Happy American Heart Month! As promised we’re going to focus on heart health a little more intently than usual. Don’t forget, next Tuesday is Valentine’s Day, so make your plans. I think Mary’s really going to be happy with mine; more about that next week.
Sometimes numbers do matter.
If you’ve recently had your cholesterol checked, you’ve already taken a big step toward a healthier lifestyle. Congratulations. But if you’ve gotten the news that your cholesterol is high, you might be wondering how that could be.
There are no symptoms of high cholesterol, which means if your cholesterol is high, you won’t feel it. The only way to tell if it’s too high is with a blood test.
It’s likely the cause of your high cholesterol is your diet; there are some genetic factors that can cause high cholesterol, too.
To understand how your diet can affect your cholesterol, it helps to understand what cholesterol is and how it works.
Cholesterol, a fat in your blood, is actually made up of two types—the good and the bad. “Good” cholesterol is also called High-Density Lipoprotein (HDL). It’s the cholesterol system’s transport mechanism and moves the “bad” cholesterol, called Low-Density Lipoprotein (LDL), throughout your body. Too much bad LDL cholesterol (the sticky kind) in your blood will begin to build up in your arteries, forming plaque in them and making it more difficult for blood to travel through your body.
Your goal should be to keep your LDL low and your HDL high.
Your body produces some cholesterol naturally in your liver. However, some foods you eat also contain saturated fat that can increase your cholesterol levels. Meat, poultry, eggs, milk, butter and other animal products, as well as some processed foods like crackers, cookies, cakes and many fast foods like fried chicken, fries and burgers, all contain cholesterol.
If you have high cholesterol, your doctor may recommend changing your diet to help lower it.
Fruits, vegetables, high-fiber foods like oatmeal or oat bran, foods high in fatty-acids like salmon or albacore tuna, nuts and avocados can help lower your total cholesterol so it’s below 200mg/dL.
In addition to your diet, being overweight, not getting enough exercise, smoking and ageing can contribute to high cholesterol.
Your diet and lifestyle aren’t the only reasons your cholesterol may be high. An uncommon genetic disorder called familial hypercholesterolemia (FH) could make cholesterol high.
Familial hypercholesterolemia is a genetic defect where your body can’t remove that bad LDL cholesterol from your blood and it begins to build up. It’s a serious condition that can cause heart attacks and strokes at an early age.
People with FH may experience chest pain or be diagnosed with coronary artery disease at a young age, get cholesterol deposits on the eyelids or fatty deposits under the skin, notice cramps in the calves when walking or experience toe sores that don’t easily heal.
A recent study from Geisinger Health System and Regeneron Genetic Center found that FH often goes undiagnosed and untreated, and it’s about twice as common as once thought.
The best way to diagnose FH is through genetic testing.
If you are found to have FH, your doctor may recommend you make lifestyle changes first, such as limiting foods high in cholesterol, losing weight and getting plenty of exercise.
Sometimes high cholesterol cannot be managed on its own. In this case, your doctor may prescribe a type of medication called a statin to lower bad cholesterol or raise your good cholesterol. Newer injectable drugs are remarkably effective in treating very resistant forms of FH and may be life-saving.
Finding high cholesterol levels at an early age should trigger a search for FH through genetic testing and may help you avoid a heart attack or stroke. It’s also vital to alert your family if this genetic defect is found so others can be tested and treatment started early.
So get your cholesterol level checked, watch what you eat and by all means order the roses (by the way, a little chocolate, once in a while, is OK too).
Dr. Alfred Casale is chairman of surgery for the Geisinger Heart Institute, co-director of the Cardiovascular Service Line for the Geisinger Health System and Associate Chief Medical Officer of the Geisinger Health System and Chair of the Geisinger Heart Institute. Readers may write to him via [email protected]