Looking for ways to keep your heart at its healthiest? Improving your cholesterol can be a great way to start. Cholesterol is fat that the body carries throughout the bloodstream and uses to transport vitamins, minerals and other substances to cells. Cholesterol can also give insight into your risk for heart attack and stroke.
Kevin McElligott, MD, a cardiologist with Atlantic Health System, shares what impacts cholesterol levels, how it’s measured and tips to help improve your numbers.
What are the Cholesterol Numbers to Know
Cholesterol tests are blood tests that are done after fasting. The most common test is a “lipid profile” which looks at total cholesterol, high-density lipoproteins (HDL, or “good cholesterol”), low-density lipoproteins (LDL, “bad cholesterol”) and triglycerides. LDL levels are an important predictor of your chances of having a heart attack or stroke. Patients with lower LDL have a reduced risk of these conditions, and most interventions aim to get LDL levels down.
Cholesterol is only one piece of the puzzle of estimating and reducing risks of heart attacks and strokes. Broadly, if you have an elevated risk of heart attacks and stroke, you should aim to get your LDL number as low as possible. While individual goals will vary depending on your risk, reducing your LDL to below 70 mg/dL is a good goal.
Generally, the higher your LDL number is, the higher your risk of heart attacks and strokes. It is especially important that if your LDL level is greater than 190 mg/dL, you talk to your primary care provider or cardiologist about your heart health.
“When I talk to people about why cholesterol is the way it is, I tell them that their cholesterol levels are determined by some combination of genetics that you have no control over and lifestyle factors that you can influence,” says Dr. McElligott. “For some patients, their genetics plays the biggest role, and for some others, their cholesterol level is almost completely dependent on their lifestyle.”
How Patients can Improve Their Cholesterol
It’s important to monitor your cholesterol so you can try to prevent heart attacks and strokes. For most people with no known history of heart problems, the American College of Cardiology recommends evaluating your risk for a heart attack or stroke every five years, including with a lipid profile. This estimate looks at your risk of having a heart attack or stroke in the next 10 years. Low risk is less than 5%, while higher risk is greater than 20%.
Fortunately, you can make simple lifestyle changes to lower your cholesterol:
- Change your diet: Eat heart-healthy foods like vegetables, fruits and whole grains, and cut down on sugar, saturated fats and sodium. Consider swapping animal-based proteins like red meat for plant-based ones like tofu, legumes or quinoa.
- Exercise: Get 150 minutes per week of moderate-intensity exercise like brisk walking, dancing or doubles tennis, or 75 minutes per week of high-intensity physical activity like jogging, swimming, fitness classes or even shoveling snow.
- Lose weight: If you’re overweight, adjust your caloric intake to promote weight loss.
- Quit smoking: When you quit smoking, after just one year, your risk of heart attacks and strokes drops close to that of a nonsmoker.
It can take a while before interventions begin working, so wait three months to recheck your cholesterol. Developing good habits like a healthy diet and exercise can have long-term, positive benefits.
What to do When Lifestyle Changes Aren’t Enough
If lifestyle changes aren’t enough to bring down your cholesterol, a cardiologist can help. Your doctor can work with you to make informed decisions and discuss different therapy options that can help reduce overall risk.
Medications including statins, ezetimibe and other therapies can supplement lifestyle changes to improve cholesterol. Your risk of heart attack and stroke improve with different therapies but should be balanced with the risk of side effects.
“Any patient that is concerned can see a doctor for their heart health,” says Dr. McElligott. “Heart attacks and strokes are common and can be devastating. Talk to your primary care provider or cardiologist to learn about your risk and create a plan to lower it."
Be Proactive About Your Health
To stay safe and healthy, it's good to have a primary care provider who knows and understands your health history and wellness goals.