Louis J. Scala, M.D.
Many Americans do not understand the role that cholesterol—a fat-like substance found in all cells of the body—plays in heart health and heart disease. When there is too much cholesterol in the blood, cholesterol can build up on artery walls and slow or stop blood flow to the heart. Here’s what you need to know . . .
Cholesterol is a waxy, fat-like substance found throughout the body. Our bodies need it to make hormones, vitamin D, and substances that help digest foods. Our bodies produce the cholesterol we need. However, cholesterol is also found in some of the foods we eat.
Cholesterol travels through the bloodstream in small packages called lipoproteins. These packages are made of fat (lipids) on the inside and proteins on the outside. Two main kinds of lipoproteins carry cholesterol throughout the body:
Low-density lipoproteins (LDL): LDL cholesterol is often called “bad” cholesterol. A high LDL level leads to a buildup of cholesterol in your arteries. (Arteries are blood vessels that carry blood from your heart to your body.)
High-density lipoproteins (HDL): HDL cholesterol is often called “good” cholesterol. HDL carries cholesterol from other parts of your body back to your liver. Your liver removes the cholesterol from your body.
Having healthy levels of both types of lipoproteins is important.
How Does Cholesterol Cause Heart Disease?
When there is too much cholesterol (a fat-like substance) in your blood, it builds up in the walls of your arteries. Over time, this buildup causes “hardening of the arteries”. These arteries become narrowed and blood flow to the heart is slowed down or blocked. The blood carries oxygen to the heart, and if enough blood and oxygen cannot reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack.
Many people are unaware that their cholesterol level is too high because high blood cholesterol itself does not cause symptoms. It is important to find out what your cholesterol numbers are. High numbers increase the risk for developing heart disease and the chance of having a heart attack. Cholesterol lowering is important for everyone–younger, middle age, and older adults; women and men; and people with or without heart disease.
What Do Your Cholesterol Numbers Mean?
Everyone age 20 and older should have their cholesterol measured at least once every 5 years. It is best to have a blood test called a “lipoprotein profile” to find out your cholesterol numbers. This blood test is done after a 9 to 12 hour fast and provides information about your Total Cholesterol (LDL, HDL, and Triglycerides).
If it is not possible to get a lipoprotein profile done, knowing your total cholesterol and HDL cholesterol can give you a general idea about your cholesterol levels. If your total cholesterol is 200 mg/dL* or more or if your HDL is less than 40 mg/dL, you will need to have a lipoprotein profile done. See how your cholesterol numbers compare to the tables below.
HDL (good) cholesterol protects against heart disease, so for HDL, higher numbers are better. A level less than 40 mg/dL is low and is considered a major risk factor because it increases your risk for developing heart disease. HDL levels of 60 mg/dL or more help to lower these risks.
Triglycerides can also raise heart disease risk. Levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more) may need treatment.
What Affects Cholesterol Levels?
Many factors can affect blood cholesterol levels. You can control some, but not others:
Diet. Saturated fat and cholesterol in the food you eat make your blood cholesterol level go up. Saturated fat is the main culprit, but cholesterol in foods also matters. Reducing the amount of saturated fat and cholesterol in your diet helps lower your blood cholesterol level.
Weight. Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol. Losing weight can help lower your LDL and total cholesterol levels, as well as raise your HDL and lower your triglyceride levels.
Physical Activity. Not being physically active is a risk factor for heart disease. Regular physical activity can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also helps you lose weight. You should try to be physically active for 30 minutes on most, if not all, days.
Things you cannot control that affect
cholesterol levels include:
Age and Gender. As women and men get older, cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women’s LDL levels tend to rise.
Heredity. Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.
Treating High Cholesterol
The main goal of cholesterol-lowering treatment is to lower your LDL level enough to reduce your risk of developing heart disease or having a heart attack. The higher the risk, the lower the LDL goal will be. To find your LDL goal, see the boxes below for your risk category. There are two main ways to lower your cholesterol:
Drug Treatment–if cholesterol-lowering drugs are needed, they are used together with TLC treatment to help lower your LDL.
Once your LDL goal has been reached, your doctor may prescribe treatment for high triglycerides and/or a low HDL level, if present. The treatments often include losing weight if needed, increasing physical activity, quitting smoking, and possibly taking a drug.
Dr. Scala has been selected a Castle Connolly 2015 “Top Doctor” by a physician-led team of researchers in the field of Cardiovascular Disease.
South Cape Business Center
3208 Chiquita Blvd. S, Suite 110
Cape Coral, FL 33914
Therapeutic Lifestyle Changes (TLC)–includes a cholesterol-lowering diet, physical activity, and weight management. TLC is for anyone whose LDL is above goal.
Dr. Louis J. Scala has been voted TOP DOCTOR four consecutive years by Castle Connolly. He received his medical degree at the State University of New York Health Science Center. He completed his Residency at Brown University, and Cardiology Fellowship at Cedars-Sinai Medical Center at UCLA. He is Board Certified in Internal Medicine and specializes in Cardiovascular Disease.