Q: Why is it important to know and manage your total cholesterol?

A: The risk of coronary heart disease rises as blood cholesterol levels increase. When other risk factors are present, this risk increases even more.

Cholesterol is a necessary component of our bodies, but additional dietary cholesterol is not needed. Excess cholesterol in the blood stream can form a thick, hard deposit called plaque in the artery walls. This build-up causes arteries to become thicker, harder and less flexible. When blood flow is restricted, chest pain called angina can result. When blood flow to the heart is severely restricted and a clot stops the flow completely, a heart attack results.

Q: What should my total cholesterol level be?

A: Medical experts recommend that total cholesterol levels be less than 200 mg/dL in order for an individual to be at lower risk for heart disease. Borderline high cholesterol is 200 to 239 mg/dL; high blood cholesterol is 240 mg/dL and above. A person with this level has more than twice the risk of heart disease as someone whose cholesterol is below 200 mg/dL.

Q: What’s the difference in “good” versus “bad” cholesterol?

A: About one-fourth to one-third of blood cholesterol is carried by high density lipoprotien (HDL). Often called the “good” cholesterol, high levels of HDL seem to protect against heart attack because it carries cholesterol away from the arteries and back to the liver where it is passed from the body. Optimal HDL levels are 40 mg/dL and higher.

When too much low-density lipoprotein (LDL) cholesterol circulates in the blood, it can slowly build up in the artery walls that feed the heart and brain. Together with other substances, it can form artery-clogging plaque that can eventually cause a heart attack or stroke. LDL cholesterol of less than 130 mg/dL is the optimal level for most people.

Cholesterol Management in Your Golden Years

Q: Why should cholesterol be managed in older adults?

A: High cholesterol levels that go untreated or unmanaged increase one’s risk for coronary heart disease (CHD), which is the leading cause of death in both men and women over 65 years old and can cause long-term disability. Cholesterol treatment in high-risk individuals who are 65-80 years old is beneficial and reduces the likelihood of a heart attack or other coronary heart disease event.

Q: How do you know if you are “high-risk” for coronary heart disease?

A: You are considered high-risk if you have known CHD: you have had a heart attack, angioplasty, bypass operation, abnormal stress test, other diagnosis of atherosclerosis or you have diabetes mellitus.

Q: Am I still at high-risk if I have not had a heart attack?

A: You still are at high-risk, if your cholesterol level is high and you have one other major risk factor, such as high blood pressure, diabetes, obesity or smoking.

Q: What must I do to lower my cholesterol?

A: To lower your cholesterol, live a heart-healthy lifestyle. Eat a heart-healthy diet that includes fresh vegetables, fruit, whole grains, low-fat dairy products, and limit fatty foods. Exercise regularly, avoid smoking, control high blood pressure, manage your diabetes and maintain a healthy weight. Your doctor also may recommend cholesterol-lowering drugs.

Q: What is the healthy range for cholesterol?

A: A healthy range for total cholesterol is less than 170 mg/dL and an LDL cholesterol of less than 100, or less than 70 mg/dL if you are in the high-risk category.

Q: How does regular exercise help keep LDL cholesterol levels in check?

A: Low-density lipoprotein (LDL) or the “bad” cholesterol we hear about is most dangerous when it appears as small, compact particles. Even moderate exercise like walking or gardening can help keep LDL cholesterol large and “fluffy.” That’s a step in the right direction.

Q: What constitutes a healthy diet? Do you have to be vegetarian to be heart healthy?

A: Make heart healthy eating part of your daily routine. Eat a variety of foods you like in moderate amounts, choosing from all food groups, such as complex carbohydrates, proteins, fruits, vegetables, dairy and minimal fats and sugars.

Eliminating or reducing red meat, refined sugar and flours, and caffeine can help point you in the right direction toward more healthy eating. Adding fiber also boosts healthy eating and has been proven to help lower blood sugar and cholesterol levels. Consider reducing your sodium intake to no more than 3,000 mg daily. And don’t forget to drink at least eight 8-ounce glasses of water a day to help your body’s digestive functions and to curb your appetite.

Q: What percent of daily calories should come from fat?

A: A normal diet should consist of less than 30 percent of calories from fat. The percentage is even less–20 percent–for people working to prevent heart disease, and even lower – 10 percent – for people working to reverse heart disease.