What Does It Really Mean to Have High Cholesterol?

If you’ve ever had a cholesterol test, you’ve probably seen your doctor look concerned when your “bad” LDL cholesterol was too high. Most of us think high cholesterol = heart attack. But what does having high cholesterol really mean for your health? I’ve dealt with this issue personally, so I wanted to share some things I’ve learned after my own high cholesterol diagnosis.

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What is Cholesterol Anyway?

Cholesterol is a waxy substance found naturally in your body that your liver makes to perform important jobs like building cells and producing hormones. We need some cholesterol to function normally. There are a few different types:

  • LDL cholesterol is the “bad” kind that can build up in your arteries and cause heart disease.
  • HDL cholesterol is the “good” kind that carries the LDL away from your blood vessels to your liver where it can be eliminated.
  • Triglycerides are another fat that can raise heart risks when elevated.

For most adults, the ideal cholesterol numbers are:

  • Total cholesterol under 200
  • LDL under 100
  • HDL over 60
  • Triglycerides under 150

If your cholesterol is higher than these levels, your doctor may say you have high cholesterol or hyperlipidemia. That was my diagnosis a few years ago at my annual checkup when my total and LDL cholesterol were borderline high.

What Causes High Cholesterol?

High cholesterol can be caused by a mix of factors:

  • Diet - Eating a lot of saturated fat, trans fat, and cholesterol raises your levels.
  • Weight - Being overweight or obese can increase LDL and triglycerides.
  • Lack of exercise - Inactivity causes cholesterol to build up.
  • Genetics - Some people inherit genes for higher cholesterol.
  • Health conditions - Things like diabetes, kidney disease, and hypothyroidism can impact cholesterol.
  • Medications - Some prescription drugs, like birth control pills, can raise cholesterol as a side effect.
  • Age/sex - Levels typically rise as we get older. Men under 55 and women under 65 tend to have lower amounts.

So in my case, my high-ish cholesterol is likely due to a combination of indulging in biscuits & gravy too often, not getting enough cardio exercise, and my genes.

How Dangerous Is High Cholesterol Really?

Because high LDL cholesterol can lead to plaque buildup in your arteries over time and raise heart attack risks, it seems very alarming. However, newer research is finding that having high cholesterol alone doesn’t necessarily doom you to heart disease.

It turns out cholesterol levels alone aren’t the best predictor of cardiovascular problems on their own. Some people can have total cholesterol over 250 and still maintain healthy arteries and live long lives. Other bigger risk factors like smoking, diabetes, and high blood pressure can also impact your overall heart health.

That being said, I still take my high cholesterol seriously. But I no longer think having a high total cholesterol number alone means I’m definitely going to have a heart attack soon. As part of my overall health, it’s something I want to improve through lifestyle changes and monitor with my doctor. But it doesn’t mean automatic catastrophe either.

What You Can Do About High Cholesterol

The good news is high cholesterol can often be lowered through natural means like:

  • Losing extra weight if you need to. I’ve started doing strength training to build muscle and help burn more fat.
  • Doing regular cardiovascular exercise. I try to jog or bike 3-4 days a week.
  • Cutting back on saturated and trans fats. I’ve stopped buying cookies and chips and eat avocado instead of cheese.
  • Eating more plants, fiber, and cholesterol-lowering foods like beans, oatmeal, and salmon. I make a big pot of vegetable soup with barley once a week for healthy lunches.
  • Take supplements known to reduce cholesterol like fish oil, garlic, and psyllium husk.
  • Reduce stress through yoga, meditation, or whatever works for you. Stress contributes to high cholesterol.
  • Quit smoking and limit alcohol if needed. Both can raise cholesterol.

Within 3-6 months of making these changes, I was able to get my total and LDL cholesterol down to normal ranges! Through lifestyle alone, you can often improve your cholesterol significantly.

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When Medication May Be Needed

If cholesterol remains high after making diet and exercise changes, your doctor may prescribe a statin medication like atorvastatin or rosuvastatin. Statins can lower LDL cholesterol by 50% or more by reducing how much your liver makes.

Some new cholesterol medications called PCSK9 inhibitors are even more effective but very expensive, so they aren’t usually the first choice.

I was nervous about taking statins after hearing about potential side effects like muscle pain. But my doctor started me on a low dose of atorvastatin, and I haven’t had any issues. Statins can be life-saving for those at high risk of heart disease. But lifestyle changes should be tried first when possible.

Know Your Risk Factors

Not everyone with high cholesterol needs medication. Your doctor will assess your overall heart disease risk based on factors like:

  • Your cholesterol ratios - Higher total LDL and lower HDL increase risk.
  • Other health conditions - Diabetes, high blood pressure, kidney disorders, etc.
  • Family history - If close relatives had early heart disease.
  • Lifestyle habits - Like smoking, poor diet, inactivity.
  • Age and sex - Older men have higher risk.
  • Ethnicity - African Americans have greater prevalence of high cholesterol.
  • Other blood markers like CRP and calcium scores that measure inflammation and plaque levels.

My doctor did a thorough evaluation and determined my 10-year risk of heart attack was low enough to hold off on cholesterol medication for now. I'll continue rechecking my cholesterol every 6 months and may need a statin later as I age or if my numbers worsen.

The Takeaway

Getting diagnosed with high cholesterol was scary. But learning more about what it really means for my health helped me take a more balanced view. While I'm being proactive with lifestyle changes, I no longer feel like my high cholesterol equals a heart attack destiny.

If you've been told your cholesterol is elevated, have an open discussion with your doctor about your specific risk factors. Create a personal action plan to start improving your levels through diet, activity, and possibly medication. Knowledge and prevention are powerful tools to take control of your cholesterol and your heart health!

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