Did you know one-third of Americans have elevated LDL cholesterol? That’s the “bad” cholesterol, also known as low-density lipoprotein levels. It’s bad because it builds up in your arteries and increases your risk over time for heart attack and stroke.
“The trouble with high cholesterol is that there are no symptoms until it causes big problems,” says UVA cardiologist Angela Taylor, MD, the co-director of the Diabetes Cardiovascular Clinic. “The biggest danger is that you can’t prevent the consequences of high cholesterol if you don’t get it checked.”
Gender Differences in High Cholesterol
It’s especially important for women to know their cholesterol levels, Taylor says.
“For women, 60 percent of those who have sudden cardiac death from a heart attack had no idea they had coronary artery disease,” she says. “The first presentation of the problem was death.”
For men, cholesterol builds up within their arteries, and they get a blockage that causes symptoms. Men are more likely than women to be diagnosed and treated with a stent before high cholesterol leads to a heart attack.
But with women, Taylor says, cholesterol build-up often goes unnoticed. “With women, the cholesterol builds up in the artery, but the artery stretches so it gets packed into the artery wall and goes undetected. A woman’s artery wall can be 60 percent packed with cholesterol before it shows up on a stress test or cardiac catheterization.”
Get Tested: Know Your Cholesterol Levels
What should you do? A simple blood test will measure the level of cholesterol in your blood.
Men and women need to get their cholesterol checked every five years after age 20. But if you have a family history of early coronary artery disease or cholesterol problems, you should get checked earlier and more often, Taylor says.
“It is very simple, just a nice and easy blood draw,” Taylor says. “It’s such an easy thing to do to prevent a bad thing from happening.”
According to the American Heart Association:
- Your LDL should be under 100.
- If you have risk factors like diabetes or coronary artery disease, you should keep your LDL under 70.
- Your total cholesterol level should be under 200.
If you do have high cholesterol, your doctor may ask you to make lifestyle changes (diet and exercise) to lower your cholesterol, or you may need medication.
Younger patients, women who want to get pregnant and those with few other risk factors or health concerns are often encouraged to alter their behaviors before resorting to medication.
Taylor suggests physical activity, as well as moderation when it comes to diet:
- Limit animal products (meat and dairy), which are highest in cholesterol.
- Increase your portions of leafy greens. These veggies contain sterols and stanols, which actually absorb cholesterol and help excrete it from the body.
- Exercise is a must — at least 30 minutes per day most days of the week as recommended by the AHA.
Medication — called statins — is necessary for many people with high cholesterol, like those who also have diabetes or metabolic syndrome. Doctors are also more likely to prescribe medications for patients 40 or older because the risk of problems from high cholesterol goes up as you age, Taylor says. “We absolutely recommend medication for many patients.”
When to See a Cardiologist
Most people can get their cholesterol checked by their primary care doctor. But if you have family members who’ve had early heart attacks (ages 30-40), Taylor says, you should consider seeing a preventive cardiologist who can look for specific problems and do more extensive tests.
What About Kids and Cholesterol?
The latest statistics show that 10 percent of U.S. children have unhealthy cholesterol levels and one-third of kids are overweight or obese.
Taylor says the American Academy of Pediatrics recommends that all kids get a cholesterol screening between ages 9 and 11. Most children aren’t put on medications, though, because of side effects and toxicity issues, she says.