Nearly one of every three American adults have high levels of low-density lipoprotein cholesterol (LDL-C), which is considered the “bad” cholesterol. Cholesterol is a fat-like, waxy substance that can be found in all parts of your body. It helps your body make cell membranes, many hormones, and vitamin D. The cholesterol in your blood comes from two sources: the foods you eat and your liver. Your liver makes all the cholesterol your body needs. LDL, bad cholesterol, contributes to the formation of plaque buildup in the arteries, which is linked to higher risk for heart attack and stroke.
What are the risk factors?
The new Cholesterol guidelines from the American Heart Association and other leading health organizations for the first time offer detailed risk assessment strategies based on complicating conditions, age, gender, ethnicity and numerous patient scenarios. These guidelines are the first issued since 2013 and continue the focus on identifying and addressing lifetime risks for cardiovascular disease. Experts state that lowering bad cholesterol in high risk patients is best for reducing heart disease. An LDL-cholesterol above 160 is considered very high.
The 2018 guidelines urge doctors to talk with patients about “risk-enhancing factors” by providing a more personalized standpoint of a person’s risk. High cholesterol treatment is not one size fits all, and the guidelines stress the importance of individualized care. In addition to traditional risk factors such as smoking, high blood pressure and high blood sugar, the guidelines address under-estimated risk in some individuals. You can help lower your cholesterol by:
- Avoiding foods high in saturated fat and dietary cholesterol
- Maintaining a healthy weight
- Quitting smoking
Risk-enhancing factors also include family history and ethnicity, as well as certain health conditions such as metabolic syndrome, chronic kidney disease, chronic inflammatory conditions, premature menopause or pre-eclampsia and high lipid biomarkers.
While statins are still the first choice of medication for lowering cholesterol, new drug options are available for people who have already had a heart attack or stroke and are at highest risk of having another. For those people, medication should be prescribed in a stepped approach, but these discussions should be had with your doctor. However, a healthy lifestyle should be the first step in prevention and treatment to lower your risk for heart disease and stroke. Also, if you have a family history of heart disease, it is important to start young with living a heart-healthy lifestyle.
Royce Dean Yount was born and raised in New Orleans. He completed his fellowship from Louisiana State University in Interventional Cardiology and his residency in Internal Medicine from Louisiana State University. Dr. Yount specializes in Interventional Cardiology and Cardiovascular Diseases. He is also board certified in Internal Medicine, Cardiovascular Diseases and Interventional Cardiology.