A high level of low-density lipoprotein -- LDL, or "bad" -- cholesterol is one of the major controllable risk factors for heart disease. According to the American Heart Association, heart disease is the leading cause of death in the United States, with 2,300 Americans dying of it each day. The National Heart, Lung and Blood Institute reports that 50 percent of heart disease deaths occur in women. Because many people who die unexpectedly of heart disease had no previous symptoms, it is important to know your risk factors. While risk factors such as age, sex and family history can't be controlled, many are affected by lifestyle. These include weight, activity level, blood pressure, tobacco use and cholesterol levels.
Total Cholesterol
Your health care provider can check your fasting lipid profile, also known as a cholesterol test. The total cholesterol level is made up of your LDL cholesterol, your high-density lipoprotein, or "good," cholesterol and triglycerides. According to the AHA, your cholesterol level can be affected by your age, sex, family health history and diet. A total cholesterol level of less than 200mg/dL is considered desirable, while 200 to 239 mg/dL is borderline high and 240mg/dL or higher is high. A high level more than doubles your heart disease risk.
LDL Cholesterol
When LDL levels get too high, these packages deposit cholesterol on the artery walls that feed the heart and brain. This contributes to the buildup of plaque, narrowing the arteries and making them less flexible -- known as atherosclerosis. If a clot forms and blocks a narrowed artery, heart attack or stroke can result. Many people inherit genes that cause them to make too much LDL but eating saturated fat, trans fat and dietary cholesterol also increase LDL. For LDL cholesterol, less than 100 mg/dL is optimal; 100 to 129 mg/dL is near or above optimal; 130 to 159 mg/dL is borderline high; 160 to 189 mg/dL is high; and 190 mg/dL or higher is very high. Your doctor will look at your other risk factors to determine what your LDL level should be.
HDL Cholesterol
HDL is considered the "good" cholesterol because healthy levels may protect against heart attack and stroke. According to the AHA, many experts believe that HDL carries LDL cholesterol away from arteries and back to the liver, where it's passed from the body. HDL may remove excess cholesterol from arterial plaque, slowing its buildup. Less than 40mg/dL for men and less than 50 mg/dL for women is considered low -- a major risk factor for heart disease; 60mg/dL and above is high -- protective against heart disease. To raise HDL levels, avoid tobacco smoke, maintain a healthy weight and get at 30 to 60 minutes of physical activity on most days.
Triglycerides
Triglycerides are the most common form of fat in the body. The AHA reports that many people with heart disease and diabetes have high triglyceride levels. High triglycerides along with low HDL or high LDL speed up atherosclerosis. For triglycerides less than 150 mg/dL is normal; 150 to 199 mg/dL is borderline high; 200 to 499 mg/dL is high; and 500 mg/dL or above is very high. The main treatment for elevated triglycerides is lifestyle change. Control weight, eat a heart-healthy diet, get regular activity, avoid tobacco smoke, limit alcohol intake and limit added sugars.
Lifestyle Changes
The NHLBI's Guide to a Healthy Heart recommends several lifestyle changes to reduce your risk for heart disease and stroke. Eat a heart-healthy diet that is rich in vegetables, fruits, whole grains, high-fiber foods, lean meats and poultry and fat-free or 1 percent fat dairy products. Include fish at least twice a week. Choose foods that are low in saturated and trans fats and cholesterol. Aim for a healthy weight. If you are overweight, losing just 5 to 10 lbs. can improve lipid levels and blood pressure. Get at least 30 minutes of moderate-level physical activity more days than not. Walk, bike swim, jog, dance, rake leaves or garden -- choose what you enjoy and get a partner to improve your success. Also, avoid tobacco smoke.
Dietary Fat and Cholesterol
To lower LDL cholesterol, replace saturated and trans fats with heart-healthy mono- and polyunsaturated fats. Saturated fats tend to be solid at room temperature and are mostly found in animal products like meats and dairy products. Eat red meat less often, opting for lean cuts like loin and round. Choose white meat poultry without the skin. Trans fats, or hydrogenated fats, are found in processed foods like margarines and baked goods. Read labels to choose foods with no trans fat. Cholesterol is only in animal products -- meats, dairy products and eggs. If you have high cholesterol, limit dietary cholesterol to 200mg per day.
References
- American Heart Association: Prevention and Treatment
- NHLBI: Your Guide to a Healthy Heart
- American Heart Association: Why Cholesterol Matters
- American Heart Association: What Your Cholesterol Levels Mean
- American Heart Association: About Cholesterol
- American Heart Association: Good vs. Bad Cholesterol
