Cholesterol really matters. How much you ask? For every one percent decrease in your cholesterol, your risk of developing heart disease decreases by two percent.
That’s why it’s important for you to lower high cholesterol whether you are looking to prevent heart disease or are trying to prevent any further damage following a heart attack.
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While lowering your cholesterol may seem like a daunting task, it is possible. At Cleveland Clinic’s Preventive Cardiology & Rehabilitation program, a long-term study of its patients showed significant improvements in LDL management – even as early as the second follow-up visit – for both patients taking statins and those who are statin intolerant. In patients who do not tolerate statins, we can typically achieve on average an additional 30 point reduction in LDL cholesterol in the Preventive Cardiology Clinic using a combination of alternative medications and approaches.
If you have high cholesterol or other risk factors for developing heart disease, Cleveland Clinic’s Preventive Cardiology & Rehabilitation program can help. We evaluate our patients’ health with very special attention to modifiable risk factors, especially hyperlipidemias, such as high LDL cholesterol, increased triglycerides, low HDL cholesterol, high blood pressure, homocysteine, as well as sedentary lifestyle, obesity and diabetes.
Our team is familiar with the latest and most effective drugs for lowering cholesterol as well as for hypertension and diabetes. Besides prescribing medications to manage your cardiac risk, we can also prescribe highly individualized lifestyle adjustments that can enhance your efforts to stay well and symptom-free. Although many people know the importance of a heart-healthy lifestyle, few are sure of how to implement healthier ways of living in their own day-to-day lives.
If you haven’t had a recent cholesterol screening, be sure to get one on your calendar. Experts recommend getting a cholesterol panel at 20 years of age, and then every five years. If you have high risk factors for heart disease, your doctor may recommend a yearly check.
It is best to have a test called a “lipoprotein profile.” This blood test is done after fasting for nine to 12 hours and provides a snapshot of your total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides (a type of fat in your blood).
The first line of attack for lowering your cholesterol is a combination of changes in lifestyle: diet, exercise and weight loss.
A heart-healthy diet from the National Cholesterol Education Program called the TLC (therapeutic lifestyle changes) diet can help lower your cholesterol. This is a low-saturated-fat, low-cholesterol eating plan that calls for less than 7 percent of calories from saturated fat and less than 200 mg of dietary cholesterol per day. The TLC diet recommends only enough calories to maintain a desirable weight and avoid weight gain. If your LDL is not lowered enough by reducing your saturated fat and cholesterol intakes, you can increase the amount of soluble fiber (think: oats, oranges, beans) in your diet. You can also add certain food products that contain plant stanols or plant sterols (such as cholesterol-lowering margarines) to boost your diet’s LDL-lowering power.
Aim for 30 minutes of physical activity on most, if not all, days. It can help raise HDL and lower LDL and is especially important for those with high triglycerides and/or low HDL levels, who are overweight with a large waist measurement (more than 40 inches for men and more than 35 inches for women). Your activity should be of moderate intensity, which means you are able to carry on two to three word sentences. Try running, walking briskly, swimming or dancing.
Losing weight if you are overweight can help lower LDL and is especially important for those with a cluster of risk factors that includes high triglycerides and/or low HDL levels and being overweight with a large waist measurement. Research shows that women whose waist measures more than 35 inches and men more than 40 inches are at a greater risk for developing heart disease. What’s more, the ratio of this waist measurement relative to your hip measurement appears to be one of the strongest predictors of the chances of having a heart attack.
If you aren’t able to lower your cholesterol enough through lifestyle changes, your doctor may recommend you begin drug treatment. (You will still need to continue your lifestyle changes to keep the dose of medicine as low as possible, and lower your risk in other ways!) There are several types of drugs available for cholesterol lowering including statins, bile acid sequestrants, nicotinic acid, fibric acids and cholesterol absorption inhibitors. Your doctor can help decide which type of drug is best for you.
To make an appointment with any of our Preventive Cardiology specialists, please call 216.444.9353. For more information on implementing a low cholesterol diet, contact Preventive Cardiology by phone at 216.444.9353 or toll-free at 800.223.2273, ext. 49353.
Cholesterol and triglycerides are the two main types of fat molecules — or lipids — in the body. Without them, the body could not function. For instance, cholesterol is an essential component of cell membranes and is used by the body to produce vitamin D and hormones such as estrogen. It also is used to produce substances that aid digestion. Triglycerides are a major source of energy.
The body has two main sources of cholesterol and triglycerides: the liver and your diet. Cholesterol is found only in animal products (meat, milk, cheese, butter and cream). For some people, eating excesses of cholesterol-rich foods will raise blood cholesterol levels. In normal, healthy humans, the liver produces all the cholesterol the body needs, so you really don’t need supplemental cholesterol from your diet.
Triglyceride levels can be elevated for a number of reasons: excess sugar, alcohol, fat or calories or uncontrolled diabetes. In addition, some medical conditions and medications, or your genetic makeup, can cause elevated triglyceride levels.
Cholesterol and triglycerides travel throughout the body via the bloodstream, but only with the help of lipoproteins — LDL and HDL — which ferry these fat molecules to various destinations. LDL, or low-density lipoprotein, is known as the bad cholesterol because it sneaks through artery walls and unloads cholesterol there. This is how coronary artery disease, the most common type of atherosclerosis, begins and progresses. HDL, or high-density lipoprotein, clears cholesterol from the bloodstream and ferries it back to the liver for removal from the body. HDL can also help clear the cholesterol that LDL leaves embedded behind artery walls. That’s why it’s called the good cholesterol.
So, in general, optimal lipid levels are characterized by low levels of LDL and high levels of HDL.
Last reviewed by a Cleveland Clinic medical professional on 05/01/2019.
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