Imagine pouring bacon grease down your kitchen sink every day. Eventually, the pipe clogs, and water no longer drains. Now imagine that the pipe is a vital artery, and the bacon grease is cholesterol-- a fatty buildup that clings to blood vessel walls. When cholesterol completely blocks blood flow, a heart attack or stroke can strike.
According to Duke cardiologist Nishant Shah, MD, regularly checking and managing your cholesterol levels is one of the easiest ways to prevent cardiovascular disease in the future. Here Dr. Shah explains why it’s important to test your cholesterol levels and when to consider medication.
What Your Cholesterol Results Are Telling You
A simple blood test measures your cholesterol. Results will show several types of cholesterol:
- LDL or low-density lipoprotein (the “bad” cholesterol)
- HDL or high-density lipoprotein (the “good cholesterol”)
- Total cholesterol, which represents all the cholesterol in the blood (both good and bad)
- Triglycerides, a different type of cholesterol that can also increase heart risk
“LDL cholesterol is one of the most important types to keep track of,” Dr. Shah said. “The other numbers help inform how aggressive we need to be managing cholesterol.”
Guidelines say LDL levels should stay below 100 milligrams per deciliter (mg/dL) in healthy people without known cholesterol buildup in their blood vessels and without a prior heart attack or stroke. If you know you have cholesterol buildup in your arteries or if you’ve already experienced a heart attack or stroke, your LDL level should stay under at least 70 mg/dL, the lower the better.
Don’t assume that you’re too young or too healthy to have high cholesterol, Dr. Shah warned. High cholesterol is often silent until a major event occurs.
Cholesterol is routinely checked during annual physicals, but don’t be afraid to ask your primary care doctor or cardiologist about it just to be sure. People with certain risk factors or who are taking cholesterol medications should have their cholesterol checked more often, Dr. Shah said.
Where Does Cholesterol Come From?
Cholesterol comes from two main sources. The first, you may have guessed, is food like meat, shellfish, dairy, and fried foods. The second, lesser-known source is genetics. “Unfortunately, your genes can cause your body to produce too much cholesterol,” Dr. Shah said.
Lifestyle Changes Can Lower Cholesterol
The first step to lowering your LDL cholesterol is improving your diet and exercise habits. Avoiding cholesterol-rich foods, incorporating more fruits and vegetables, and exercising regularly can lower your LDL levels.
When to Consider Cholesterol Medication
If diet and exercise alone aren’t effective, your doctor may recommend a cholesterol-lowering medication. “I totally understand being hesitant about starting a new medication; it can be daunting,” said Dr. Shah. “The good news is that there are lots of great medication options, and you may not need a lot of medication to get you to a safe place.”
Duke Cares for Routine and Complex Patients
Duke Health offers the full range of cholesterol care, from simple nutrition and exercise support to advanced medication management. Our specialized Duke Cardiometabolic Clinic treats people with genetically elevated cholesterol and people who need more advanced care than their current treatment regimen. “We also partner with providers across Duke Health and elsewhere to get patients to a heart-healthy lifestyle sooner,” said Dr. Shah.” It all starts with knowing your numbers so we can be as proactive as possible.”
