Understand Your Health: What is Cholesterol?

High cholesterol is a major risk factor for heart disease and stroke, but what exactly is cholesterol and how does it affect your heart? When you consider that one in three Americans has high cholesterol, the answer to that question is pretty important.

Huong Tong, M.D., a family medicine physician on the medical staff at Texas Health Denton and Lewisville Family and Urgent Care, a Texas Health Physicians Group practice, explains that cholesterol is a fat-like substance that circulates in our blood.

“There are different components of cholesterol,” she says. “There’s good cholesterol (HDL) and bad cholesterol components (LDL and triglyceride).”

The American Heart Association explains that your body needs cholesterol to build cells, which is a positive thing, but too much can be a problem.

Cholesterol comes from a couple of places — your body and other animals. Your liver actually makes all the cholesterol your body needs for cell growth. Foods high in saturated fats and trans fats cause the liver to make more cholesterol than your body needs.

“The difference between the good and bad cholesterol is that the good cholesterol (HDL) helps remove the bad cholesterol (LDL) from your arteries and prevent your arteries from being clogged up,” Tong explains. “This allows your blood to flow smoothly and carry the essential nutrients to each organ in your body, particularly the heart and brain, preventing heart attack and stroke.”

In other words, the higher the HDL level, the more protected your heart is.

If your ratio skews the other way, with a higher LDL and triglyceride level, your heart is not only vulnerable; it’s in danger.

“When there’s too much of these (LDL and triglycerides) circulating in the blood vessel, they can aggregate and create a plaque,” Tong explains. “Over time, the plaque builds up and can obstruct the blood flow to your heart, brain or extremities. This can lead to heart attack, stroke or peripheral vascular disease.”

So how do you know if you have more HDL than LDL? Tong says it’s a matter of a simple blood test.

“A simple way to find out about your cholesterol level is through a fasting lipid test,” she says. “Discuss with your primary care physician to see if a screening test is indicated for you.”

Tong says that screening frequency depends on a lot of factors, including age and family history.

“This is going to be different for people depending on their age, sex, family history, comorbidity, medical history and other risk factors,” she says.

In general, Tong says lipid screenings should begin with men ages 20 to 35 if they have increased factors for heart disease, and for men 35 and older if they do not. In women, lipid screenings should start at age 20 to 45 if they have increased risk factors, and 45 or older if they do not.

“There is no specific guideline on the interval of screening,” she says. “However, frequency of screening ranges from one to five years depending on your age, past cholesterol level and risk factors.”

Those risk factors include a history of diabetes, high blood pressure, heart disease, stroke, smoking and obesity, as well as any family history of risk.

The good news is that some of the causes of high cholesterol can be reversed.

“There are many factors that influence the cholesterol level. Some are modifiable and some are not,” Tong says. “For example, age, hereditary, sex and ethnicity are factors that we unfortunately cannot modify.

“However, the good news is there are many other things you can do to keep your bad cholesterol down, including exercising, eating more vegetables and fruits, cutting down on fatty/greasy food, losing weight, and smoking cessation,” she adds. “These are modifiable factors that you can be in control of to help drive the bad cholesterol (LDL) down and raise your good cholesterol (HDL) up.”

Start making your heart health a priority today. Learn your risk by taking a free heart health assessment at TexasHealth.org/heart.

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