Cholesterol is a serious health concern that’s called a silent killer because there’s usually no warning signs or symptoms that indicate there’s a problem, and it seems to be on people’s mind. According to Google Trends, there are five top questions regarding cholesterol that people have been searching consistently the last year and Dr. Norman Lepor, a Los Angeles-based cardiologist with Cedars-Sinai addresses them. Read on to find out more—and to ensure your health and the health of others, don’t miss Already Had COVID? These Symptoms May “Never Go Away”.
Using Google Trends, the top rising Google queries related to cholesterol from 5/18/21 – 5/18/22 are these, the top questions that have been researched the most over the last year:
- What is cholesterol? – top overall query about cholesterol
- How do I know if I have high cholesterol? top overall query about cholesterol
- What causes high cholesterol in women? — a question that has risen 300% in the last year
- What reduces cholesterol quickly? — a question that has risen 70% in the last year
- What is a normal range for LDL and HDL cholesterol? — a question that has risen 70-90% in the last year (questions about LDL have risen between 80-90% and HDL have risen 70%).
Dr. Lepor explains, “Cholesterol is a fat-like, waxy substance that helps your body make cell membranes, many hormones, and vitamin D. The cholesterol in your blood comes from two sources: the food you eat and your liver. Cholesterol is carried into your bloodstream on spherical particles called lipoproteins. The two most commonly known lipoproteins are low-density lipoproteins (LDL) known as the ‘bad cholesterol’ and high-density lipoproteins (HDL) known as the ‘good cholesterol.’
LDL cholesterol plays a major role in the development of plaque in arteries called atherosclerosis that is a risk factor for heart attack and/or stroke. What’s important to know is that most of the cholesterol in our bodies is made by our liver – not the food we eat – so when someone has high cholesterol, a low fat, low cholesterol diet may not be enough to slow down the development of plaque in their arteries that is made by LDL. Lipid-lowering cholesterol medication is often needed over and above a low fat, low cholesterol diet to get to levels that slow down the development of plaque in our arteries.”
Dr. Lepor says, “High cholesterol typically has no symptoms until it has progressed, and you have developed atherosclerosis (plaque) in your arteries that puts you at risk for heart attack and/or stroke. A blood test called a lipid panel is the only way to check your cholesterol levels. Because high cholesterol is a precursor to heart disease, heart attack and/or stroke, it is important to see your doctor regularly for annual visits so they can assess your risk for heart disease and conduct the necessary tests.
To optimize cholesterol levels, health care professionals will often recommend lifestyle modifications such as reducing dietary intake of saturated fats, and increasing intake of ‘good’ fats called monounsaturated and polyunsaturated fats. Foods high in good fats include vegetable oils (such as olive, canola, sunflower, soy, and corn), nuts, seeds, and fish.
However, in the vast majority of people with high cholesterol, the addition of medication is necessary to achieve good cholesterol levels. There is an inherited genetic condition known as familial hypercholesterolemia where very high LDL levels are seen at a young age. These patients are at very high risk of heart attack and/or stroke and can take multiple cholesterol lowering medications – on top of diet and exercise – to reduce LDL to desirable levels.”
Dr. Lepor shares, “It is quite common for young healthy women to have higher total cholesterol levels that is unrelated to heart disease since it is the HDL or “good” cholesterol that is elevated. This elevation of HDL-cholesterol is related to the female sex hormone, estrogen. But, particularly during menopause when hormone levels fluctuate, we may see changes in the balance of HDL and LDL cholesterols, which can put women at risk. One way for post-menopausal women to know if their HDL cholesterol levels are protective against heart disease or not is to undergo a test called a coronary calcium score, where plaque in your arteries can be detected.”
According to Dr. Lepor, “It can take months to lower cholesterol with diet and exercise changes alone, and for some diets won’t be enough to slow down the development of plaque in their arteries. However, the use of cholesterol medications enables us to start lowering cholesterol much faster. Statins are the most commonly used medication to lower cholesterol. Statins have been around for decades, but some people are not able to tolerate statins or are not able to get their LDL cholesterol low enough through lifestyle modifications and a statin. Fortunately, now there are newer cholesterol medications that can be added on top of statins that are particularly useful for people with known heart disease who may need more help lowering their LDL. The latest of these medications, called Leqvio (inclisiran), is given by a healthcare professional twice a year, after two initial injections, and can lower cholesterol by more than 50%. Medications can have certain side effects, so it’s important to speak with a doctor to determine the best treatment option if you need extra help with lowering your LDL cholesterol beyond lifestyle modifications.”
Dr. Lepor states, “There is no one size fits all in terms of cholesterol levels, and because high cholesterol has few warning signs, it is important to see a physician for your annual physical to maintain good health. Physicians will assess your risk of heart attack and/or stroke by taking into account your cholesterol levels, family history of heart attack and/or stroke, and other risk factors such as diabetes, smoking and hypertension. The higher your risk of having a heart attack and/or stroke, the lower we want the LDL cholesterol to be.
For most people, we like LDL levels to be lower than 100 mg/dl to prevent heart attack and/or stroke, but in patients who have known heart disease, we now recommend LDL-cholesterol levels to be lower than 70 mg/dl. HDL levels less than 40 mg/dl in men and less than 50 mg/dl in women are risk factors for heart attack and/or stroke. An HDL level greater than 50 mg/dl in women and greater than 40 mg/dl in men is considered a healthy level.” And to protect your life and the lives of others, don’t visit any of these 35 Places You’re Most Likely to Catch COVID.