It could have life-saving effects.
When your doctor tells you that your cholesterol levels are too high, you might think, “Well, I feel fine.” That’s because high cholesterol on its own doesn’t necessarily cause symptoms. However, reaching target cholesterol levels is an investment in your long-term health. After all, high cholesterol can take a toll on your health.
The Health Risks of High Cholesterol
High cholesterol is a significant risk factor for heart disease, particularly a subtype called atherosclerotic cardiovascular disease (ASCVD). This can then increase your risk for heart attacks and strokes.
When you have too much LDL (“bad”) cholesterol in your body, it builds up in your blood vessels. Here, it hardens and forms plaque, which narrows and hardens the arteries. This process is known as atherosclerosis. It can partially or completely block blood flow to the heart (a heart attack) or the brain (a stroke).
“When we think about atherosclerotic heart disease, we're specifically looking at the blood vessels that are supplying blood to the heart muscle,” says Lawrence Phillips, MD, cardiologist at NYU Langone Health. “The reason that's important is because when you have narrowing in those blood vessels, you're at an increased risk of having symptoms like chest pain or shortness of breath, but also of having problems, such as heart attack.”
Keep in mind that heart disease is the leading cause of death in the United States, and stroke is the fifth leading cause of death. That means managing your cholesterol levels may be an important tool in mitigating your risk of these common problems.
Understanding Target Levels
“It's important to reduce your cholesterol when you're at high risk because it's going to decrease your risk of having a stroke or a heart attack,” says Dr. Phillips. “We need to make sure that when people are looking at their high cholesterol, that they're learning the risks over the long term and seeing the benefit that comes from aggressively treating it early on.”
There is not a defined “perfect” cholesterol level, but in general, your total cholesterol level should be less than 200 mg/dL (milligrams per deciliter). More specifically, your LDL level should be at or below 100 mg/dL.
If your doctor is concerned about your cholesterol profile, you have many ways to reach your target cholesterol levels. This may start with heart-healthy lifestyle changes, such as:
- Reducing intake of saturated fat
- Eliminating intake of trans fats
- Exercising regularly
Additionally, there are many effective medicines that can help lower LDL cholesterol. The most common treatment for high cholesterol is statin therapy.
“A statin medication impacts the way that cholesterol is produced by the liver, and can be beneficial by reducing your cholesterol almost 50 percent,” says Dr. Phillips. Your doctor may recommend statins or other medicines if lifestyle changes aren’t enough to reach your target cholesterol levels.
“We have lots of medications that can be used with different classes that will impact and lower your cholesterol, [and] it's a teamwork between me, their physician, and them as the patient, to come up with a plan that works best for them,” says Dr. Phillips.
Lawrence Phillips, MD, is a cardiologist at NYU Langone Health. Dr. Phillips is the assistant professor of the Department of Medicine at NYU Grossman School of Medicine, the assistant clinical director for strategic affairs at Leon H. Charney Division of Cardiology, the director of the Nuclear Cardiology Laboratory, the medical director for Outpatient Clinical Cardiology, and the associate director of the Cardiovascular Disease Fellowship Program.
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There are some hard, fast rules
when it comes to cholesterol,
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where you really want someone to have lower numbers.
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Ideally, you want the total cholesterol
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to be below 200 to 240,
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and their LDL, their 'bad' cholesterol,
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to be less than 160.
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However, the aggressiveness we're going to use
and the decision
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to use medications versus
just lifestyle modifications alone
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will be dependent on other factors as well.
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It's important to reduce your cholesterol
if you're at higher risk
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because it's gonna decrease your risk of having
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a stroke or a heart attack.
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For most people who don't have other medical problems,
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it's a very difficult concept
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because they're not used to taking medications.
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However, we need to make sure
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that when people are looking at their high cholesterol,
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that they're learning the risks over the long term
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and seeing the benefit that comes
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from aggressively treating it early on.
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So to lower your cholesterol,
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we first start with lifestyle modifications,
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and that includes increasing exercise programs
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so that you're decreasing your sedentary lifestyle.
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It includes changing your diet to decrease fats,
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decrease fried foods,
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decrease some of your cheese intake,
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and increase your vegetable.
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If you're a smoker, it's a great opportunity
to stop smoking
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because we know that smoking increases your risk
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of developing narrowing your blood vessels,
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but also increases the risk of rupturing a plaque,
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which causes a heart attack or a stroke.
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Once we go beyond the lifestyle modifications,
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we think about medications.
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Medications, the first-line for cholesterol is a statin.
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A statin medication impacts the way that cholesterol
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is produced by the liver, and can be beneficial
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by reducing your cholesterol almost 50 percent.
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When I see patients who are struggling
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to reach their target cholesterol levels,
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I tell them, first, it's very common.
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We have lots of tools in our tool belt.
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We have lots of medications that can be used
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with different classes
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that will impact and lower your cholesterol.
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I also tell patients that when they get frustrated
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we're looking at a longitudinal result.
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We're looking to reduce their cholesterol over years,
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not just over a couple days,
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and that if it takes extra work, that's okay.
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- High cholesterol facts. Atlanta, GA: Centers for Disease Control and Prevention. (Accessed on September 16, 2020)
- LDL and HDL cholesterol: “bad” and “good” cholesterol. Atlanta, GA: Centers for Disease Control and prevention, 2020. (Accessed on September 16, 2020)
- Patient education: high cholesterol and lipid treatment options (beyond the basics). Waltham, MA: UpToDate, 2020. (Accessed on September 16, 2020)