Having high LDL cholesterol is one of the primary risk factors for heart disease . High cholesterol leads to plaque buildup in the arteries, which can narrow and block blood flow to the heart. Especially if heart disease runs in your family, it’s important to know what your cholesterol levels are.
What if your cholesterol numbers are still in a healthy range, yet right on the cusp of being considered high? Does that mean you’re in the clear? If you have borderline cholesterol numbers, there’s something cardiologists want you to know—and it just might save your life.
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What Is Considered 'High Cholesterol'?
“We are learning that hypercholesterolemia [high cholesterol] is arguably the most important risk factor for heart disease,” says Dr. Yaz Debull, MD, a cardiologist who uses social media to educate people about cardiovascular health. He explains that what’s so powerful about knowing what your cholesterol numbers are is that you can change them through diet and lifestyle habits; high cholesterol is a modifiable risk factor.
“You cannot change the risk if you do not know your numbers. For this reason, as a cardiologist, I highly recommend knowing your cholesterol numbers. This can be lifesaving information. Next time you are at your doctor's office, ask your doctor about checking cholesterol numbers,” Dr. Debull says.
When you’re getting your cholesterol numbers checked, your healthcare provider will check your HDL cholesterol (often referred to as “good” cholesterol) and LDL cholesterol (that’s the “bad” type). HDL cholesterol should ideally be above 60; you want this one to be high. LDL cholesterol should be low, ideally below 100. Your total cholesterol numbers should be below 200.
However, Dr. Debull offers up a caveat to using these numbers as a rubric. “LDL cholesterol is a moving target, depending on one’s risk status and her overall clinical health. For this reason, do not solely rely on the reference numbers that you received by the lab,” he says.
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Dr. Debull says that the aforementioned numbers are helpful for the general public to know, but individuals with diabetes, a family history of heart disease, high levels of calcification in their heart arteries or those who have previously had a heart attack or stroke are managed at different thresholds. “Over time, we have learned that lower is better when it comes to LDL cholesterol. In certain high risk individuals, the recommendation now is to achieve an LDL of less than 55 mg/dl,” Dr. Debull says.
What Cardiologists Want Everyone With Borderline Cholesterol Levels to Know
Okay, so you know what numbers to aim for (depending on your individual health risk for heart disease). What if technically your numbers aren’t high, but you are toeing the line? If you have borderline high LDL cholesterol, Dr. Debull says it’s still important to be cautious of it and do what you can to lower it.
In general, he says the first step is to focus on lifestyle interventions, including weight management and a low-fat diet. “While the impact of diet may not affect cholesterol dramatically, for some individuals that intervention alone may be all they need to achieve their goal, especially if the numbers are not excessively high to begin with,” Dr. Debull says. In other words, if you have borderline high cholesterol, implementing healthy lifestyle habits is supercritical and may be the only action you need to take to get your levels to a healthy place.
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What does this look like? Dr. Sergio Waxman, MD, MBA, Division Chief of Cardiology in the Department of Medicine at Newark Beth Israel Medical Center, says the most effective way to lower your LDL is through diet and exercise. “Something as simple as taking a brisk 30-minute walk every day can greatly reduce your LDL levels,” he says. Dr. Waxman recommends aiming for 30 minutes of aerobic exercise daily, or at least five times a week.
In terms of diet, Dr. Waxman says reducing red meat consumption and eating more green veggies can make a big impact. “Try green vegetables rich in antioxidants, like broccoli and spinach. To keep your LDL cholesterol low and your diet interesting, add blueberries, blackberries and raspberries to your routine, and diversify your protein sources by including fish, chicken and other unique proteins while staying away from red meat,” he says.
If your LDL cholesterol is more than borderline and is considered high, Dr. Debull says it may take more than diet and lifestyle changes to get your levels to a healthy place, such as taking statin medications.
What’s most important is to know what your cholesterol numbers are and, if they aren’t in a healthy place, talk to your healthcare provider about what you can do to change that. The good news is that cholesterol numbers can change. If your LDL cholesterol is higher than it should be, it isn’t doomed to stay that high forever. But it does require being proactive. No one can look after your health better than you!
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