Five Facts for Controlling Cholesterol

1. Your body needs some cholesterol to properly function.

Cholesterol is a lipid, which is a waxy fat-like substance that is naturally produced in the body’s liver and is needed to help build cells and carry out essential functions, explains Mark Benson, MD, Director of Cardiovascular Prevention in BIDMC’s CardioVascular Institute. Cholesterol is also found in some foods, like fatty beef, full-fat dairy and eggs. However, unlike certain vitamins and nutrients, your body doesn’t need cholesterol from external food sources to maintain health.

2. Fatty foods are the primary reason for high cholesterol

“When there is too much cholesterol in the bloodstream, it builds up in the walls of arteries and can form plaque, a sticky substance that can prevent oxygen and nutrients from reaching the heart muscle,” explains Benson. “In the worst case scenario, the end result could be a heart attack.” Foods that are high in saturated fats and trans fats are the primary reason for this buildup of cholesterol.

3. Lowering “bad” LDL cholesterol can help prevent heart problems.

“LDL [low-density lipoprotein] is known as ‘bad’ cholesterol because it deposits harmful fat in the blood vessel walls of the heart,” explains Benson. “HDL [high-density lipoprotein] is known as the ‘good’ cholesterol because it actually extracts cholesterol from blood vessel walls and transports it back to the liver for disposal.”

But, adds Benson, it’s been difficult to show that raising someone’s HDL cholesterol will reduce their risk of having a heart attack. “On the other hand, if you lower LDL cholesterol [through lifestyle interventions or medications] many large studies have shown that you can significantly reduce the risk of having a heart attack, suffering stroke or dying from heart disease.

4. Family history can play a part.

Familial hypercholesterolemia is an inherited condition that results in someone having naturally high cholesterol. In these cases, says Benson, LDL readings can be very high, typically over 190 mg/dl. “This is important, because if your genetic wiring is causing high cholesterol, you’ve probably been exposed to high LDL your whole life. For people whose LDL levels are not related to genetics, they’ve probably only had high LDL levels since they’ve entered their 40s, 50s or 60s.”

If there’s a strong family history of either high cholesterol or heart disease at a young age or if a primary relative (parent or sibling) had a heart attack, stroke or vascular disease, such as peripheral artery disease, before age 55 in men or before age 65 in women, doctors would start thinking about digging deeper to determine if there was a genetic factor at play.

5. Cholesterol medication can be tailored to the individual

Before prescribing a cholesterol-lowering medication, doctors look carefully at a patient’s cholesterol measurements, as well family history of cardiovascular disease, blood pressure, age, gender, whether you smoke, and if you have had any prior heart disease. “When we put all of this information together, we can get a fairly accurate sense of a person’s risk of developing heart disease,” says Benson. “And if that risk is high enough, then we would consider starting statin medications to control cholesterol.

Know Your Numbers