Cholesterol Archive

By lowering your blood LDL ("bad") cholesterol level, even if it is normal, you help reduce your chances of having a heart attack. It's especially important if the LDL level is above 130 milligrams per deciliter. For every 10% drop in your cholesterol level, your heart attack risk potentially falls by 20% to 30%.

There are several steps you can take to lower your cholesterol level, like losing weight if needed, being more active, and choosing healthy foods. Here are three simple steps toward a healthier, cholesterol-lowering diet:

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Peppers, which belong to the genus Capsicum, come in a variety of colors, shapes, sizes, and flavors. Bell peppers (available in green, yellow, orange, red, and even purple) make a nice addition to a salad or plate of crudités. Supermarkets carry bags of assorted mini bell peppers that are convenient both for snacking and using in recipes.

While sweet bell peppers are crunchy and mild, hot peppers — such as jalapeños, serranos, and habaneros — provide a tongue-tingling punch of heat. They contain varying amounts of the phytochemicals responsible for the spiciness in hot peppers.

Research we're watching

About four in 1,000 adults in this country are born with a genetic condition marked by abnormally high cholesterol levels, known as familial hypercholesterolemia (FH). Their "bad" LDL cholesterol can be two to three times as high as the common target LDL value of 100 milligrams per deciliter (mg/dL) or lower for healthy people. But only about half of people with FH are getting proper treatment for the disease, according to a report in the May 22 issue of Circulation.

For the study, researchers analyzed health surveys done between 1999 and 2014 with nearly 42,500 adults in the United States. Although more than 80% of people with FH or severely high cholesterol were aware of their condition, only half were taking cholesterol-lowering statins. And among those who were, only one-third were taking optimal doses of the drugs.

For people at high risk, PCSK9 inhibitors may prevent heart attacks and save lives. But gaining access to these pricey drugs remains a challenge.

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Three years ago, the FDA approved two drugs that lower harmful LDL cholesterol values dramatically — by more than 50%. The drugs, alirocumab (Praluent) and evolocumab (Repatha), belong to a new category of medications known as PCSK9 inhibitors. Both are given by a self-administered injection once or twice a month.

They're intended for people whose cholesterol levels remain stubbornly high, despite making lifestyle changes (such as diet and exercise) and taking the maximum dose of a high-potency statin and other cholesterol-lowering drugs. In the past two years, results from two large studies found that both PCSK9 inhibitors lowered the risk of serious heart-related events such as heart attack and stroke by 15%.

Research we're watching

Is your workplace noisy? You may want to keep close tabs on your blood pressure and cholesterol. A CDC study published in the American Journal of Industrial Medicine found that high cholesterol and high blood pressure were more common among workers who toiled in noisy environments.

The study found that 25% of U.S. workers surveyed reported experiencing noise exposure at work. The noisiest industries included mining, construction, and manufacturing.

Research we're watching

Cholesterol-lowering statins may be underused in younger people at risk for heart attack, new research suggests.

The study, in the Jan. 23, 2018, Journal of the American College of Cardiology, included more than 1,600 people ages 50 and younger who had experienced a heart attack. Only one in eight was taking a statin before the heart attack.

On call

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Q. I am about the same age as President Trump, and I also had a recent physical. My LDL (bad) cholesterol reading was 136, which my doctor thought was too high. But Mr. Trump's doctor said his LDL cholesterol of 143 was "excellent." Which is it?

A. The report of President Trump's health status brought out many armchair cardiologists — and real cardiologists — to comment on his cholesterol levels and risk for heart disease. The White House doctor's report stated that the president's "heart health" (not his cholesterol) was deemed excellent based on a normal exercise test and heart ultrasound. However, his LDL level of 143 was felt to be too high, and his doctor recommended doubling the president's statin medication. While the president doesn't show evidence of current heart disease, what is his future risk? A 71-year-old man with his cholesterol value would have a 10-year risk of heart attack, stroke, or cardiac death of 16% (about a one-in-six chance).

Research we're watching

People who carry excess weight but have normal blood pressure, blood sugar, and cholesterol values are sometimes dubbed "fat but fit." But they're still more likely to develop heart disease than people who aren't overweight, a new study suggests.

Researchers analyzed more than 7,600 cases of heart disease that occurred over a 12-year period in 10 European countries. They also used data from 10,000 healthy people without heart disease as a comparison group. Compared with people at a healthy weight, those who were overweight or obese had up to a 28% higher risk of developing heart disease.

Research we're watching

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Want to help improve your cholesterol profile? Swap your midmorning muffin for a handful of almonds, suggests a study in the Aug. 1, 2017, Journal of Nutrition.

Nutritionists have long known that eating almonds and other nuts tends to lower harmful LDL cholesterol and raise desirable HDL cholesterol. But recent evidence suggests that the heart-protecting effects of HDL depend on a person's particular complement of the various forms of HDL, some of which are more beneficial than others.

A certain amount of healthy fat is good for your heart.

Low-fat, no-fat, fat-free. Fat has been shamed for so long, it's easy to think there's no place for it in a heart-healthy diet. But the opposite is true. "It's a myth that lowering fat intake is healthy," says Dr. Frank Sacks, professor of cardiovascular disease prevention at the Harvard T.H. Chan School of Public Health. "The key is to use more healthful unsaturated fats and less of the detrimental saturated fats."

The good and the bad

To understand the role of fat in heart health, you first have to look at where it's found in food. There are two types of fat: saturated and unsaturated.