Everyone age 20 and older should have his or her cholesterol measured at least once every five years. A blood test called a lipoprotein panel can help show whether you’re at risk for coronary heart disease by looking at substances in your blood that carry cholesterol. This blood test is done after a 9-to-12-hour fast (no eating) and gives information about your:
Total cholesterol–a measure of the total amount of cholesterol in your blood, including low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol.
LDL (bad) cholesterol–the main source of cholesterol buildup and blockage in the arteries
HDL (good) cholesterol–HDL helps remove cholesterol from your arteries
Triglycerides–another form of fat in your blood that can raise your risk for heart disease
Major Risk Factors That Affect Your LDL Goal
High blood pressure (140/90 mmHg or higher or on blood pressure medication)
Low HDL cholesterol (less than 40 mg/dL)
Family history of early heart disease (heart disease in father or brother before age 55; heart disease in mother or sister before age 65)
Age (men 45 years or older; women 55 years or older)
Diet. Saturated fat and cholesterol in the food you eat make your blood cholesterol level rise. Saturated fat is the main problem, but cholesterol in foods also matters. Reducing the amount of saturated fat and cholesterol in your diet helps lower your blood cholesterol level.
Weight. Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol. Losing weight can help lower your LDL and total cholesterol levels, as well as raise your HDL and lower your triglyceride levels.
Physical Activity. Not being physically active is a risk factor for heart disease. Regular physical activity can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also helps you lose weight. You should aim to be physically active for 30 minutes on most, if not all, days.
Things outside of your control that also can affect cholesterol levels include:
Age and Gender. As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women’s LDL levels tend to rise.
Heredity. Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.
Lowering Cholesterol Using Therapeutic Lifestyle Changes (TLC)
TLC is a set of lifestyle changes you can make to help lower your LDL cholesterol. The main parts of TLC are:
The TLC Diet. The TLC Diet. This is a low-saturated-fat, low-cholesterol eating plan that calls for less than 7 percent of calories from saturated fat and less than 200mg of dietary cholesterol per day. The TLC diet encourages you to choose a variety of nutritious and tasty foods. Choose fruits, vegetables, whole grains, low-fat or nonfat dairy products, fish, poultry without the skin, and, in moderate amounts, lean meats. The TLC diet recommends only enough calories to maintain a desirable weight and avoid weight gain. If LDL is not lowered enough by reducing saturated fat and cholesterol intake, the amount of soluble fiber in your diet can be increased. Certain food products that contain naturally occurring substances found in some plants (for example, cholesterol-lowering margarines) can also be added to the TLC diet to boost its LDL-lowering power. More information on the TLC diet is available in the Your Guide to Lowering Your Cholesterol with TLC (www.nhlbi.nih.gov/health/public/heart/chol/chol_tlc.pdf).
Weight Management. Losing weight if you are overweight can help lower LDL and is especially important for those with a cluster of risk factors that includes high triglyceride and/or low HDL levels and being overweight with a large waist measurement (more than 40 inches for men and more than 35 inches for women).
Physical Activity. Regular physical activity (30 minutes on most, if not all, days) is recommended for everyone.
Drug Treatment. Even if you begin drug treatment to lower your cholesterol, you will need to continue your treatment with lifestyle changes. This will keep the dose of medicine as low as possible, and lower your risk in other ways as well. There are several types of cholesterol-lowering drugs available, including:
Statins, which block the liver from making cholesterol
Bile acid sequestrants, which decrease the amount of fat absorbed from food
Cholesterol absorption inhibitors, which decrease the amount of cholesterol absorbed from food and lower triglycerides
Vitamins and supplements—Niacin, which blocks the liver from removing HDL and lowers triglycerides, and omega-3 fatty acids, which increase the level of HDL and lowers triglycerides
Your healthcare provider can help decide which type of drug is best for you.