Questions for the Experts: Can you help me understand more about cholesterol?

We asked members of our medical staff to answer some common questions they hear from their patients. Read Nicholas Stamato, MD, FACC, answer to:

I need to understand more about cholesterol, because high cholesterol runs in my family.

Answer: Cholesterol is a fat-like substance that travels through the blood. It is an important part of the cells of our body. When arteries become blocked and cause a fatal heart attack, examination commonly shows the walls are narrowed by cholesterol and fat-filled “plaques.” The higher a person’s blood cholesterol level, the higher their risk of having a heart attack.

Your body makes the cholesterol it needs. But you also get it in your diet (for example, full-fat dairy products, fried foods and fatty meat). Too much cholesterol can be dangerous.

Research has shown over the past 50 years that lowering cholesterol with diet or medication lowers risk of heart attack. If you have high cholesterol, you have a higher chance of developing heart disease, or having a heart attack or stroke. A heart-healthy lifestyle is especially important if you have high cholesterol.

Our understanding of cholesterol has changed dramatically over time. In Cardiology we tend to focus on the “bad” cholesterol, called LDL. This is the cholesterol that is most responsible for leading to blockage in the arteries. Fortunately, it is also the type of cholesterol that can be reduced by the medications we have available. Forty years ago, a normal blood level of LDL was thought to be anything below 160. Within the last five years we have learned that a normal LDL cholesterol is probably in the range of 50. This is dramatically lower than 160, 120, 100, or even the 70 that we thought was normal just a few years ago. This helps explain why half of the people we see with heart attacks have LDL cholesterol around 100. We had previously thought that those higher LDL levels would not lead to heart attacks, but that now appears to be wrong. Other factors like diabetes, smoking, and high blood pressure multiply the risk from a high cholesterol number.

There are things we can do to lower your “bad” cholesterol before trying medication. First and foremost is to follow a healthy diet, one based with a high amount of plant-based foods such as vegetables and fruits. A diet that is high in fish helps protect against heart attack; and if and when we eat meats, we should try to eat meats from animals that have been raised on grass and that have not been processed.

Just know that it sometimes takes medication to lower the bad cholesterol and lower the risks of further heart problems, depending on how high your LDL cholesterol is, and whether or not you already have hardening of the arteries. It’s always a good idea to talk about your individual cholesterols numbers with your doctor.

Visit the American College of Cardiology to read more about cholesterol.

Cardiology in Gillette, Wyoming

Nicholas Stamato, MD, FACC, practices at Campbell County Medical Group Cardiology, which is part of CCH’s robust Cardiovascular Services program at Campbell County Memorial Hospital in Gillette, Wyoming. The cardiac care team includes our physicians, registered nurses in the Clinic, as well as a team of registered nurses and technicians in the Cardiac Cath Lab and Cardiac Rehabilitation. Learn more at www.cchwyo.org/heart. Call 307-688-3700 to schedule an appointment.