Cholesterol and Heart Health
Maintaining Healthy Cholesterol Levels and the Impact on Cardiovascular Health
by Linda P. Kurian, MD
Pennsburg Family Practice
Many patients are concerned about their cholesterol levels - or become concerned when their doctor tells them levels are too high. Why should you care about your cholesterol levels? Bad cholesterol levels put you at risk for heart disease or stroke by causing a build-up of plaque in your artery walls.
Know Your Numbers
Everyone should know their cholesterol numbers. "Bad" cholesterol - known has LDL - should be lower than 130. LDL is what contributes to the plaque buildup in your arteries. "Good" cholesterol - known as HDL - should have a level higher than 40 to be cardio-protective in men, and a level higher than 50 to be cardio-protective in women. Its role is to help prevent or clear the buildup in the arteries. One way to remember which kind of cholesterol should be high and which should be low is to remember that LDL numbers should be low - both words begin with L. HDL should be high - and both words begin with H.
Know Your Family History and Risk Factors
Keeping cholesterol at healthy levels is important for everyone but special care needs to be taken with people who have other risk factors, such as a family history of high blood pressure, coronary artery disease or premature cardiac disease. Several factors impact cholesterol levels. Some people have a genetic pre-disposition to high cholesterol. Lifestyle factors, such as diet and exercise, play a role. In fact, lifestyle changes are so important that I usually recommend that patients try changes in diet and exercise before I prescribe statins, the kind of medication that can help to lower cholesterol. Losing weight and exercising can lower cholesterol levels as effectively as drugs.
A low-fat, low cholesterol diet, with fats making up no more than 20 to 30 percent of the total calorie intake, is recommended. Consuming 25 grams of fiber daily can help to reduce cholesterol levels. Keeping an eye on your intake of tropical oils and shellfish is helpful, because both are high in cholesterol. Aerobic exercise that gets your heart rate up is recommended for 20 to 30 minutes, four or five times per week.
If lifestyle changes aren't effective, other factors should be considered. That may mean steering away from smoking. I also screen for other conditions that may cause high cholesterol, including diabetes, thyroid issues and liver disease.
When statins are prescribed for patients, it is important to monitor liver function every six weeks when they are first prescribed and every six months after that. If patients do not respond to statins, their liver function should be checked.
You CAN Change the Bad to Good
Controlling cholesterol levels is possible with lifestyle changes and medication. In partnership with their primary care physician, most patients can change bad numbers to good numbers.
Linda P. Kurian, MD is board-certified in family medicine and is a member of Pennsburg Family Practice. To make an appointment with Dr. Kurian, please call 215-679-4421.