Cracking the code on cholesterol numbers

You've heard about "good" and "bad" cholesterol, HDL and LDL, but putting the pieces together to figure out healthy levels takes a little digging.

To make it easier, here's a breakdown of what it means to have healthy vs high cholesterol levels and what you can do to change them with your lifestyle and medication.

"Having healthy cholesterol levels reduces your chance of heart disease and stroke," explains Said Iskandar, MD, a cardiologist at Halifax Heart Center in South Boston, Va. "So, finding a way to bring them into the healthy zone is an important factor for good health."

What is cholesterol?

Your liver makes all the cholesterol you need. Blood circulates the waxy, fat-like substance to all the cells in your body. In turn, your body uses cholesterol to make hormones and vitamin D. It also helps your cell membranes make protective layers.

Animal sources provide additional cholesterol. Egg yolks, meat and cheese all contain cholesterol. Even plant sources can contribute to high cholesterol levels. Palm, kernel and coconut oils contain saturated fat, which can increase bad cholesterol.

"Cholesterol is considered a lipid," Dr. Iskandar says. "That means it won't dissolve in water and can be separated from the blood to perform certain functions."

Why is too much cholesterol harmful?

When you have too much cholesterol in your blood, it can combine with other substances in the blood to form plaque.

Plaque sticks to the walls of your arteries. This buildup of plaque, known as atherosclerosis, can narrow or block arteries that carry oxygenated blood away from the heart. The plaque blockages reduce blood flow.

Coronary artery disease is a condition that develops when plaque blocks coronary arteries. When a lot of plaque accumulates, it can lead to a heart attack or stroke. The Centers for Disease Control and Prevention estimates that about one in 20 adults aged 20 or older have coronary artery disease. (link to: https://www.cdc.gov/heart-disease/data-research/facts-stats/index.html)

What is good and bad cholesterol?

You've heard of HDL and LDL. Here's what it means:

HDL – High-density lipoprotein. This is sometimes called "good" cholesterol because it helps your body eliminate extra cholesterol. HDL carries cholesterol from other parts of your body back to your liver. Your liver then removes the cholesterol from your body. Lower cholesterol reduces your chance of heart disease and stroke.

LDL – Low-density lipoprotein. This is sometimes called "bad" cholesterol because a high LDL level – or high cholesterol – leads to plaque buildup in your arteries.

Other cholesterol numbers:

Triglycerides – The most common type of fat in your body, triglycerides come from food, and your body also makes them. High triglycerides increase your risk of heart and vascular disease.

Total cholesterol – Measures the total amount of cholesterol circulating in your blood. Your total blood cholesterol is the sum of your HDL and LDL cholesterol levels plus 20 percent of your triglyceride level.

What cholesterol levels are considered healthy?

"To check your cholesterol levels, your primary care provider or cardiologist will order a lipid panel," Dr. Iskandar says. "You will need to fast for 10-12 hours before your test, but you can drink water. This will give us a more accurate reading."

Here are healthy ranges for total cholesterol, LDL and HDL:

How often should I check my cholesterol levels?

Since you won't have symptoms of high cholesterol, only a blood test can track changes. How frequently you should have a lipid panel drawn depends on factors such as age, family history and your risk of heart disease.

• Age 19 or younger:
  • The first test should be between ages 9 to 11
  • Children should have the test again every five years
  • Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack or stroke
• Ages 20 to 65:
  • Younger adults should have the test every five years
  • Men ages 45 to 65 and women ages 55 to 65 should have it every one to two years
• Over age 65:
  • Yearly testing

How can I improve my cholesterol levels?

While we know what to do, sticking with heart-healthy goals is not always easy. For a refresher, focus on:

• Eating healthier – Eat foods high in fiber and low in saturated fats, trans fats and cholesterol.
• Increasing physical activity – The surgeon general recommends 2.5 hours of moderate exercise, like brisk walking or biking, for adults each week. Children and adolescents should get one hour of physical activity every day.
• Reaching a healthier weight – To determine if your weight is healthy, you can calculate your body mass index (BMI).
• Quitting smoking – The chemicals you inhale when you smoke cause damage to your heart and blood vessels. Sentara Health Plans offers a free tobacco cessation program called "Stay Smokeless for Life." The self-paced program teaches about the nature of nicotine addiction and effective ways to control dependency and addiction through a video library and toolkit.

Some people will need to take medication to help their cholesterol levels.

"Statins are the class of prescription medicine used to reduce cholesterol," Dr. Iskandar adds. "Statins work in the liver to prevent cholesterol from forming. They are most effective at lowering LDL (bad) cholesterol. They also help lower triglycerides and raise HDL (good) cholesterol."

 

If you are due to visit your primary care physician to check cholesterol levels or need to find one, use our provider directory.