If you have heart disease, or are worried about developing it, there are some very real things you can do to reduce your risk says Lexington Clinic cardiologist Terence Ross, M.D.
“By now, everybody has heard that if they smoke, the most important thing they can do for their hearts is stop,” says Dr. Ross. “But there’s a lot of confusion out there about other steps you can take to reduce your risk, chief among them, the recommendations involving cholesterol.”
Over the past several decades, Dr. Ross noted, recommendations regarding dietary cholesterol have swung one way and then another. Even today there are conflicting reports on whether reducing the amount of cholesterol you eat is necessary, or even helpful.
“I think when it comes to your heart, the best advice is to err on the side of caution,” Dr. Ross said. “In the future, we may find that dietary cholesterol has absolutely no impact on heart health. But for now, we know for sure that cholesterol levels in the blood are directly correlated to heart health. So the safe course of action is to reduce both dietary and blood cholesterol levels as much as possible.”
Why is cholesterol important
Cholesterol is a naturally occurring substance produced in the liver. The body uses it to make hormones and vitamin D, to digest foods and to help the organs function properly. Cholesterol is a sticky, waxy substance that has been identified as the main ingredient in plaque, which builds up on the inside of artery walls, narrowing them and making them less flexible. This condition, called atherosclerosis, can reduce or cut off blood flow to important tissues, including the heart. When the heart muscle doesn’t receive enough blood or oxygen, it begins to die, and a heart attack occurs.
What causes high cholesterol
Some people have a genetic predisposition to high blood cholesterol – it runs in families. “People with a family history of early heart attack or high cholesterol should be tested early in their lives and regularly for blood cholesterol levels,” Dr. Ross said. “If necessary, medications can be prescribed to help manage these levels and reduce the risk of coronary artery disease.”
High cholesterol is a common condition, even among those with no family history of the condition. Even young people can develop high cholesterol. Cholesterol levels tend to rise as we age, Dr. Ross, noted, beginning around the age of 20. Levels continue to increase through age 60 or 65. Men’s levels rise earlier than women’s, but after age 50, women’s cholesterol levels begin to rise at a rate similar to that of men before age 50.
“We can’t control family history, race, gender or age, but we can control other factors that contribute to high cholesterol levels,” Dr. Ross said, including diet, obesity, activity levels and tobacco use. “All of these have been shown to influence blood cholesterol levels and their ratios.”
Having said that – not all cholesterol is “bad.” In fact, one type of cholesterol, called high-density lipoprotein, or HDL, is considered to be good because it helps to clear low-density cholesterol from the bloodstream, preventing it from building up on artery walls.
The first step in managing cholesterol levels is knowing your levels – total cholesterol, HDL and LDL, or low-density lipoprotein. LPL is known as the “bad” cholesterol because a high LDL level leads to a buildup of cholesterol in your arteries.
A simple blood test can reveal all of your cholesterol information. Recommended cholesterol levels vary based on age and gender. For most adults, a healthy total cholesterol is 200 mg/dL or less, Dr. Ross says.
Here are Dr. Ross’s recommendations for lowering blood cholesterol levels:
• First, if you are overweight, lose weight. Losing weight can lower your LDL cholesterol and raise your HDL ratio.
• Get more physical activity, at least 30 minutes a day nearly every day of the week.” Moderate activity – a brisk walk, jumping rope, bicycling at 10 mph or faster, swimming laps – count.
• Third, manage stress. Stress often leads to unhealthy activities, like snacking on junk food. If you’re under stress, find healthy outlets, like exercise, meditation or outdoor activities.
• Eat healthy foods, including whole grains, minimally processed foods, lean meats and fish, fresh vegetables and fruits. The TLC (Therapeutic Lifestyle Change) and DASH diets have been scientifically proven to help lower blood cholesterol and lower heart attack risk, Dr. Ross notes. Information about these diets are available online at the National Heart Lung and Blood Institute website.
Finally, Dr. Ross recommends working with a physician to closely monitor and manage your cholesterol levels. In some cases, medications may be needed to bring levels down and manage heart attack risk. “Many people are reluctant to start taking cholesterol medications, but in the long run, these medications are extremely helpful and much less life-changing than a heart attack,” he noted.
When to get your cholesterol checked
Pediatricians recommend the first cholesterol check occur between the ages of 9 and 11 and be repeated again every five years, unless an abnormality is detected. Children with a strong family history of high blood cholesterol should have their blood levels checked beginning at age 2.
Adults age 20 to 45 should have their cholesterol checked every five years, unless there’s a family or personal history. Beginning at age 45 for men and 55 for women, cholesterol should be checked every one to two years.
Terence Ross, M.D., is a clinical cardiac electrophysiologist and cardiologist with Lexington Clinic. His office is located at Lexington Clinic East, 100 N. Eagle Creek Drive, Lexington. New patients are welcome. To schedule an appointment, please call (859) 258-5300.