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High Cholesterol

Cholesterol is a waxy, fat-like compound found in every cell in the body. There are two primary types of cholesterol:

  • Low-density lipoprotein (LDL):  Commonly known as “bad cholesterol” because it can build up in blood vessels and block arteries
  • High-density lipoprotein (HDL):  Often called “good cholesterol” because it has the opposite effect; the higher your HDL cholesterol, the lower your risk of developing blocked arteries

Unhealthy cholesterol levels—too-high LDL and/or too-low HDL—can result from a poor diet, a sedentary lifestyle, cigarette smoking and certain medications.

People with high (LDL) cholesterol levels often experience no symptoms, which is part of the problem. Because excess LDL typically harms the body “silently,” the first symptom of this condition may be a heart attack, stroke or painful blocked leg artery.

The cardiologists at WakeMed can you help monitor your cholesterol regularly and help you lower it if it is elevated.

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How Cholesterol Is Measured and What’s Normal

Cholesterol is measured with a lipid panel. This blood test—conducted after a 12- to 14-hour fast—measures both types of cholesterol as well as triglycerides, a type of fat found in your blood that can increase your risk of heart disease.

  • Desirable total cholesterol levels, which are a combination of LDL and HDL levels, are less than 200 mg/dL.
  • Total cholesterol levels between 200 and 239 mg/dL are considered borderline high.
  • Anything 240 mg/dL or above is considered high cholesterol.
  • An ideal LDL level is less than 130 mg/dL.
  • The HDL level should be greater than 50 mg/dL for women and greater than 40 mg/dL in men.
  • Triglyceride levels should be below 150 mg/dL.

Everyone over the age of 20 should have their cholesterol checked at least every five years. Men older than 45 and women older than 50 may need to have their cholesterol checked every year or two, especially if they have a family history or other risk factors.

Assessing High Cholesterol’s Impact on Cardiovascular Health

For patients with high cholesterol levels, cardiac imaging studies can then be used to determine if the unhealthy cholesterol levels are negatively affecting the cardiovascular system. These imaging studies may include:

  • Echocardiogram ("echo") tests: Echocardiography is a type of cardiac imaging that uses sound waves to create moving pictures of the heart and its blood vessels at rest and during exercise. Echocardiogram images help cardiologists diagnose, evaluate and monitor many heart conditions. Types of echo tests include:
    • Transthoracic 2-D echocardiography (TTE): This common, non-invasive echo study is performed externally, outside of the chest. TTE can be performed using bubbles (to identify problems with cardiac blood flow) or DEFINITY® contrast (to further clarify imaging).
    • Transesophageal echocardiography (TEE): This minimally invasive study can help cardiologists get a closer look at cardiovascular structures if more information is needed after a TTE study.
  • Cardiac CT and MRI: Cardiac computed tomography (CT) and magnetic resonance imaging (MRI) are two advanced, non-invasive ways to look inside the heart and thoroughly assess the cardiovascular structures.

Treating High Cholesterol

The first treatment for high cholesterol is to make lifestyle changes. That means increasing exercise to be physically active most days of the week for 30 to 60 minutes.

People with high cholesterol also should watch what they eat. An ideal low-cholesterol diet is low in fatty foods like certain meats, dairy products, egg yolks and shellfish, and higher in fresh fruits and vegetables, lean meats, nuts and whole grains.

Those with unhealthy cholesterol levels also should do their best to quit smoking, as cigarettes raise LDL and triglyceride levels.

Making these lifestyle modifications lowers elevated LDL to normal values in many people. Cholesterol-lowering medications may be necessary for patients with multiple risk factors or a history of cardiovascular disease.

Make an Appointment

If you or someone you know would like more information on lowering cholesterol levels, we encourage you to make an appointment with one of WakeMed’s experienced cardiologists.