Heart Doctor Explains Cholesterol Levels
Williamsburg seniors take note of heart health month and learn about cholesterol!
You hear it all the time: know your numbers, watch your cholesterol, HDL is good, LDL is bad. But what does it all mean?
Suzanne Steinbaum, M.D., Director, Women and Heart Disease with the Heart and Vascular Institute at Lenox Hill Hospital in New York, helps us understand cholesterol, as well as cholesterol-lowering drugs called statins, based on the updated cholesterol guidelines.
These updated guidelines are the result of the latest medical research and rewrite best practices for the first time in a decade.Here are Dr. Suzanne Steinbaum answers to common questions:
What is cholesterol?“Cholesterol itself isn’t bad. In fact, cholesterol is just one of the many substances created and used by our bodies to keep us healthy.
Cholesterol comes from two sources: your body and food. Your liver and other cells in your body make about 75 percent of blood cholesterol. The other 25 percent comes from the foods you eat. Cholesterol is only found in animal products.
There are two types of cholesterol: “good” and “bad.” It’s important to understand the difference, and to know the levels of “good” and “bad” cholesterol in your blood. Too much of one type — or not enough of another — can put you at risk for coronary heart disease, heart attack or stroke.”
What does cholesterol consist of?
“There are several different parts of the cholesterol profile. One of them is the high-density lipoprotein (HDL), another one is the low-density lipoprotein (LDL) and triglycerides.”
What is “bad” cholesterol?
SS: We have called the LDL cholesterol the “bad” cholesterol. If there’s too much LDL cholesterol in the blood, it can lead to plaque formation in the arteries, so we don’t want that LDL cholesterol to be too high.
What is “good” cholesterol?
“HDL is what we call the “good” cholesterol. When you have a high HDL, it is protective. It actually sort of shuttles the LDL out of the arteries and protects the lining of the arteries from developing plaque. The female sex hormone estrogen tends to raise HDL cholesterol, and as a rule, women have higher HDL (good) cholesterol levels than men. Estrogen production is highest during the childbearing years.
GRFW: How can people increase their HDL?
SS: You may be able to raise your HDL (good) cholesterol levels through weight loss, dietary changes and physical activity. Your doctor may also prescribe medicine to help.
GRFW: What should women know about triglycerides?
SS: Triglycerides are the most common form of fat in the body. Many women who have heart disease or diabetes have high triglyceride levels. A high triglyceride level combined with low HDL cholesterol or high LDL cholesterol seems to speed up atherosclerosis (the buildup of fatty deposits in artery walls). Atherosclerosis increases the risk for heart attack and stroke.
Older women tend to have higher triglyceride levels. Triglycerides go up due to being overweight/obese, physical inactivity, cigarette smoking, excess alcohol consumption, other diseases such as type 2 diabetes, some drugs, genetic factors, and/or a diet very high in carbohydrates (60 percent or more of calories).
GRFW: What can women do treat high triglycerides?
SS: Reducing saturated and trans fats in the diet are a great starting place for women to improve triglyceride and HDL levels.
GRFW: What changed with the new cholesterol guidelines?
SS: The guidelines advise doctors to consider a patient’s overall health in treatment decisions. And that’s why one of the biggest changes in the cholesterol guidelines could lead to more people taking cholesterol-lowering drugs called statins. Doctors have long prescribed statins based on a cholesterol number, particularly the level of LDL (bad) cholesterol.
But the guidelines advise assessing factors such as age, gender, race, whether a patient smokes, blood pressure and whether it’s being treated, whether a person has diabetes, as well as blood cholesterol levels in determining their overall risk for a heart attack or stroke. They also suggest that healthcare providers may want to consider other factors, including family history. Only after that very personalized assessment is a decision made on what treatment would work best.
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