When it’s time for your annual primary care provider visit, one health value they’re likely checking is your cholesterol levels. So, you probably already know that keeping your cholesterol levels within range is essential for your overall health.
It’s important that you have the facts on cholesterol. Here, Kevin Miller, MD, a Cardiologist at the Florence Wormald Heart and Vascular Institute at St. Elizabeth, debunks some common myths about cholesterol.
Myth #1: All cholesterol is bad
There are two types of cholesterol:
- HDL, or “healthy” cholesterol, helps remove cholesterol from your arteries and reduces your risk for atherosclerosis (thickening or hardening of the arteries).
- LDL cholesterol deposits cholesterol onto your artery walls. Over time, this can lead to atherosclerosis.
You should strive to keep your HDL cholesterol level as high as possible and your LDL cholesterol level as low as possible. “In some circumstances, the good cholesterol can offset bad cholesterol,” explains Dr. Miller. “The ratio of total cholesterol divided by HDL cholesterol is commonly used for risk assessment. If that number is less than 3.0, it can be cardioprotective, independent of the LDL readings.” For example, if your total cholesterol is 170 mg/dl but the HDL cholesterol level is 60 mg/dl, that’s a healthy ratio and can promote heart health.
Myth #2: Everyone can reduce their LDL cholesterol level with diet and exercise alone
Unfortunately, this is not the case. “There’s more to the story than having a poor diet, being inactive or drinking too much alcohol,” explains Dr. Miller. Many people do all the right things –exercise regularly and pay attention to their diet, reduce stress levels and limit alcohol intake – but they can still have high cholesterol from a hereditary component. In these cases, taking a cholesterol medicine can help keep the LDL cholesterol below the recommended upper limit.
Myth #3: Being on a cholesterol medication means you’re unhealthy
This is not necessarily true. Some people simply cannot control their cholesterol levels with lifestyle changes due to genetic factors. “There’s often a stigma with a young patient taking a cholesterol medication, but the reality is, some need to take one to help control their levels due to genetic factors,” says Dr. Miller.
Myth #4: Medication can raise HDL cholesterol levels
HDL cholesterol is the “healthy” type of cholesterol that you can work to increase, especially if your LDL cholesterol is on the higher side. “HDL cholesterol is what we have the least control over with medication,” says Dr. Miller. “Research has been conducted around medication and HDL levels and unfortunately, nothing has been shown as safe and effective at raising HDL.” Regular exercise and a heart-healthy diet can increase your HDL cholesterol level, but medication cannot substantially bump up that level.
Myth #5: Cholesterol medications are dangerous
The most commonly used type of cholesterol medication are statin drugs. “The landmark studies demonstrating the safety and efficacy for statins lowering cardiovascular events such as heart attack, stroke, angioplasty, bypass surgery and death, were conducted in trials enrolling tens of thousands of patients. This medication class may be the most studied and have some of the strongest supporting evidence in the entire field of cardiovascular medicine,” says Dr. Miller. Statin drugs are very effective at lowering LDL cholesterol levels.
Between 90 and 95% of people who use statin medications will experience no side effects. For the 5 to 10% of people who experience side effects, the majority of side effects are muscle cramps or sore muscles. “It’s important to note that these side effects are temporary,” says Dr. Miller. “People won’t experience permanent muscle issues by taking statins.”
Only 1 to 2% of people will have side effects so severe that they can’t tolerate taking any type of statin drug. In this case, there are at-home injectable medications available for people. These agents are extremely effective, proven to be safe with minimal to no side effects, and now are routinely covered on most prescription plans.
Don’t delay, talk to your doctor about cholesterol
If you aren’t already on a regular cholesterol screening schedule, speak with your St. Elizabeth primary care provider about your risk factors and the schedule that makes sense for you.
