get you to your goal. Even if you are at target, it is always essential to exercise regularly, make smart dietary decisions and stop smoking.
Ultimately, this strategy and closely following your cholesterol levels can make you heart healthy.
David M. Donaldson, MD, is an Auburn native and currently a cardiologist at Massachusetts General Hospital in Boston.
Cholesterol is a complex collection of many different fats. It largely comes from two sources; the food we eat and from production by our own body. Some cholesterol is actually good and crucial for a healthy body, while other types of cholesterol are extremely bad and associated with heart disease.
The good cholesterol is called HDL or high density lipoprotein. HDL circulates in the body and collects some of the bad cholesterol and removes it from circulation before it can cause damage. The bad cholesterol is called LDL or low density lipoprotein and causes blockages. Just remember, you want your HDL to be high, and your LDL to be low.
There are a couple of numbers that all adults should remember about their own cholesterol. Your total cholesterol is actually a composite score of HDL, LDL and another type of fat called triglycerides. The total cholesterol is nice to know, as it is one number and easy to remember. Your goal total cholesterol should be less than 200. If it is higher, your risk of heart disease unsafely increases. In fact, if it is greater than 240, then you are twice as likely to develop heart disease as those with cholesterol less than 200.
However, as this total cholesterol takes into account both good and bad cholesterol, it is important to know how your total cholesterol breaks down. This is particularly important if you have heart disease or currently take a cholesterol lowering medication. In this case, your physician should check a fasting lipid profile, which will allow your total cholesterol to be broken down into the three major components: HDL, LDL and triglycerides.
Additionally, what is defined as acceptable is markedly affected by whether you already have heart disease or you have significant risk factors for developing it? Such as the more risk factors you have, the lower your cholesterol should be. While if you already have heart disease, the goal should be as low as possible.
HDL is the good cholesterol, and the higher the HDL the better. Low HDL is defined as less than 40 in men less than 50 in women. Low HDL is associated with heart disease and stroke. While an HDL greater than 60 is protective and actually reduces your risk of heart disease.
LDL is the bad cholesterol and constitutes the majority of your total cholesterol value. In patients with no known history of heart disease or strokes, the target LDL should be less than 100. If it is 160 or greater, this is too high. As mentioned previously, much more stringent LDL levels apply to those with many risk factors or those with established heart disease. Regardless of your LDL, diet and exercise will lower your LDL and risk of developing heart disease.
Triglycerides are also a type of fat that can cause damage. Elevated triglycerides seem to be associated with obesity, sedentary lifestyles, diabetes, high carbohydrate diets, excess alcohol and tobacco. All raise triglycerides and further increase risk of heart disease. The good news is that addressing the above can sometimes rapidly lower triglycerides to target. The goal triglyceride level should be 150 or less.
So when should you have your physician check your cholesterol? It seems that a baseline sample as a young adult is appropriate, especially those with a known family history of early heart disease and stroke. Certainly every adult should have his or her cholesterol checked at least once.
If your cholesterol is at target, most physicians and the American Heart Association recommend follow up cholesterol checks every five years. If you have heart disease or are taking cholesterol-reducing medications, your physician will want frequent samples until the strategy of lifestyle modification and medications get you to your goal. Even if you are at target, it is always essential to exercise regularly, make smart dietary decisions and stop smoking.
Ultimately, this strategy and closely following your cholesterol levels can make you heart healthy.
David M. Donaldson, MD, is an Auburn native and currently a cardiologist at Massachusetts General Hospital in Boston.
