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

Statins may offer a long-term legacy benefit

Statins seem to have long-lasting heart benefits. Men who took a statin for five years during middle age had lower rates of heart attack and hospitalization for heart failure 20 years later compared with men who didn’t take the drugs.  More »

Why you may need a statin

Age can be the deciding factor in the decision to take a cholesterol-lowering drug. Many women over 65 and most over 70 may benefit from using a statin. (Locked) More »

Do you need a cardiologist?

For people with high blood pressure and high cholesterol, a primary care provider can usually effectively manage those conditions. But some people may need more focused care from a general cardiologist, or one with more specialized expertise. (Locked) More »

Heart attack despite low cholesterol?

About half of all heart attacks occur in people with "normal" cholesterol levels. Other conditions such as smoking, high blood pressure, or obesity could raise the risk of a heart attack. (Locked) More »

Cholesterol: What's diet got to do with it?

For many people, focusing on lowering dietary cholesterol alone has little effect on their blood cholesterol level. Limiting saturated fat (found mainly in animal-based foods like meat and cheese) may help lower blood cholesterol. But the source of calories used to replace those missing calories makes a difference. Substituting with unsaturated fats (found in fish, nuts, and plant oils) is likely beneficial, while substituting with refined carbohydrates (foods full of white flour or sugar) is not. (Locked) More »

The new cholesterol-lowering drugs

Two new injected drugs can dramatically reduce “bad” LDL cholesterol. They can be lifesaving for people who have extremely high LDL because of a genetic condition called familial hypercholesterolemia. Men with high cholesterol who can’t take statins because of side effects can also benefit. The long-term safety and effectiveness of the drugs are still being studied. The drugs are expensive, which will likely limit their use at first.  (Locked) More »

Can LDL be too low?

A low-density lipoprotein (LDL) level of 50 mg/dL reduces the risk of a recurrent heart attack and does not appear to impair cognition. Ongoing trials are looking at the effects of reducing LDL to 40 mg/dL or lower. More »

New studies support statin guidelines

The latest guidelines used to determine who should take a cholesterol-lowering statin to prevent heart disease appear to be more accurate and cost-effective than the previous guidelines. (Locked) More »