It may surprise you to know that cholesterol itself isn’t bad. In fact, cholesterol is just one of the many substances created and used by our bodies to keep us healthy. Some of the cholesterol we need is produced naturally (and can be affected by your family’s health history), while some of it comes from the food we eat.
There are two types of cholesterol: “good” and “bad.” It’s important to understand the difference, and to know the levels of “good” and “bad” cholesterol in your blood. Too much of one type — or not enough of another — can put you at risk for coronary heart disease, heart attack or stroke.
Cholesterol comes from two sources: your body and food. Your liver and other cells in your body make about 75 percent of blood cholesterol. The other 25 percent comes from the foods you eat. Cholesterol is only found in animal products.
A cholesterol screening measures your level of HDL and LDL. HDL is the “good” cholesterol which helps keep the LDL (bad) cholesterol from getting lodged into your artery walls. A healthy level of HDL may also protect against heart attack and stroke, while low levels of HDL (less than 40 mg/dL for men and less than 50 mg/dL for women) have been shown to increase the risk of heart disease.
If you need to increase your HDL to your reach your goals, studies show that regular physical activity can help your body produce more HDLs. Reducing trans fats and eating a balanced, nutritious diet is another way to increase HDL. If these measures are not enough to increase your HDL to goal, your healthcare practitioner may prescribe a medication specifically to increase your HDLs.
LDL cholesterol is the “bad” cholesterol. When too much of it circulates in the blood, it can clog arteries, increasing your risk of heart attack and stroke.
LDL cholesterol is produced naturally by the body, but many people inherit genes from their mother, father or even grandparents that cause them to make too much. Eating saturated fat, trans-fats and dietary cholesterol also increases how much you have. If high blood cholesterol runs in your family, lifestyle modifications may not be enough to help lower your LDL blood cholesterol. Everyone is different, so work with your doctor to find a treatment plan that’s best for you.
Too much cholesterol in the blood can lead to cardiovascular disease. Cardiovascular disease is the No. 1 cause of death in the United States. 2,200 Americans die of cardiovascular disease each day, an average of one death every 39 seconds. The good news is, you can lower your cholesterol and reduce your risk of heart disease and stroke. Take responsibility for managing your cholesterol levels. Whether you’ve been prescribed medication or advised to make diet and lifestyle changes to help manage your cholesterol, carefully follow your doctor’s recommendations.
Your diet, weight, physical activity and exposure to tobacco smoke all affect your cholesterol level — and these factors may be controlled by:
- eating a heart-healthy diet
- enjoying regular physical activity
- avoiding tobacco smoke.
Know Your Fats
Knowing which fats raise LDL cholesterol and which ones don’t is the first step in lowering your risk of heart disease.
Cooking for Lower Cholesterol
It’s not hard to whip up recipes that fit with the low-saturated-fat, low-cholesterol eating plan recommended by scientists to help you manage your blood cholesterol level and reduce your risk of heart disease and stroke.
Understand Drug Therapy Options
For some people, lifestyle changes alone aren’t enough to reach healthy cholesterol levels. Your doctor may prescribe medication. Learn about:
- types of cholesterol-lowering drugs
Avoid Common Misconceptions
We have created a list of the common misconceptions, along with the true story, about cholesterol.
Work with Your Doctor
It takes a team to develop and maintain a successful health program. You and your healthcare professionals each play an important role in maintaining and improving your heart health. Know how to talk with your doctor about your cholesterol levels and be sure you understand all instructions. Follow your plan carefully, especially when it comes to medication — it won’t work if you don’t take it as directed. And learn how to make diet and lifestyle changes easy and lasting.
Good vs. Bad Cholesterol
Cholesterol can’t dissolve in the blood. It has to be transported to and from the cells by carriers called lipoproteins. Low-density lipoprotein, or LDL, is known as “bad” cholesterol. High-density lipoprotein, or HDL, is known as “good” cholesterol. These two types of lipids, along with triglycerides and Lp(a) cholesterol, make up your total cholesterol count, which can be determined through a blood test.
LDL (Bad) Cholesterol
When too much LDL (bad) cholesterol circulates in the blood, it can slowly build up in the inner walls of the arteries that feed the heart and brain. Together with other substances, it can form plaque, a thick, hard deposit that can narrow the arteries and make them less flexible. This condition is known as atherosclerosis. If a clot forms and blocks a narrowed artery, heart attack or stroke can result.
HDL (Good) Cholesterol
About one-fourth to one-third of blood cholesterol is carried by high-density lipoprotein (HDL). HDL cholesterol is known as “good” cholesterol, because high levels of HDL seem to protect against heart attack. Low levels of HDL (less than 40 mg/dL) also increase the risk of heart disease. Medical experts think that HDL tends to carry cholesterol away from the arteries and back to the liver, where it’s passed from the body. Some experts believe that HDL removes excess cholesterol from arterial plaque, slowing its buildup.
Triglyceride is a form of fat made in the body. Elevated triglycerides can be due to overweight/obesity, physical inactivity, cigarette smoking, excess alcohol consumption and a diet very high in carbohydrates (60 percent of total calories or more). People with high triglycerides often have a high total cholesterol level, including a high LDL (bad) level and a low HDL (good) level. Many people with heart disease and/or diabetes also have high triglyceride levels.
Lp(a) is a genetic variation of LDL (bad) cholesterol. A high level of Lp(a) is a significant risk factor for the premature development of fatty deposits in arteries. Lp(a) isn’t fully understood, but it may interact with substances found in artery walls and contribute to the buildup of fatty deposits.
What Your Cholesterol Levels Mean
The American Heart Association endorses the National Cholesterol Education Program (NCEP) guidelines for detection of high cholesterol: All adults age 20 or older should have a fasting lipoprotein profile — which measures total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides — once every five years. This test is done after a nine- to 12-hour fast without food, liquids or pills. It gives information about total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides.
Your test report will show your cholesterol levels in milligrams per deciliter of blood (mg/dL). To determine how your cholesterol levels affect your risk of heart disease, your doctor will also take into account other risk factors such as age, family history, smoking and high blood pressure.
Total Cholesterol Level Category
- Less than 200 mg/dL Desirable level that puts you at lower risk for coronary heart disease.
- A cholesterol level of 200 mg/dL or higher raises your risk.
- 200 to 239 mg/dL Borderline high 240 mg/dL and above High blood cholesterol.
- A person with this level has more than twice the risk of coronary heart disease as someone whose cholesterol is below 200 mg/dL.