High Cholesterol: Assessing Your Risk
High cholesterol is one of the big risk factors for heart disease and heart attack. It's also a risk factor for stroke and peripheral artery disease. Assessing your risk is a first step in preventing these diseases. Have you been told that your cholesterol is too high? If so, you should discuss this with your healthcare provider. This is especially true if you have other risk factors for heart disease.
Get smart about cholesterol and your heart disease risk. One of the first things to know is that having high cholesterol can start early in life and continue throughout your lifetime. It can increase your risk of developing these conditions over time. Talk with your healthcare provider about how to get started controlling your cholesterol and other factors that increase your risk.
Why is high cholesterol a problem?
Blood cholesterol is a fatty substance in your bloodstream. The body needs cholesterol to make cell membranes and for hormone production. It travels through the bloodstream and is used by the tissues for normal function. But, when blood cholesterol is too high, it contributes to plaque formation in the blood vessels and causes inflammation. The plaque builds up in the walls of arteries that carry blood from the heart to the body. Over time, the heart may not get enough oxygen, which can lead to a heart attack. It can lead to stroke if the plaque builds up in the arteries of the brain.
3 steps to assessing your risk
Step 1. Find your risk factors for heart disease and stroke
How your cholesterol numbers affect your heart health depends on your other risk factors for heart attack and stroke. Check off each risk factor below that applies to you:
Age. Are you a man 45 years old or older or a woman 55 years old or older?
Blood pressure. Do you have high blood pressure? Do you take medicine to treat high blood pressure?
Cholesterol levels. Have you been told you have high cholesterol? Do you take medicine to control your cholesterol? Have your LDL ("bad") cholesterol and triglyceride levels stayed high over time even with a healthy diet and exercise?
Smoking. Do you smoke or use tobacco products such as electronic cigarettes or other products with nicotine? These products increase inflammation in the arteries. Inflamed arteries tend to attract cholesterol deposits and are vulnerable to scarring and damage. Quitting smoking and other tobacco products can reduce this inflammation and reduce the risk for heart disease and stroke.
Diabetes. Do you have diabetes? Is your blood sugar level well-controlled? If you have diabetes, you may be able to lower your risk of heart disease or a stroke by keeping your LDL cholesterol level lower than what is advised for people who don't have diabetes.
Exercise. Do you exercise very little or not very often? Your provider may recommend that you get moderate to vigorous physical activity for at least 40 minutes each day. You should do this for at least 3 to 4 days each week. If you're not doing moderate to vigorous physical activity as often as this, it may not be enough. You may be at higher risk for heart disease.
Diet. Do you eat a diet that is high in saturated or trans fats, cholesterol, sugar, or alcohol? Do you not eat enough fruits, vegetables, lean meats, or eat sugars or drink alcohol sparingly? If so, you may be at increased risk for heart disease.
All of the things listed above can increase risk for blockages in the arteries of your heart, brain, and legs. This can lead to heart disease, heart attack, stroke, and peripheral artery disease.
To help find your overall risk, your provider may use one of several risk calculators. These take into account your cholesterol level and other risk factors. Ask your healthcare provider about your 10-year risk for heart disease.
Depending on these results, your provider may talk with you about other conditions that can influence your risk and affect your treatment decisions, such as a family history of heart problems before the age of 55 in male relatives or age 65 in female relatives.
Your provider will want to help you understand your risk and options for treatment.
Step 2. Test your cholesterol
High cholesterol has no symptoms. Getting your blood tested is the only way to know if your cholesterol level is high. Ask your provider how often to have your cholesterol checked Cholesterol testing most often needs no preparation. Your healthcare provider will tell you if you need to fast before the test. This means you don’t eat for a certain amount of time before the test is done. A blood sample is taken and sent to a lab. There, the amount of cholesterol and triglyceride in your blood is measured. There are 2 types of cholesterol in the sample. The first is HDL (“good cholesterol”). The second is LDL (“bad cholesterol”). Cholesterol test results are most often shown as the total cholesterol, the HDL and LDL cholesterol, and the triglyceride levels. .
The optimal level of LDL has changed over time and depends on your risk factors. Talk with your provider about what level is best for you. It's important to know your cholesterol numbers. But depending on all of your risk factors, your healthcare provider will talk with you about your results and what is important for overall health.
Fill in your numbers below.
HDL cholesterol: LDL cholesterol: Total cholesterol: Triglyceride:
Step 3: Discuss the results with your healthcare provider
If your cholesterol level is higher than normal, your healthcare provider will advise how you can lower your level. Steps may include lifestyle changes such as diet, physical activity, and quitting smoking. Your provider may also prescribe medicine to lower bad cholesterol.
Making a plan that will work for you is an important discussion to have with your healthcare provider. You and your provider can estimate your risk of developing heart disease or stroke. This information can guide your decision to start medicine and lower your risk. This discussion should be ongoing. This is because your risk factors including cholesterol levels can change over time.
If you have high cholesterol, you may need your cholesterol level tested more often. This is to make sure your medicine and lifestyle changes are working to reduce your risks of having a heart attack or stroke.