Checking your cholesterol levels might not top the list of the top 10 things to do—but knowing your cholesterol levels can be a key factor in your overall health, no matter your age.
People in their 20s may never think about checking their cholesterol, but they should because it may reveal a genetic predisposition to high cholesterol they didn’t know existed. The sooner it is treated, the more damage can be avoided. “
Dr. Michael Farbaniec, Cardiologist, Milton S. Hershey Medical Center, Penn State Health
In fact, the National Heart, Blood, and Lung Institute recommends initial testing between ages 9 and 11, and testing every five years thereafter.
People over 40 should have an annual lipid profile, and if their primary care physician doesn’t ask for it, they should ask for it to be added to their annual blood work — because it’s so easy to overlook, along with so many others, says Farbaniec. The problem requires maintenance.
What Are Healthy Cholesterol Levels?
Cholesterol is a waxy substance produced in the liver that is found in the blood and in all cells of the body and is needed to make cell walls, produce hormones, act as a cell protector, and more. In order for muscles and cells to obtain energy, cholesterol is transported as low-density lipoprotein (LDL), often referred to as “bad cholesterol,” and high-density lipoprotein (HDL), or “good cholesterol.”
In addition to total cholesterol, the lipid panel measures these lipoproteins as well as triglycerides and fatty acids in the blood, which the body uses for energy. Directly influenced by exercise and diet, high levels of triglycerides combined with low HDL cholesterol or high LDL cholesterol levels can increase your risk of plaque buildup, fatty liver, heart disease and stroke.
While many people can cite their total cholesterol numbers and be happy if it’s below the recommended threshold of 200 mg/dL, it turns out that it’s most important to know what is known as non-HDL cholesterol. This number is calculated by subtracting HDL from total cholesterol.
“We’ve changed the way we think about total value because we know we’re underestimating the risk that people are dying of heart disease,” Farbaniec said. “If your total cholesterol is below 200, but your HDL is 25 and your LDL is 170, that’s not good.”
Treat risk, not numbers
Ideally, non-HDL cholesterol should be less than 130 mg/dL in people without risk factors. For those at increased risk of heart disease due to a family or personal history of cardiovascular disease, other health problems, or familial hypercholesterolemia (inherited high cholesterol that is not affected by changes in diet or exercise), LDL values It should be below 70 mg/dL, says Farbaniec. Triglyceride values should be below 150 mg/dL. Values above 200 are considered high.
That said, it is important to consider risk factors for cardiovascular disease on an individual basis rather than relying on numbers.
“I had a patient with normal cholesterol, but she had a family history of heart disease at an early age, and she was very concerned,” Farbaniec said. “I had a coronary calcium scan and it showed a lot of calcified plaque buildup. This told me that although her numbers were good, she was still at risk, but there were things we could do now to prevent more plaque. Blocks piled up.”
Other people at risk for high cholesterol are those with high blood pressure, obesity, diabetes, premature heart disease, vascular disease and familial hypercholesterolemia, he said. Certain medications may also cause elevated levels.
The American College of Cardiology offers a risk calculator in which users can enter factors such as age, blood lipid values, and other factors to estimate the risk of atherosclerotic cardiovascular disease.
take the first step
It is not difficult to complete the blood lipid test. All it needs is your doctor’s lab sheet.
Today, most physicians do not require fasting for routine screening because non-HDL cholesterol levels do not change on an empty stomach. Some patients, especially those already on treatment, may still wonder how long to fast for a lipid test, and the answer is about 10 hours, Farbaniec said.
Statins, prescription drugs used to lower cholesterol levels, are the mainstay of treatment for high cholesterol, but there are many other options, Farbaniec said.
“The most important thing is to get your lipid profile done,” he said. “No one can feel it if they have high cholesterol, but the test results can help us with preventive treatments for a healthier future.”
Studies have shown that statins can also shrink or stabilize plaque buildup, providing another reason why knowing your cholesterol profile is important for overall health.
Penn State Health Milton S. Hershey Medical Center