Based on everything we’ve heard about cholesterol over the last few decades, it would be easy to assume that it’s pure evil. But the reality is much different, and much more nuanced than the headlines would suggest.
In spite of its bad name, cholesterol plays a key role in many functions in our bodies. Without it we could not live. Cholesterol aids in digestion and the manufacture of hormones. It’s also a structural building block in all of our cells.
But when cholesterol get out of control, that can indicate problems that need to be managed. Here are a few things to know about cholesterol and heart disease.
First, there is no longer a target level for cholesterol.
Last year, the American Heart Association and the American College of Cardiology published new guidelines for the prevention heart disease. Now the US Preventive Services Task Force has made public their own new set of guidelines (still in draft form) for preventing heart disease.
In the past, if you had an elevated cholesterol level, you would be started on a statin drug. Your blood would be tested and dose adjusted regularly until the right level was achieved. Now the use of statins isn’t based on cholesterol level at all, but on your overall risk for heart disease. This includes not only your cholesterol levels, but your family history, smoking history, the presence of diabetes and more.
Second, the use of statin medications to lower cholesterol doesn’t necessarily lower the risk of heart attack in every person who takes them.
In fact the lower your cardiovascular risk, the less benefit statins will confer. So even if you have elevated cholesterol but are at otherwise very low risk for heart disease, a statin may not do much to prevent heart disease. But if you are at high risk, even with a not-so-high cholesterol level, statins could offer a substantial benefit.
These new guidelines represent a significant shift in our approach to the treatment of cholesterol and the prevention of heart disease. And with all such change, there is controversy. If you take a statin for high cholesterol or to prevent heart disease, it is important that you don’t discontinue your medication or change your dosage without consulting with your physician. The most significant part of these new recommendations is understanding the individual risk profile for each patient. Check with your doctor to find the right course of action for you and your circumstances.
Third, “low-fat” isn’t the same as “heart healthy.”
A heart-healthy diet includes lots of whole foods with a foundation of fruits and vegetables, and including whole grains and healthy fats that come from nuts, fish, and limited amounts of unprocessed meats.
Most foods marketed as “low-fat” foods have been highly processed and include unhealthy additions (like lots of processed sugars) to make up for the fat that was removed. When you shop, stick to the perimeter of the grocery store where the fruits, vegetables, meat and dairy are located. Avoid the aisles as much as possible. And if a food has a nutrition label, read it. It’s probably there for a reason.
If you live in the Greenville, TX area and you’re wondering about your cholesterol levels, your risk for heart disease, or have other questions about your health, please contact us at Hunt Regional Medical Partners. We’ll help you get started on your own path to good health.
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