Heart Disease and Lowering Cholesterol
What Numbers Should I Look For? continued...
What Affects Cholesterol Levels?
A variety of factors can affect your cholesterol levels. They include:
- Diet. Saturated fat, trans fat, and cholesterol in the food you eat increase cholesterol levels. Reducing the amount of saturated fat and trans fats and cholesterol in your diet helps lower your blood cholesterol level. Increasing the amount of fiber and plant-derived sterols can also help lower LDL cholesterol.
- Weight. In addition to being a risk factor for heart disease, being overweight can also increase your cholesterol. Losing weight can help lower your LDL, total cholesterol levels, and triglyceride levels, as well as raise your HDL.
- Exercise. Regular exercise can lower LDL cholesterol and raise HDL cholesterol. You should try to be physically active for 30 minutes every day.
- Age and Gender. As we get older, cholesterol levels rise. Before menopause, women tend to have lower total cholesterol levels than men of the same age. After menopause, however, women's LDL levels tend to rise.
- Heredity. Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.
- Medical conditions. Occasionally, a medical condition may cause an elevation of cholesterol levels in the blood. These include hypothyroidism (an underactive thyroid gland), liver disease and kidney disease.
- Medications. Some medicines, like steroids and progestins, may increase "bad" cholesterol and decrease the "good" cholesterol.
How Is High Cholesterol Treated?
The main goal in treating high cholesterol is to lower your LDL levels. To lower cholesterol, eat a heart-healthy diet, exercise regularly, and maintain a healthy weight. Some may also need to take cholesterol-lowering drugs.
Doctors determine your "goals" for lowering LDL based on the number of risk factors you have for heart disease.
Major risk factors include: age (men 45 years and older, women 55 years and older), cigarette smoking, high blood pressure, an HDL less than 40 mg/dL, family history of premature heart disease in a first-degree male relative (father or brother) less than age 55 and first-degree (female) relative less age 65.
- If you have 0-1 risk factor for heart disease, you are at low-to-moderate risk. Generally, lifestyle changes are effective in keeping the cholesterol in check.
- If you have 2 or more risk factors for heart disease, you are at moderate risk, depending on what heart disease risk factors you have. Your doctor may recommend lifestyle changes, but most people require cholesterol-lowering drugs, along with an appropriate diet and exercise program.
- If you have known heart disease, diabetes, or multiple risk factors, you are at high risk. Most people in this group will require a combination of cholesterol-lowering drugs and lifestyle changes to control their cholesterol levels.
LDL cholesterol goals include the following:
- Category I, Highest Risk (ten-year risk greater than 20%*): your LDL goal is less than 100 mg/dL. For those with a very high risk (those who have had a recent heart attack, those with cardiovascular disease or peripheral artery disease combined with diabetes or poorly controlled risk factors, or those with metabolic syndrome), it may be most effective for the LDL goal to be less than 70 mg/dL.
- Category II, Next Highest Risk (ten-year risk 10-20%*): your LDL goal is less than 130 mg/dL. Your doctor may set your LDL goal at less than 100 mg/dl if your LDL is 100-129.
- Category III, Moderate Risk (ten-year risk less than 10%*): your LDL goal is less than 130 mg/dL. Your doctor may set your LDL goal at less than 100 mg/dl if your LDL is 100-129.
- Category IV, Low Risk (0-1 risk factor*): your LDL goal is less than 160 mg/dL.