Greetings, Southwest Heath District!

Since the Hooked on Health kickoff, a few of you have had questions about your cholesterol profile. Most questions center around what the different components of the profile mean and what the correlation is between the concentration of these components and heart disease and stroke.

This month, which just happens to be Heart Health Month, I’d like to provide an overview of the cholesterol profile to help you determine your risk of heart disease. Keep in mind this overview should not supersede counsel from your healthcare provider. After factoring in your medical history and physical condition, your healthcare provider is best able to determine your risk and course of action. In fact, I strongly encourage those of you who have not already done so to share your screening test results with your health care provider.

As you know, cholesterol is a lipid (fat) that is found normally in the body. When cholesterol levels are high, fatty deposits build up in the arteries, including those of the heart and brain. The greater the build-up of deposits on the walls of the artery, the narrower the passage becomes. That in turn restricts the flow of oxygenated blood to tissues and organs. Without sufficient oxygenated blood, tissues, organs and, ultimately, the individual will die.

Fats do not dissolve readily in water. Cholesterol molecules are able to dissolve in the blood stream because they are coated with a protein layer. The various combinations of lipids (fat) and proteins or lipoproteins are the components of the cholesterol profile. They differ by density, net surface charge and size. 

Research has shown a correlation between concentration of blood lipoproteins and risk of heart disease and stroke. Although there are five classes of lipoproteins in the blood, the typical cholesterol profile measures the concentration (or level) of total cholesterol; triglycerides; low-density lipoproteins (LDLs); and high-density lipoproteins (HDLs).  Ideal levels for persons with or without heart disease are:

1. Total Cholesterol: less than 200 mg/dl
2. LDL cholesterol (bad cholesterol): less than 100 mg/dl
3. HDL cholesterol (good cholesterol): 40 mg/dl or higher
4. Triglycerides: less than 150 mg/dl

The National Cholesterol Education Program recommends that adults (20 years of age and older) have a cholesterol profile at least every five years. If you or your loved ones have not had your cholesterol levels screened in five years, please do so. High cholesterol, like hypertension, is a silent killer. Because there are no symptoms, many people with elevated cholesterols are unaware of their increased risk of heart disease and stroke.

If you were recently screened and your levels are abnormal, you are not alone. In 2005, 32% of adults in Georgia were told by a healthcare provider that their cholesterol was elevated. The good news is that there are things that you can do to improve cholesterol levels and reduce your risk of heart disease and stroke. You can choose lean meats and poultry without skin; select low-fat dairy products; reduce or eliminate foods containing partially hydrogenated oils (trans-fats); eat less than 300 mg. of cholesterol a day; quit smoking; exercise more; and lose weight if you are overweight.

Studies have shown that among people with heart disease, lowering cholesterol can reduce the risk of dying from heart disease, having a non-fatal heart attack, and needing heart bypass surgery or angioplasty. Studies have also shown that among people without heart disease, reducing cholesterol levels can diminish the risk of developing heart disease. This is true for those with high cholesterol and those with average levels. For example, every 1% decrease in blood cholesterol lowers the risk of heart disease by 2%. A combination of diet and exercise is best, because decreasing dietary cholesterol alone actually decreases HDL (good cholesterol) as well as triglycerides and LDL (bad cholesterol). Exercise raises HDL levels.
 
Unlike family history, age, gender, and race, an elevated cholesterol level (with the exception of HDL) is a modifiable risk factor for heart disease. Eating better, exercising, and taking cholesterol-lowering medication can control it. It is that simple. Just do it.

Jacqueline H. Grant, MD, MPH, MPA

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