Managing High Cholesterol: What You Should Know
Managing High Cholesterol: What You Should Know
Cholesterol is a type of fat found in the blood, and it's an essential component of every cell in our body. It helps form cell membranes, produce certain hormones, and create substances that help digest food. However, when cholesterol levels get too high, it can lead to serious health problems, particularly cardiovascular disease.
What Are Cholesterol Levels?
When you get a cholesterol test, also known as a lipid panel, there are several key numbers you’ll hear about:
Total cholesterol – This is the sum of all the cholesterol in your blood.
LDL (Low-Density Lipoprotein) – Often referred to as "bad" cholesterol, LDL carries cholesterol to cells. If too much LDL is circulating in your blood, it can accumulate on the walls of your arteries, leading to plaque buildup and a condition called atherosclerosis. This can increase your risk of heart attack, stroke, and other cardiovascular issues.
HDL (High-Density Lipoprotein) – Known as "good" cholesterol, HDL helps remove excess cholesterol from the bloodstream and carries it back to the liver, where it is processed and excreted. Higher levels of HDL are generally considered protective against heart disease.
Triglycerides – These are another type of fat in your blood that can contribute to the buildup of plaque in your arteries if levels are too high.
For most adults, the goal is to have:
Total cholesterol under 200 mg/dL
LDL cholesterol under 100 mg/dL (for those at higher risk, even lower is ideal)
HDL cholesterol above 40-60 mg/dL (higher is better)
Triglycerides under 150 mg/dL
These targets can vary depending on individual health factors, such as age, family history, and pre-existing conditions like diabetes or high blood pressure, heart disease or prior stroke.
Risks of High Cholesterol
When your cholesterol levels are too high, it can create serious health risks. Here’s how:
Atherosclerosis: High LDL cholesterol contributes to the formation of plaque in the arteries. Over time, this plaque can narrow the arteries, making it harder for blood to flow. This increases your risk of heart attacks, strokes, and peripheral artery disease.
Heart Disease: Elevated cholesterol is a key risk factor for coronary artery disease (CAD), where the coronary arteries that supply blood to the heart become clogged. This can lead to chest pain (angina), heart attacks, and other cardiovascular complications.
Stroke: Just like the heart, the brain relies on a steady supply of oxygenated blood. When arteries in the brain become narrowed or blocked by plaque, the risk of ischemic stroke increases.
Peripheral Artery Disease (PAD): When plaque builds up in arteries outside the heart, especially in the legs, it can lead to PAD. This condition can cause pain and cramping often initially with exertion, and even tissue damage.
High cholesterol is often referred to as the "silent killer" because there are typically no symptoms until a serious event, like a heart attack or stroke, occurs. That's why routine screening and regular check-ups are essential, especially if you have risk factors such as a family history of heart disease, smoke cigarettes or have high blood pressure.
The Role of Diet, Exercise, and Medications in Managing Cholesterol
While cholesterol has a genetic component, lifestyle changes—particularly in diet and exercise—play a significant role in managing it. Here's how you can take charge of your cholesterol levels:
1. Diet and Cholesterol
For years, the medical community believed that eating foods high in cholesterol, like eggs or red meat, directly contributed to high cholesterol levels. However, recent research has shown that the relationship between dietary cholesterol and blood cholesterol is more complex. The majority of the cholesterol in our blood is actually produced by our liver, not from the cholesterol we eat. In fact, our body adjusts its own production based on the amount of cholesterol we consume.
That being said, some foods do influence cholesterol levels in ways that are worth paying attention to:
Trans fats and saturated fats: Foods high in saturated fats, not necessarily high in cholesterol itself, can significantly impact cholesterol levels by increasing circulating levels and increasing cholesterol production. These fats are often found in processed foods, baked goods, and fatty cuts of meat.
Unsaturated fats: These healthy fats, found in olive oil, avocados, and fatty fish, can help lower LDL levels and raise HDL levels.
Fiber: Soluble fiber, found in oats, beans, fruits, and vegetables, can help lower LDL cholesterol by binding with cholesterol in the digestive system and removing it from the body.
While foods high in cholesterol may not be the biggest factor in increasing cholesterol levels in our blood, these foods are often also high in trans fats and saturated fats that increase our risk of plaque buildup, heart attacks and strokes. Incorporating healthy foods into our diet—while reducing processed foods, sugars, and unhealthy fats—can be highly beneficial for our overall health.
2. Exercise and Cholesterol
Physical activity is another cornerstone in managing cholesterol. Regular exercise, especially aerobic activities like walking, running, cycling, or swimming, can:
Increase HDL cholesterol (the "good" cholesterol).
Lower LDL cholesterol (the "bad" cholesterol) and triglycerides.
Improve overall heart health by lowering blood pressure, improving blood sugar control, and maintaining a healthy weight.
The American Heart Association recommends at least 150 minutes of moderate-intensity exercise per week for adults. Even if you start with just a few minutes a day, the benefits of regular exercise will accumulate over time.
3. Medications for Cholesterol
For some people, lifestyle changes alone may not be enough to bring cholesterol levels into a healthy range. In these cases, medications can help. The most commonly prescribed medications are statins, which work by blocking a substance your body needs to make cholesterol. Statins can lower LDL cholesterol and reduce the risk of heart attack and stroke.
Other types of cholesterol-lowering drugs include:
Ezetimibe: Reduces the absorption of cholesterol from food.
PCSK9 inhibitors: A newer class of injectable drugs that can lower LDL cholesterol significantly.
Fibrates and niacin: These medications primarily help lower triglycerides and can raise HDL cholesterol.
Supplements such as red yeast rice may be effective in lipid lowering as well.
Medication decisions are made on a case-by-case basis, depending on a patient's overall risk for heart disease, as well as their cholesterol levels and other health factors.
The Genetics of Cholesterol: Why It's Not Just About Diet
It's important to understand that while diet and exercise can influence cholesterol levels, they are not always enough to control them, especially if your body has a genetic predisposition to high cholesterol. The liver produces the vast majority of the cholesterol in your body, and some people’s livers naturally produce more cholesterol than others.
Familial hypercholesterolemia is a genetic condition where individuals have very high levels of LDL cholesterol, even in childhood. It’s an inherited disorder that affects about 1 in 250 people and significantly increases the risk of heart disease at a young age. Even with a healthy lifestyle, people with familial hypercholesterolemia may still require medications to manage their cholesterol effectively.
Final Thoughts
Cholesterol management is a multifaceted approach that involves understanding your personal risk factors, making healthy lifestyle choices, and sometimes taking medications. While diet plays a role in managing cholesterol, it’s not the only factor—genetics, especially the liver’s production of cholesterol, plays a crucial part in determining your blood cholesterol levels. Regular check-ups with your doctor are important to monitor your cholesterol and ensure you’re taking the right steps to protect your heart health. Whether through diet, exercise, or medication, managing cholesterol can help reduce your risk of heart disease, stroke, and other cardiovascular problems, leading to a longer, healthier life.
Florida Direct Primary Care
At Florida Direct Primary Care, we develop individualized treatment plans that promote overall health and wellness, tailored to each patient’s unique health needs and goals. If you’re in the St. Augustine area and looking for a primary care doctor, sports medicine or obesity medicine doctor, contact us to learn more about the practice. Visit FloridaDPC.com, email us at info@FloridaDPC.com, or call 904-650-2882.
This web site is provided for educational and informational purposes only and does not constitute the provision of medical advice or professional services. The information provided should not be used for diagnosing or treating individual health problems or diseases. Those seeking medical advice should consult with a licensed physician.Ready to become a Florida DPC member? Click here to register.
