High cholesterol has been dubbed a silent killer, because it doesn’t produce symptoms until major damage is done. So here’s what you need to know about this symptomless threat to your health. Plus, how to prevent cholesterol buildup, which can lead to heart attacks, strokes and other cardiovascular diseases.
Up until 2013, simply knowing your (good and bad) cholesterol numbers was considered enough. But in December 2013, the American Heart Association and American College of Cardiology came out with a new formula to calculate a person’s risk of heart attack or stroke within the next 10 years. It incorporated not only cholesterol count, but also blood pressure, family history, gender, race, age and health risks like smoking and being overweight.
In terms of gender, men tend to develop coronary disease about 10 years earlier than women. As a result, men who are genetically predisposed to coronary disease should begin getting screened at age 25, whereas women can usually wait until they’re 35. Men and women with low risk factors, including no family history of heart disease or stroke, normal blood pressure and a healthy lifestyle can put off screening until age 35 and 45, respectively, according to Dr. Jerry Greenberg, a cardiologist in Vail, Colorado. Though it’s always helpful to have a baseline reading at younger ages.
In terms of race, Mexican American males show the highest percentage of high cholesterol, followed by African American men, Caucasian women, Caucasian men, Mexican American women, and African American women.
While a third of American adults have high cholesterol, less than half seek treatment.
Cholesterol naturally occurs in the body; it’s a waxy substance that makes up cell membranes, so it ‘s essential for health.
However, there’s good cholesterol (HDL) and bad cholesterol (LDL). Good cholesterol works to remove bad cholesterol, to prevent heart disease.
The problem comes in when, due to genetics, people don’t have enough good cholesterol to take care of the bad. It can also occur when people – genetically predisposed or not – eat a diet high in meat and dairy products, both of which contain cholesterol. In addition, the liver produces more cholesterol than normal when people consume diets high in saturated and trans fats.
Excess cholesterol starts to build up, or form plaque, in arteries, which pump blood through the body. Plaque can then break apart – out of the blue – and cause a clot, which can lead to a stroke or heart attack when oxygenated blood can’t reach the brain or heart. That’s why it’s important to control cholesterol.
People with high LDL face twice the risk of developing heart disease as those with levels lower than about 200 mg/dL do.
Preventing Heart Attack and Stroke
Though most doctors use the new medical formula to assess risk of coronary disease, many also still tend to treat cholesterol – be it through medications like statins, lifestyle changes or both – when LDL measures around 190 or over (and lower if a person has other risk factors).
Controlling any high blood pressure, again through medication, lifestyle changes or both, is also essential, because the higher force of blood pumping through arteries causes microscopic tears, which results in scar tissue, which in turn becomes a resting place for cholesterol, fat and other particles (plaque).
Smoking causes tighter, smaller arteries, so plaque build up is even more detrimental. Obesity increases blood pressure and cholesterol.
And, believe it or not, sugar consumption plays an important role in cholesterol levels. Even simple carbohydrates, like white bread, tortillas and pasta, affect triglyceride levels. High levels of triglycerides, a fat, and LDL accelerate atherosclerosis, or plaque deposits inside arteries. Sugary snacks and drinks – even so-called “healthy” energy drinks you may find at the gym – contain high levels of sugar, which is stored as detrimental fat if not burned off (and most people don’t burn off the amount of sugar found in sodas and sweets, even if they work out for an hour a day or more).
It’s amazing, but cutting most simple sugars out of a diet can result in a 20 to 30 point drop in cholesterol count.
The best dietary choices are whole foods, like vegetables and fruits. You don’t have to completely ban junk food; start by avoiding family-size portions of potato chips and sweets. When eating processed foods, choose ones with the least amount of ingredients (and the most simple ingredients, as long as it’s not sugar); and progressively incorporate more vegetables and fruits into your diet, while cutting back on excess portions of meat, dairy and unhealthy snacks.
And, of course, everyone knows that exercise goes a long way in overall health, including cholesterol. Regular exercise can increase good cholesterol by 5 to 8 points (mg/dL) and also lower triglycerides by 30 to 40 percent. Anything from walking or circuit training to aerobics, strength training and even yoga can help; the important thing is that you exercise regularly. The bad news: Exercise doesn’t seem to reduce bad cholesterol. But remember, good cholesterol “eats up” bad, and lowering triglycerides lowers the opportunity for LDL to pair up with these fats and wreak havoc.
Cholesterol doesn’t have to be a killer, by any means. You have the power to lower damaging cholesterol through the choices you make in lifestyle, diet and other prevention measures.
Dr. Jerry Greenberg
Community Health Specialist Claudia Hilty