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If you’re like most people, you know the importance of keeping your cholesterol levels within a healthy range. According to Centers for Disaster Control and Prevention (CDC), this means less than 100 mg / dL of low density lipoprotein (LDL), more than 60 mg / dL of high density lipoprotein (HDL) and less than 150 mg / dL of triglycerides.
But beyond just knowing whether your cholesterol is too high or not, understanding the role cholesterol plays in promoting and preventing disease can help you stay healthy. Deirdre Mattina, MD, preventive cardiologist at the Cleveland Clinic. “When you learn more about your cholesterol, it will help you have a more informed conversation with your doctor. It can help your healthcare team identify your risk for heart disease early and develop a treatment plan that will help you live longer and more vitally, ”she says.
So what should you know about cholesterol to prevent heart disease, stroke, and more? Read on.
1. Total cholesterol is only part of the picture.
When you collect your blood test results, there is a good chance that you are focusing on your total cholesterol, focusing on that number. However, Dr Mattina says what’s more important than total cholesterol is understanding each of the different components that make up this score. “You really have to break down the different types of cholesterol to get the full picture,” says Dr Mattina. A typical cholesterol test will measure the following:
- LDL: This is considered the “bad” cholesterol because it causes plaque to build up in your arteries and increases your risk for heart attack and stroke. (The more buildup, the stiffer and narrower your arteries, and the harder it is for blood to flow freely to and from the heart.) For the general population, less than 100 is ideal, and a score above 160 is considered high. However, if you’ve ever been diagnosed with heart disease, you’ll want your LDL to be below 70 and maybe even lower, adds. Randal Thomas, MD, medical director of the Mayo Clinic cardiac rehabilitation program.
- HDL: This is considered the “good” cholesterol because it keeps LDL cholesterol away from the arteries and back to the liver, where it is broken down and flushed out of the body. For men, the ideal range is between 40 and 100 HDL; for women, 50 to 100 is ideal, says Dr Thomas
- Triglycerides: It is a type of fat in the blood that your body uses for energy. For most people, a triglyceride score over 150 is considered high, according to Dr. Thomas, and over 1,000 is dangerously high. Combining high triglycerides with low “good” HDL cholesterol or high “bad” LDL cholesterol can increase your risk for heart attack and stroke.
To get a more accurate picture of how your cholesterol may put you at risk for heart disease, add these three components of cholesterol, then subtract your HDL count. “This the number tells us how many cholesterol particles are circulating that put you at risk, ”says Dr Mattina. (Speak CDC Guidelines, you will want this number to be 250 mg / dL or less.)
2. Even if you have normal cholesterol levels, you can still have a heart attack.
For women, in particular, the new thought is that it’s not just the cholesterol particles that transmit the risk of heart disease, but how that cholesterol behaves, says Dr. Mattina. “A lot of people with normal cholesterol have heart attacks, and that’s probably because their cholesterol behaves in an inflammatory way,” she says.
The best way to tell if you have inflammatory cholesterol particles in your blood is to get a high-sensitivity C-reactive protein (CRP) test, says Dr. Mattina. “This is not checked in a typical cholesterol panel and is not specific to heart disease, but it will give your doctor a feeling of overall inflammation in your body” which will then help guide your treatment plan. . (CRP is a byproduct of inflammation, and experts okay, predicting heart disease is as good as measuring LDL.)
If your C-reactive protein is high, your doctor may also prescribe a coronary calcium score to better understand your risk for heart disease. This test involves a low-dose x-ray of the heart to look for hardened cholesterol in the arteries, says Dr. Mattina. “If you have a high calcium score, that tells us that there is hardened cholesterol in the arteries around the heart,” she says. “This is when we will want to consider cholesterol-lowering drugs as a treatment option to prevent heart attacks.”
3. Eating well can improve your cholesterol levels, but you may need to Medicines.
There is no doubt that certain unhealthy habits will cause your triglycerides and LDL cholesterol to rise and cause your HDL levels to drop. According to American Heart Association, a diet high in saturated fat and simple carbohydrates, smoking, lack of exercise, and being overweight or obese all negatively impact your cholesterol and increase your risk for heart disease. On the flip side, improving your diet by choosing healthier fats and increasing your fiber intake, exercising more and quitting smoking can go a long way in controlling your cholesterol levels.
That said, even if you make all of the right choices in an effort to improve your cholesterol profile, medication may still be needed – and it’s important to understand that you may not be able to improve your cholesterol level with just it. lifestyle measures, says Dr. Mattina. “This is especially true if you’ve had a heart attack when we need to drastically lower your LDL cholesterol,” she says. “However, if you make big changes in your habits, you can have an impact on the total dose or the amount of cholesterol medication you take for maintenance.”
4. Preventive cardiologists can help you keep tabs on your cholesterol and heart health.
Considering that heart disease is the leading cause of death in this country, more of us live with high cholesterol, says Dr Mattina – and the longer cholesterol lasts in the bloodstream, the more likely it is to build up in your blood vessels and cause dental plaque to build up and break down. increased inflammation. Plus, there is very little data that shows we can reverse the damage caused by high levels of “bad” cholesterol, she says. “For the most part, the best we can do is stabilize cholesterol and keep it from getting worse,” says Dr Mattina. “Which means prevention is essential. And the earlier you start, the better. “
If you have a parent who had a heart attack in your 30s or 40s, your doctor might suggest seeing a cardiologist when you are in your 20s, says Dr. Mattina. “I also love seeing women of childbearing age, regardless of their family history, because we see the risk of heart disease increase when women have gestational diabetes and preeclampsia during pregnancy. Chronic diseases that cause chronic inflammation, such as autoimmune diseases like lupus and rheumatoid arthritis, can also put you at a higher risk for heart disease, even if your cholesterol is not high, adds the Dr Mattina. Ask your doctor what he thinks is right for you, given your medical history.
If you want to be proactive, make an appointment with a preventive cardiologist, regardless of your age or risk factors, says Dr. Mattina. “This type of specialist will be able to assess your cholesterol levels and your overall risk of heart disease and help you develop a long-term health plan,” she says. “When it comes to heart disease, the sooner you identify your risk and treat it if necessary, the better.”
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