SPRINGFIELD – How many times have you heard the phrase “know your numbers” when it comes to your health?
National Cholesterol Education Month in September serves as an important reminder for all adults to have their cholesterol measured through a simple fasting blood test, to know their cholesterol numbers and their risk for cardiovascular disease – such as age, gender and family history, none of which is in our power to change – and to follow a heart-healthy lifestyle to lower their risk and keep it down.
“We know from research that high cholesterol is one of the major risk factors for heart disease and that lowering your cholesterol can decrease your risk of cardiovascular disease,” Dr. Timothy Egan, a non-invasive cardiologist in the Heart and Vascular Program at Baystate Medical Center, said.
Many risk factors contribute to having high or low cholesterol, including heredity, diet, lack of exercise, excess weight, age and sex, alcohol and stress levels. Also, racial and ethnic minorities, including African Americans and Hispanics, are at greater risk for developing high cholesterol.
Cholesterol is a waxy substance used in making the walls that surround cells and in making a number of hormones used in human metabolism. Some cholesterol comes from the liver and other cells in your body, other cholesterol comes from food. For some, high cholesterol is inherited, but many times it is the result of eating too many trans fats, saturated fats, and dietary cholesterol from animal products.
Cholesterol travels through our bloodstream with the aid of a lipoprotein, which is a combination of proteins and cholesterol. There are two types of cholesterol – LDL and HDL – determined by which one the lipoprotein carries. LDL stands for low-density lipoproteins, otherwise referred to as “bad cholesterol,” which deposits cholesterol in the blood vessels, forming plaque and increasing one’s risk of heart attack and stroke. HDL cholesterol stands for high-density lipoproteins, considered to be the “good” cholesterol, which remove cholesterol from plaque and out of the bloodstream through the liver.
According to Egan, when it comes to your cholesterol numbers, the National Cholesterol Education Program, launched by the National Heart, Lung, and Blood Institute (NHLBI) in 1985, recommends LDL goals of less than 160, or if you have two risk factors for cardiac disease then less than 130. For those with cardiac disease or diabetes, the optimal level is less than 100. HDL levels should be more than 40 or 50, and are mostly determined by genetics and lifestyle. HDL less than 40 is a risk factor for blood vessel disease, while HDL over 60 may reduce the risk of heart attack and stroke. Desirable total cholesterol numbers should be less than 200, with 240 considered high.
“Our goal is to first introduce lifestyle modifications as a way to lower cholesterol, unless a person has already had a heart attack and has high cholesterol. But, when diet and exercise fail, we turn to cholesterol medications,” Egan said.
Egan noted the most common class of medications used to treat cholesterol are statins. These include Rosuvastatin (Crestor), atorvastatin (Lipitor), simvastatin, pravastatin, lovastatin, fluvastatin, and pitavastatin.
“Our decision to prescribe one statin over another is based on the potency, side effects, and cost to the patient,” said Egan, who noted generic statins have been shown to be just as successful in lowering LDL.
According to the Baystate cardiologist, while some clinicians vary on when to begin screening for cholesterol, the National Cholesterol Education Program recommends beginning at age 20, while the U.S. Preventive Services Task Force recommends at the age of 35 for men and 45 for women, all depending on the patient’s general health and risk factors.
“While some may worry about possible side effects from statins, such as muscle and liver damage, they are uncommon and for most patients the benefits of medication far outweigh the risks,” Egan said.
For more information on the Heart and Vascular Program, visit baystatehealth.org/heart.