Cholesterol and Your Heart Health

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High cholesterol is a major risk factor for heart disease

High cholesterol can lead to a build up of plaque that narrows (or blocks) your arteries (atherosclerosis), which increases your risk of heart disease and stroke.

What is it?

It is one of the fats - or lipids - in your blood. Despite all the negative hype about it, it plays an important role - our body uses it to make cell membranes, hormones, Vitamin D, and bile salts for absorption of fat.

Up to 20% of the cholesterol we need comes from the food we eat. The remainder (approximately 80%), is made by our liver.

There are two main types:

Low-density lipoprotein (LDL) often called bad cholesterol because high levels in the blood promote the build-up of plaque in the artery walls. Plaque can reduce the flow of blood through the arteries and can cause chest pain (angina), heart attack, or, if the blood flow to the brain is blocked, stroke.

High-density lipoprotein (HDL) called the good cholesterol because it helps carry LDL-cholesterol away from the artery walls to the liver where it can be disposed of by the body.

ldl and hdl cholesterol

Triglycerides are another type of fat found in the blood. Triglycerides are essentially a fuel used for energy production. High triglycerides are linked with excess weight, excess alcohol consumption, and diabetes. Your triglyceride level is usually measured at the same time as your cholesterol.

So while these fats play important roles in our bodies, elevated levels are a major risk factor for heart disease. And, according to the Mayo Clinic Heart Book, "approximately 55 percent of American adults have total levels higher than 200 mg/dL," which puts them at risk (see below).

Total cholesterol is a common measurement of all the different levels found in your blood. While your total level doesn't tell the whole story - you need to know the levels of each of the lipids - it is a good overall indicator of risk.

If you have heart disease, your doctor will be watching your lipid and triglyceride levels. To reduce your risk, your doctor may want your levels even lower than what is considered desirable for the general population.

What can you do?

Know your levels! People with high risk levels typically have twice the risk of heart disease. There are no symptoms. You must have your levels checked through blood testing. Ask your doctor for a copy of your blood test results after each check and keep a ongoing record.

In the US the most common form of measurement is:

Desirable = less than 200 mg/dL
Borderline-high risk = 200�239 mg/dL
High risk = 240 mg/dL and over

Another way of measuring the recommended levels for people with heart disease is in mmol/L as shown in the table below. This form of measurement is used in many countries outside the US.

recommended cholesterol levels

The ratio is your total chol over HDL. So, for example, if your total was 4.5 and your HDL was 1.6, your ratio would be 2.8.

Lower your levels! Reducing your levels by 10 percent reduces your risk of future coronary illness by 20 percent.

Reduce your fat intake.

Choose healthy fats such as polyunsaturated and monounsaturated, found mainly in vegetable oils, nuts, and fish.

Limit your intake of saturated fat (found mainly in red meat and high-fat dairy products).

Avoid trans fats often found in foods made with shortening or partially hydrogenated vegetable oil, hard margarines, fast foods, and many processed foods. Trans fats raise bad and lower good cholesterol.

Eat more whole grains, cereals, vegetables, and fruit.

Snack wisely. Choose fruit, low-salt pretzels, rice cakes, or plain popcorn, rather than high fat or junk food snacks.

Use lower-fat cooking methods such as baking, broiling, or steaming and avoid fried food.

Quit smoking. Smoking increases LDL (bad)- which you don't want.

Get exercise. Being physically active can improve HDL (good) levels.

If you are taking medications, take as directed.

Take the American Heart Association's Cholesterol Quiz.

I already have heart disease... Isn't it too late?
Not at all. Studies show that lowering your levels

reduces the further development of blockages and heart attacks

reduces the need for angioplasty

reduces the need for bypass surgery

reduces death rates

Everyone can benefit from lower cholesterol - if you have heart disease, it's well worth the effort because you can reduce future heart disease and live longer.

Medication
If you have tried modifying your activity levels and your diet - and you still have higher readings than optimum - your doctor will prescribe medication. Here are some questions you should ask:

1. What is the name of the medication?

2. What is the medication supposed to achieve?

3. When and how should I take my medication?

4. What foods, drinks, or other medications should I avoid when taking this medication?

5. What are the possible side effects. What should I do if I experience them?

6. How long will I be taking this drug?

7. Can you provide further information about this medication?

See our page on managing your medications.

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