True or False?
The lower my cholesterol, the lower my risk for heart disease.
True and False. The statement above is true. According to
the statistics, your risk for heart disease is lower when you have low total
cholesterol and low LDL (low density lipoprotein) cholesterol. LDL cholesterol
is the fatty substance that is most related to arterial blockage.
The statement above is also false. Your risk for heart disease is
actually higher if you have a low HDL (high-density lipoprotein) cholesterol
level. HDL is the "good" cholesterol; it carries fat out of the coronary
arteries.
If a product’s package reads "low cholesterol," it is low in fat and safe to eat.
False. A lot of foods marked "low cholesterol" contain
oils that may be high in saturated fats and transfats, substances that research
suggests may be as bad if not worse for you as cholesterol. Unsaturated fats,
such as vegetable oils, are also high in calories.
Remember, all fats are high in calories — one gram of fat has 9
calories. Protein and carbohydrate each have 4 calories per gram. It’s true that
we all need some fat in our diets. However, choose monounsaturated fats such as
olive oil, canola oil, peanut oil, nuts and seeds. Monounsaturated fats do not
increase blood cholesterol when included in a low-fat meal plan. The total
amount of fat in your diet should be about 25 to 35 percent of your daily intake
(or 1 tbsp. of the fats listed above, per meal).
The best age to have my cholesterol level checked is age 50 because that’s the peak age for heart attacks in men.
False. It is important to have your cholesterol level
checked when you are young, since the process of arterial clogging (called
atherosclerosis) is a gradual one and takes many years. Heart attacks that occur
in people age 50 and above may be the result of plaque that began to form on the
inside of their coronary arteries when these people were teenagers.
Total cholesterol should be measured at least every five years
starting at age 20. If your cholesterol levels are within the normal range and
you do not have other risk factors for heart disease, you can continue getting
tested every five years. If your cholesterol levels are too high, you should
talk with your doctor about making lifestyle changes or taking medication. You
and your doctor should also discuss a re-testing schedule.
Note: If you have high cholesterol and your doctor has told
you there may be an underlying genetic cause, you may want to have your
children, under age 20, get their cholesterol levels tested. Talk with your
children’s health care providers about cholesterol testing.
Cholesterol is the only risk factor for cardiovascular disease that I should worry about.
False. There are several other important risk factors
that predispose you to cardiovascular disease. The good news is that most of
these risk factors can be changed by making small modifications in your
lifestyle. Cigarette smoking is by far one of the strongest risk factors for
cardiovascular disease. However, your risk is drastically reduced after one year
of not smoking. After four years of being smoke-free, your risk for
cardiovascular disease is equivalent to that of a non-smoker.
Other risk factors for cardiovascular disease include physical
inactivity, diabetes, uncontrolled high blood pressure, and obesity. The
following guidelines may help you prevent the development and/or progression of
cardiovascular disease:
- Add 30 minutes of moderate exercise most days of the week
- Lower the amount of fat in your diet to under 35 percent of your intake
- Manage your high blood pressure, diabetes, and other medical conditions
Since both of my parents died from coronary disease when they were young, there’s little
I can do to prevent this disease from developing in me.
False. While your family history is an important risk
factor (and not changeable), you can control your risk of developing
cardiovascular disease by controlling high cholesterol (through diet and
sometimes medication), quitting smoking, managing high blood pressure and
diabetes and exercising regularly. In fact, recent research shows that you can
stop or reverse the progress of atherosclerosis by following a very strict risk
factor modification program.
Because atherosclerosis is a slow, gradual process that probably
starts in childhood, it is important to have your cholesterol levels tested at
age 20. Those who have a strong family history of heart disease should be even
more vigilant in testing their cholesterol levels. A strong family history is:
- Having a first-degree male relative who had a heart attack, angioplasty,
or bypass under age 55.
- Having a first-degree female relative who had an angioplasty, heart
attack, or bypass under age 65.
Fact summary
- Twelve million Americans have coronary artery disease, making it the
leading cause of death in this country.
- More than 90 million adults have cholesterol levels that are higher than
desirable.
- High blood cholesterol is a major risk factor of coronary artery
disease, but one that is also quite modifiable.
- Lowering your cholesterol level by 1 percent lowers your risk for heart
disease by 2 percent.
- For some people, losing excess weight will lower total blood cholesterol levels.
- Egg yolks and organ meats, such as liver, are the foods highest in
cholesterol. (One egg yolk has 213 milligrams of cholesterol.)
Cholesterol information
Total Cholesterol (TC): Directly linked to risk of heart and blood vessel disease
Goal values:
- 75-169 mg/dL for those age 20 and younger
- 100-199 mg/dL for those over age 21
High Density Lipoprotein (HDL) "Good cholesterol": High
levels linked to a reduced risk of heart and blood vessel disease
Goal value:
- Greater than 45 mg/dl for men and greater than 55 mg/dl for women
Low Density Lipoprotein (LDL) "Bad cholesterol": High levels
linked to an increased risk of heart and blood vessel disease and is a major
treatment target for cholesterol lowering medications
Goal values:
- Less than or equal to 70 mg/dL for those with heart or blood vessel
disease and for other patients at very high risk of heart disease
- Less than or equal to 100 mg/dL for high risk patients (for example:
some patients who have diabetes or multiple heart disease risk factors)
- Less than 130 mg/dL for individuals who are at low risk for coronary
artery disease
Triglycerides (TG): Elevated in obese or diabetic patients.
Level increases from eating simple sugars or drinking alcohol. Associated with
heart and blood vessel disease.
Goal value:
Talk with your doctor about a regular schedule for cholesterol testing.
©Copyright 1995-2008 The Cleveland Clinic Foundation. All rights reserved
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional written health information, please contact the Health Information Center at the Cleveland Clinic (216) 444.3771 or toll-free (800) 223.2273 extension 43771 or visit www.clevelandclinic.org/health/. This document was last reviewed on: 10/1/2007
