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Many people believe cholesterol is only bad for you, when actually cholesterol can be good for you. Like most things, cholesterol in excess or deficit can lead to poor health and major health risks but when managed correctly, cholesterol helps your body stay healthy! In general, cholesterol is a form of fat that is found in human and animal products. Your body produces cholesterol to help maintain a healthy cardiovascular system, cellular function and brain function. Therefore, cholesterol is not all bad but when found in extremes it can lead to serious health complications. There are many different forms of cholesterol but for our purposes, we will focus on just a few of them. Namely, your total cholesterol, LDL, HDL and triglycerides. 

High Cholesterol and Low Cholesterol

The main risk for high cholesterol is a heart attack or stroke. When your cholesterol is too high, it starts to build up in your arteries, decreasing the amount of space your blood has to flow through. This decrease in proper blood flow can cause cholesterol to build up and break off, creating a blood clot. The blood clot can then cause a heart attack or stroke when it moves throughout your bloodstream. Therefore, high levels of cholesterol increases your risk for a heart attack and stroke. 

High Cholesterol Build Up
How Cholesterol Builds Up Within Arteries

On the other hand, there is a point where low cholesterol can adversely affect your health but is an uncommon problem, especially in the more developed parts of the world. Cholesterol low enough to be a health concern is more commonly seen with severe malnutrition and is associated with prolonged starvation. For our purposes, low cholesterol based on a lab value will not generally adversely affect your health.

HDL, LDL and Triglycerides

HDL (high density lipoprotein) is commonly referred to as a person’s ‘good cholesterol’. If present in sufficiently high amounts, it can be a protective form of cholesterol that actually lowers your risk of heart attack and stroke. To qualify as a protective agent, generally your HDL must be consistently above 60. There is not an upper limit to how high your HDL should be; in general the higher you can get your HDL, the better. The best way to raise your good cholesterol is to exercise regularly and eat a diet rich in fish and meats that are low in fat such as turkey, pork and lean chicken.  

Triglyceride Test

Triglycerides are a form of cholesterol that are lined to a person’s glucose metabolism. In general, your triglyceride levels should be below 150. Elevation of triglycerides are commonly seen in diabetics with poorly controlled glucose. When your blood sugar is excessively elevated, it causes triglycerides to form which results in your triglyceride levels to increase, usually above 300-400. Controlling your blood sugar will have a dramatic effect on your triglyceride levels and many times your triglyceride levels will become normal once the blood sugars are controlled. In some cases, triglycerides levels reach well into the thousands, anywhere from 1000-4000. This is not associated with diabetes but is a genetic problem that results from abnormal gene function. In either case, medications are frequently effective in bringing the triglycerides values to a level that does not adversely affect your long-term health.

Your total cholesterol is just that, the sum of all the different forms of cholesterol such as your LDL cholesterol, HDL cholesterol and triglycerides. In general, it is desirable for your LDL to be less than 100, your HDL to be greater than 50 and your total cholesterol to be less of 200. These targets can be a bit different based on a person’s medical conditions. For example, a person with prior stroke or coronary artery disease may aim to have an LDL below 70. Talking to your doctor about what your triglyceride levels should be and how to attain them is the best way to know how to meet your targets based on your medical history. 

What Causes High Cholesterol?

Elevated cholesterol is partially related to your diet and partially genetics. Given that we cannot alter our genes, the best way to lower your cholesterol is to avoid foods that are high in fats such as red meat and fast foods. Red meats generally will promote the elevation of a person’s bad cholesterol (LDL) and do not significantly raise the good cholesterol (HDL).

High Cholesterol can be genetic

Family history can be important. If a member of your immediate family such as your mother, father, brother or sister has elevated cholesterol, you may also suffer from a similar genetic predisposition. Obviously, your genes again cannot be changed but knowing your cholesterol numbers is an important yet simple way to identify if your cholesterol is or becomes abnormal. It can also help guide your food choices over time which can improve your health and cholesterol levels. Getting your cholesterol checked and ‘knowing your numbers’ is an important first step in the management of your cholesterol.

Chronic conditions such as diabetes, kidney disease and pancreatic problems will affect your cholesterol numbers. If you have any of these chronic conditions, a yearly cholesterol screen is usually a good idea. Your family physician is a great resource to help you identify and treat any of these issues early so you can avoid adverse long-term complications.

How to Lower Your Cholesterol 

How to lower cholesterol

The best way to lower or control your cholesterol is to exercise regularly and eat a low cholesterol diet that is low in saturated fats (red meats and fast food), while choosing foods that are high in good cholesterol such as fruits and vegetables. Keeping an eye on your carbohydrate intake and avoiding excessively eating foods like bread, sweets, potatoes and pasta will go a long way to improve your cholesterol levels. For additional information on a heart healthy diet, click here to read a prior KHC University post on heart healthy eating. You can also click here to explore a list of foods that can help improve your cholesterol numbers.

There are medications that are highly effective in reducing not only your cholesterol numbers, but also reduce your lifetime risk of a heart attack or stroke. Depending on the medicine you use, some may only lower your cholesterol levels but will not reduce your risk. This is why it is best to talk to your family physician to understand the specifics of which medications are best for you. 

Symptoms of High Cholesterol

Unless your cholesterol is significantly elevated, there are little to no symptoms. In the extreme cases of elevated cholesterol or triglycerides, you may notice yellow deposits under the skin known as xanthelasma. In these rare cases, the cholesterol levels are so elevated that they deposit in the skin. In addition, this condition is commonly seen only with the extreme forms of high cholesterol and is generally rare. Usually, you will not experience symptoms with high cholesterol so getting a cholesterol test is the only way to know if you have high cholesterol. 

Screening for High Cholesterol

high cholesterol screening

“Knowing your numbers “ is based upon your prior history or family history. If you have a family member with a prior history of high cholesterol, you should be checked so you too can ‘know your numbers’. Early screening is usually only indicated for the most severe forms of a genetically identified abnormality within a family. Outside of this, a cholesterol screen at your primary care physician should be done by age 30. The best person to discuss your cholesterol levels with is your doctor so if you think you may be at risk, consider making an appointment with your primary care doctor. We hope this post has been helpful and educational as you think about your cholesterol levels. In the meantime, remember, know your numbers and we look forward to seeing you next month at KHC University!

Thanks for letting us Kare for your heart!

Transesophageal Echocardiogram (TEE)

A transesophageal echocardiogram (TEE) is an invasive heart procedure where an ultrasound probe is inserted into your esophagus (food pipe). A transesophageal echocardiogram allows your cardiologist to acquire detailed pictures pertaining to the structure, function and any valvular heart disease that many be present. This procedure demonstrates your cardiac function in much greater detail than a standard transthoracic echocardiogram.

Prior to your procedure, you should not have any food or drink for 8-12 hours. In most cases, you will be able to take your home medications as scheduled. Your cardiologist / healthcare provider will advise you if there are any requirements to alter your medication schedule. Prior to your transesophageal echocardiogram, the technologist will insert an IV in your arm as a safety precaution to begin the test. This will allow sedation to be given to make you more comfortable during your procedure. During your procedure, you will be required to lie flat for approximately 30 minutes while the test is being completed. After your transesophageal echocardiogram, you will need to refrain from driving for approximately 12 hours and will need someone to accompany you home after the procedure. You can return to your normal activities the morning after your procedure.