Key Takeaways:

• Cholesterol is a fat-like, waxy substance that can be found in many parts of your body, such as your bloodstream and cells.
• Two types of cholesterol include HDL, the “good” cholesterol, and LDL, the “bad” cholesterol.
• To reduce high cholesterol, consider lifestyle modifications such as eating a healthy diet, regular exercise and not smoking.

St. Joseph’s/Candler Primary Care Physician Dr. Anna Spelts explains the good and bad about cholesterol

Fatty particles are floating around in your bloodstream. Sounds bad, right? Well, some are actually good particles. So much so that it’s their job to remove the bad ones. It’s how many of the good particles you have versus the bad ones that can determine to your cardiovascular health.

We’re talking about cholesterol, the fat-like, waxy substance that can be found in many parts of your body, such as your bloodstream and cells.

Cholesterol comes from two sources: your liver and the foods you eat. There are two main types of cholesterol you probably have heard of: low-density lipoproteins (LDL) and high-density lipoproteins (HDL), explains St. Joseph’s/Candler Primary Care Physician Dr. Anna Spelts, who sees patients at the SJ/C Primary Care office in Richmond Hill.

LDL cholesterol, referred to as “bad” cholesterol, is a type of fat in the blood that contains the most cholesterol. When you have high amounts of this type of cholesterol in your body, it forms plaque in the arteries.

HDL cholesterol is considered the “good” cholesterol. It travels the bloodstream to remove cholesterol that shouldn’t be there. This keeps plaque from building up in your arteries.

Therefore, you want your HDL to be as high as possible, while keeping your LDL low.

What should my cholesterol numbers be?

Ideally, you want your total cholesterol levels to be less than 200 milligrams per deciliter. A reading between 200 and 239 mg/dL is considered borderline high and a reading of 240 mg/dL and above is considered high.

LDL cholesterol levels should be less than 100. Levels of 100 to 129 mg/dL may be acceptable for people with no health issues or family history of heart disease. A reading of 130 to 159 mg/dL is borderline high and 150 to 189 mg/dL is high. A reading higher than 190 mg/dL is considered very high.

An ideal reading for HDL cholesterol is 60 mg/dL or higher. A reading of 41 to 59 mg/dL is borderline low, while a reading less than 40 is considered a major risk factor for heart disease.

Related Article: Do you know your numbers?

What causes high cholesterol?

High cholesterol can be caused by many things. Genetics certainly plays a role, says Dr. Spelts.

“Even if you are maximizing all your lifestyle modifications like getting exercise every week and eating all your fruits and vegetables, sometimes cholesterol levels are still not optimal,” Dr. Spelts says. “We also want to take into account if mom, dad, grandma had a heart attack or stroke. Because that might mean we need to be more aggressive.”

Related Article: Knowing your family’s past medical history can benefit your future

Age is another risk factor that you can’t control. Cholesterol, especially your LDL cholesterol, naturally goes up with age, Dr. Spelts says.

Things you can control to keep your total cholesterol low are:

• A diet that includes lean proteins, lots of fruits and vegetables, little to zero processed foods and avoid foods high in saturated fats, such as the Mediterranean diet, Dr. Spelts says.
• Regular exercise – aim for at least 30 minutes a day, every day of moderate intensity activity with weight-barring exercise at least twice a week, Dr. Spelts says.
• Maintain at a healthy weight.
• Don’t smoke or quit smoking now.

Related Article: Should I try the Mediterranean diet?

What happens if my cholesterol is too high?

High cholesterol can lead to many cardiovascular problems. If there’s too much plaque in your arteries, it can obstruct blood flow and even rupture. That can lead to blood clots forming in your heart, which can cause a heart attack, or your brain, which can cause a stroke.

High cholesterol also can cause circulation and kidney problems.

Related Article: What are the signs of a stroke?

How do you treat high cholesterol?

If you have high cholesterol, your doctor will most likely first recommend lifestyle modifications to include diet, exercise and stop smoking if you are a smoker.

If lifestyle modifications don’t work, or if genetics are playing a role in your high cholesterol levels, your doctor may prescribe medication. But that’s not a “get out of jail free card.”

“I tell patients it is very rare a pill can do all the heavy lifting for you,” Dr. Spelts says. “There are some really great medications out there that are effective but that doesn’t mean you can go out there and be crazy with your diet and lifestyle.”

“You absolutely should maximize your life modifications, even if we put you on a medication.”

One example of a medication you may be put on is a statin. Statins are prescription medications that have been shown to lower your LDL cholesterol to try to prevent heart attack and stroke.

Over the years, statins have gotten a bad rap because some people think they cause dementia. Overall, statins are not associated with cognitive harm. Some data even suggests a protective effect against dementia.  

They are not, however, without side effects. Statins may cause muscle aches and pains, fatigue and headache.

If a statin is not right for you, there are other excellent cholesterol medications out there, Dr. Spelts says.

“It’s not a one-size fits all treatment. It’s personalized.”