Cholesterol Archive

Here's what the numbers mean — and strategies to lower your cholesterol if it's too high.

For some women who've had normal cholesterol readings all their lives, that changes at menopause. "Going through menopause often results in lipid and cholesterol changes for the worse," says Dr. Samia Mora, an associate professor of medicine at Harvard Medical School and a specialist in cardiovascular medicine the Brigham and Women's Hospital. Drops in the female hormone, estrogen, are associated with a rise in total cholesterol levels due to higher amounts of low-density lipoprotein (LDL), the "bad" cholesterol, and another blood lipid (fat) known as triglyceride. Over time this can raise heart risks, which is a reason for concern, as cardiovascular disease is the No. 1 cause of death in postmenopausal women, says Dr. Mora.

"So, it's especially important to track the numbers in perimenopause and the early years after menopause, as LDL cholesterol and total cholesterol tend to increase," she says.

These are the most effective ways to protect yourself.

Here are some alarming statistics about heart attacks:

• Every 40 seconds, someone in the United States has a heart attack.
• Every year, about 805,000 Americans have heart attacks, 75% of which are first-time attacks.
• The average age of a first heart attack among men: 65.

However, the most troubling fact about heart attacks is that many people don't take steps to protect themselves, says Dr. Deepak L. Bhatt, executive director of interventional cardiovascular programs at Harvard-affiliated Brigham and Women's Hospital Heart & Vascular Center. "Reducing your risk of cardiovascular disease is the best way to guard against heart attacks," he says. "There are simple ways to do this, but unfortunately, many people still don't follow them as they should."

Here's a look at five ways you can protect yourself from cardiovascular disease, and thus possible heart attacks, and avoid being another statistic.

You can begin to reduce your "bad" LDL cholesterol naturally by making a few simple changes in your diet.

If your cholesterol is creeping upward, your doctor has probably told you that diet and exercise—the traditional cornerstones of heart health—could help to bring it down. And if you'd prefer to make just one change at a time to lower your cholesterol naturally, you might want to begin with your diet. A major analysis of several controlled trials involving hundreds of men and women found that dietary changes reduced LDL and total cholesterol while exercise alone had no effect on either. (However, adding aerobic exercise did enhance the lipid-lowering effects of a heart-healthy diet.)

Trans fats and saturated fats can raise LDL cholesterol levels. A diet rich in unsaturated fats, whole grains, and fruits and vegetables can lower them.

Among all the grains, oats appear to be the most effective when it comes to lowering cholesterol. In fact, back in 1997, oatmeal was granted the first food-specific health claim permission by the FDA, based on research showing that soluble fiber from oats lowers the risk of heart disease.

Soluble fiber, which dissolves in water, forms a gel in the intestines. This gel traps some of the cholesterol in your body, so it's eliminated as waste instead of entering your arteries. Some evidence also suggests that eating oats helps regulate blood sugar levels and helps you feel full.

The right kind of inflammation is essential to your body's healing system. But chronic inflammation can be a problem.

The saying "too much of a good thing" applies to much of life, but especially to inflammation.

"People think inflammation needs to be stomped out at all times, but it plays an essential role in healing and injury repair to keep your body safe and healthy," says Dr. Robert H. Shmerling, medical editor of Understanding Inflammation from Harvard Health Publishing and an associate professor of medicine at Harvard Medical School. "Some inflammation is good. Too much is often bad. The goal is to recognize when inflammation is simply doing its job, and when it can potentially cause problems."

Timing may improve potency and help you cope with side effects.

We all want our medicines to be as effective as possible, and that requires effort on our part. It may be necessary to avoid taking pills with certain foods or drinks, and to check that medications won't interfere with each other.

And in some cases, it may be important to take a drug at a particular time of day. This approach, known as chronotherapy, is gaining attention as research suggests a relationship between when we take medications and how well they work.

People monitor their cholesterol levels, but they should also watch their triglycerides.

Most people have heard of the two main kinds of cholesterol: the "good" HDL and the "bad" LDL. Doctors focus on controlling LDL, as high levels can lead to a buildup of fatty deposits in the arteries and block blood flow, which can trigger a heart attack or stroke.

A blood test called a lipid profile measures your HDL, LDL, and total cholesterol levels. But within that test is another number you should not ignore: your triglyceride levels.

In the journals

High levels of low-density lipoprotein (LDL), or "bad" cholesterol, have long been associated with a greater risk of heart disease. Yet, research has shown that about 75% of heart attack sufferers do not have dangerously high LDL levels.

A study published Nov. 18, 2019, in the International Journal of Nanomedicine looked closer at this issue. Researchers found that high amounts of a subclass of LDL may be a stronger predictor of potential heart problems than overall LDL levels.

When it comes to understanding this link, the devil is in the details.

When we talk about LDL cholesterol, it's always described as bad or harmful — and with good reason. High blood levels of this artery-clogging substance boost the risk of heart disease, the nation's leading cause of death. The more you can lower your LDL cholesterol (through diet, exercise, or medications), the lower your risk of a heart attack. For heart attack survivors, national guidelines recommend aiming for an LDL cholesterol level of less than 70 milligrams per deciliter to prevent a second heart attack.

In the past year, however, two studies in the journal Neurology reported a higher risk of hemorrhagic (bleeding) stroke in people with LDL levels of 70 and lower. While that sounds worrisome, a closer look at the findings can put these results into perspective.