The Cholesterol Conundrum
Understanding your cholesterol number is an important tool in keeping your heart healthy. So find out what you need to know to stay well today … and tomorrow.

By Stacey Stapleton

What’s your number?

If you hear the question and think back to a time when it was a casual pickup line but these days associate it more with cholesterol, you’re probably concerned that yours is too high. And with good reason: Too much of the bad (LDL) or not enough of the good (HDL) are leading contributors to heart disease and stroke. In fact, finding
a healthy balance could save your life.

Cholesterol:
One piece of the puzzle

Don’t regard cholesterol only as a roadblock; the soft, waxy substance found among the fats in the bloodstream and in all the body’s cells plays a crucial role in the formation of cell membranes and certain hormones. Low-density lipoprotein cholesterol, or LDL, is dubbed the “bad cholesterol,” because elevated levels of LDL cholesterol are associated with an increased risk of coronary heart disease: LDL deposits cholesterol on the artery walls, causing the formation of a hard, thick substance called cholesterol plaque. Over time, in a process called atherosclerosis, cholesterol plaque causes thickening of the artery walls and narrowing of the arteries that feed the heart and brain. Conversely, high-density lipoprotein particles, or HDL, is regarded as the “good cholesterol” for its ability to prevent atherosclerosis by extracting cholesterol from the artery walls and disposing of it through the liver. A simple blood test reveals each of these numbers, as well as total cholesterol: the sum of LDL and HDL, plus VLDL (very low density) cholesterol and IDL (intermediate density) cholesterol. The American Heart Association recommends that this total number be less than 200.

Explains Steven Sheris, MD, chief of cardiology at The Gagnon Cardiovascular Institute at Overlook Hospital and a member of Associates in Cardiovascular Disease in Springfield and New Providence, “When white blood cells attempt to clear cholesterol from the arterial walls, they secrete enzymes and cells that form plaques, which are thick deposits that clog the arteries.” As these plaques collect they can rupture and form a clot, which can block blood flow to the heart or brain, resulting in a heart attack or stroke.

“But cholesterol is only one of the enemies,” cautions Sheris. “Having high blood pressure, diabetes, a sedentary lifestyle, being obese, or using tobacco also increases your risk of having a heart attack.” Fortunately, bringing down cholesterol levels can significantly reduce the risk of a having a coronary event. Says Sheris, “We know that even a small decrease in cholesterol can reduce your risk of a heart attack exponentially.”

Taking control of your number

“Your cholesterol level is more than just a number,” says Sheris. “It’s a way of articulating the chronic damage being done to the arteries that lead to the heart.” This means that the lower your number, the less harm you’re doing to your arteries; the longer you live with elevated cholesterol, the more damage is being done—and the effects are cumulative. If your doctor warns that your cholesterol is too high, it’s vitally important to get it down.

Your cholesterol level is affected by two factors: what you eat and your genetics. Your first line of defense should be a heart-healthy diet, which studies show can slash your cholesterol by as much as
20 percent. To get started, consider these tips.

• Limit saturated and trans-fats so that you consume no more than 300 milligrams of cholesterol a day.


• Cholesterol is found in all foods from animal sources, including dairy products. Monitor how much food you consume from animal sources and make sure meats are as lean as possible.


• Consume foods like fish, which are rich in healthy fats.


• Replace eggs with egg whites or an egg substitute.


• Balance your diet with foods like beans, fresh fruits, whole grains, and vegetables.


• Replace butter and trans-fat margarine spreads with olive oil, canola oil, or white wine vinegar when cooking. Flavor your food with spices instead of fatty additives like sour cream.


• Start each day with oatmeal. Experts agree that this is one of the top cholesterol-lowering foods.

If, despite all your smart eating, your cholesterol is still too high, genetics are to blame: Something is amiss with the way your body manages its cholesterol. Fortunately, this can be controlled with prescription medications. “When taken properly, cholesterol medication can reduce your risk of having a heart attack or stroke by a third as soon as you begin taking it,” explains Sheris. “Although you may not feel any different while you’re on these medications, they are working to slow the development of the plaques that can lead to heart attack and stroke.”

Extensive research has proved that the current crop of cholesterol-lowering drugs are very safe. “That’s not to say that patients taking cholesterol meds don’t need monitoring,” says Sheris, “but we cannot emphasize enough the life-saving importance of taking cholesterol medication if you need it.”

Beyond numbers

Managing your cholesterol is only one part of the fight against heart disease; Sheris is quick to point out that many other health-safeguarding tools are in your hands. “Our goal is to partner with patients in the battle against coronary disease,” he says. “You make the necessary diet and lifestyle changes, and we’ll affect your genetics with the right medication if necessary. There’s nothing worse for a physician than seeing a patient who acts only after they’ve had a heart attack that could have been prevented.”

Sheris suggests starting by evaluating your overall health. Pay a visit to your doctor so you know your cholesterol number as well as your blood pressure. And if you have diabetes, make sure it’s well controlled. It’s also essential to stay active and manage your weight. Even activities like a leisurely walk, gardening, or dancing can reduce the risk of heart disease. (Swear off all forms of tobacco too. It’s a major risk factor for heart disease, since it increases the tendency for your blood to clot.) And although these changes may be tough to make, the good news is it’s never too late. Says Sheris, “Even patients in their eighties and nineties can improve their cardiac health with simple lifestyle changes.”

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For a referral to a cardiologist, call 888-280-7435.