Cholesterol is just one part of the problem - Cape Cod Healthcare

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Published on June 25, 2018

Cholesterol is just one part of the problem

What’s your number?

Chances are you know if your cholesterol is high (over 240 mg/dL) or in the safe range, but Megan Titas, MD, a cardiologist with The Cardiovascular Specialists in Falmouth, cautions that cholesterol is more than just a number.

“Yes, high cholesterol is one of the risk factors for coronary disease, vascular disease and cerebrovascular disease. High cholesterol puts you at higher risk for heart attack and stroke,” she said. “But cholesterol has to be considered along with other risk factors such as diabetes, hypertension, overweight, smoking and a sedentary lifestyle.”

It’s not just about a number.

“Rarely do I see a patient who has just one risk factor. If your cholesterol is fine, but you have other risk factors or known conditions such as heart or vascular problems, we need to be more aggressive about treatment.”

According to a survey by the American Heart Association, most people who have high cholesterol understand they need to manage their conditions, but they are confused, discouraged and uncertain about their ability to do so.

Cholesterol is a waxy, fat-like substance that travels through the blood. The American College of Cardiologists says that in and of itself, cholesterol isn’t bad; it helps create the outer coating of our cells and aids the body in making Vitamin D and certain hormones. Over time, this plaque can harden and narrow the arteries, and they recommend these basic lifestyle changes to control and reduce high cholesterol:

  • Eat heart-healthy foods, including those high in fiber and omega-3 fatty acids and low in trans fats
  • Exercise and stay physically active
  • Maintain a healthy weight
  • Don’t smoke
  • If you drink alcohol, use moderation

“If you are eating a healthy diet, exercising, not smoking and not drinking in excess—the lifestyle changes you need to make—and your cholesterol is still high, you can take medicine,” said Dr. Titas.

Statins are excellent medications that lower cholesterol and are very widely tolerated, she said.

“I refer my patients to an excellent article, “Are You Taking the Right Treatment for Your High Cholesterol?” in Consumer Reports to learn more about statins,” she said.

“We have some tricks up our sleeves to help with any side effects some people may feel with statins. For instance, patients can try different statins, reduce the dose, take Coenzyme Q10 and remember to stay hydrated. If statins are not an option for an individual, we can prescribe other cholesterol-lowering medicine.”

There’s A Tool For That

To understand how cholesterol ties in with other risk factors and how to reduce your chances of heart disease or stroke, Dr. Titas encourages patients to use what doctors use: the American College of Cardiologists’ ASCVD Risk Estimator Plus.

You will need to know your latest blood pressure and cholesterol numbers to use the app. Only people from 40 to 59 can obtain statistically valid information from the app. Enter the information—names are not required—and click “calculate.” The app instantly posts your 10-year risk of heart disease or stroke and suggests the likelihood that you need to take aspirin, statins, or other medication.

Use the information to talk with your doctor.

The app gives people a way to visualize their overall health by bringing together several test results and lifestyle factors in one place. You can change items to see, for example, how lowering your blood pressure by 10 points can impact your health.

The website is also packed with good information about how to lower your cholesterol and improve other risk factors.

“Patients need as much information as they can get. I believe the more people know, the more successful they will be in managing their own healthcare,” she said.

The good news is that the number of Americans who have high cholesterol has declined from 18.3 percent in 1999 to 12.4 percent in 2016, according to the Centers for Disease Control. While the trend is encouraging, about 95 million U.S. adults have cholesterol levels greater than 200 mg/dL and nearly 29 million have high cholesterol.

“It’s not just about numbers, it is about treating each patient as an individual. There is no such thing as one-size-fits-all medicine. It’s all about working with your healthcare provider to find the right therapy for you to stay healthy and enjoy life,” said Dr. Titas.