Cholesterol

Cholesterol isn't entirely the health villain it's made out to be, its name darkly linked to heart attack, stroke, and other types of cardiovascular disease. Our bodies need cholesterol, which is a type of lipid (another name for fat) to make cell membranes, key hormones like testosterone and estrogen, the bile acids needed to digest and absorb fats, and vitamin D. Cholesterol is so important to the body that the liver and intestines make it from scratch.

What is "bad" about cholesterol isn't the substance itself — in fact, we can't live without it — but how much of it is in the bloodstream.

The body packages cholesterol in two main particles: low-density lipoprotein (LDL), the so-called bad cholesterol, and high-density lipoprotein (HDL), the so-called good cholesterol. Too much LDL in the bloodstream helps create the harmful cholesterol-filled plaques that grow inside arteries. Such plaques are responsible for angina (chest pain with exertion or stress), heart attacks, and most types of stroke.

What causes a person's LDL level to be high? Most of the time diet is the key culprit. Eating foods rich in saturated fats, trans fats, and easily digested carbohydrates boost LDL. Genes are sometimes at the root of high cholesterol, and some medications can boost LDL.

If you have high cholesterol, making changes in your diet can help bring it down into the healthy range. Exercise can help boost the level of protective HDL. Several types of medication, notably the family of drugs known as statins, can powerfully lower LDL. Depending on your cardiovascular health, your doctor may recommend taking a statin.

Cholesterol Articles

Arterial Blood Flow Studies of the Legs (Segmental Doppler Pressures)

People who have leg pain when exercising may need an evaluation to make sure they have normal blood flow through their leg arteries. Normally blood pressure is similar whether it is measured in the legs or in the arms. If blood pressure is lower in the legs, it usually means that cholesterol buildup inside the leg arteries is interfering with circulation. By taking accurate blood pressure measurements at different locations along your legs, your doctors can determine if you have any arterial narrowing and, if so, where. In order to get accurate blood pressure measurements, your doctor uses a technique called Doppler ultrasound. Doppler ultrasound is a painless way to detect blood flowing through a small artery. It uses sound waves and a type of sonar detection system to make noise when blood flow is detected. For arterial studies of the legs (called segmental Doppler pressures), Doppler ultrasound is used in place of the stethoscope that doctors usually use when taking blood pressures. You may want to wear shorts for this exam, and your feet should be bare during the test. If you are not wearing shorts, you may have to change into a hospital gown. (Locked) More »

Don't be afraid of statins

While statin therapy helps lower LDL (bad) cholesterol, many people may still resist them because they fear side effects and do not understand how the drugs work. Yet, for many people, statins are the best way to protect against heart attack and stroke, and may provide additional benefits like reducing the risk of blood clots and protecting against Alzheimer’s. (Locked) More »

When very high cholesterol runs in the family

Familial hypercholesterolemia (FH) is an inherited condition that leads to very high levels of harmful LDL cholesterol. Although FH is as common as type 1 diabetes and cystic fibrosis, many people have never heard of it. Because it’s a leading cause of premature heart attacks, ongoing efforts seek better ways to identify FH. Genetic testing isn’t always necessary, because high LDL cholesterol is an excellent indicator of heart disease risk. In children, an LDL cholesterol level of 160 mg/dL or higher suggests FH; in adults, an LDL of 190 mg/dL or higher raises suspicion. (Locked) More »

Do you need a calcium scan?

Coronary artery calcium scans, which can reveal dangerous plaque in the heart’s arteries, are now recognized by guidelines and being are used more often than in the past. Results from the scan may help refine or reclassify a person’s risk of heart disease. But the tests don’t make sense for everyone. People who already have heart disease should not have a calcium scan, nor should people at low risk, which includes most people under age 40. Instead, the scans are an option for people who fall in between. This borderline and intermediate risk group includes people ages 40 to 75 whose 10-year risk of heart disease or stroke ranges from 5% to 20%. More »

Skip vitamins, focus on lifestyle to avoid dementia

New guidelines released May 19, 2019, by the World Health Organization recommend a healthy lifestyle—such as keeping weight under control and getting lots of exercise—in order to delay the onset of dementia or slow its progression. More »

For most people, no need for niacin

Niacin, also known as vitamin B3, is unlikely to provide any heart-related benefit for most people. Its only possible role is for people who cannot tolerate statins, but other, newer medications would likely offer greater benefits. More »