Cholesterol: The Real Truth

When most of us hear the word cholesterol, we often think it means something bad or unhealthy. But in reality, your body needs a small amount of cholesterol to function properly. Problems develop when we eat too much cholesterol or our bodies overproduce it.

Too much cholesterol in your bloodstream clogs your blood vessels and increases your risk of heart disease and stroke, says cardiologist Barry Effron, MD.

Despite more than seven decades of research, many people don't completely understand cholesterol and what they can do to lower it.

Here, according to Dr. Effron, are the facts about cholesterol:

Various factors affect cholesterol – You might think that the cholesterol level in your body is directly related to the amount of saturated fat and dietary cholesterol you eat. While it's true that what you consume can raise your levels of LDL, or bad, cholesterol, it's broader than that, Dr. Effron says. Your cholesterol levels are influenced by:

• Genetics – High cholesterol can run in families
• Age and sex –The condition typically affects people between the ages of 40 and 75. Before age 50, men have higher cholesterol levels, but after women go through menopause, their LDL levels rise.
• Obesity
• Your total fat intake – This includes saturated fats, trans fats and cholesterol

Changing your diet only goes far – Even if you eat a heart-healthy diet, you still might have high cholesterol.

"Most people can only achieve a 10 to 15 percent reduction in their cholesterol level through dietary changes," Dr. Effron says. "To significantly reduce your risk of coronary artery disease, you may need a 30 percent reduction in your total and LDL cholesterol. For most people, it's not feasible to think that diet changes alone will reduce your need to take medications."

Drugs work – Cholesterol-lowering medications statins, have been around for more than 30 years and are one of the safest classes of drugs, Dr. Effron says. Additionally, many of these drugs are available as generics, making them inexpensive to purchase.

"While some people do develop side effects – I don't want to completely diminish the hazards – there is a lot of experience with the use of statin therapies to treat and lower cholesterol," he says. "If you have side effects with the medicine you're taking, tell your doctor. We can change the drug to eliminate or minimize that."

For those who have trouble tolerating statins' side effects, the Food and Drug Administration recently approved an injectable drug to treat high LDL cholesterol. This new drug, which is pricey, is designed to be self-administered once every two weeks and is touted to lower cholesterol by 70 percent. Dr. Effron says he doesn't expect the medicine to be widely available for several years.

Try TLC – This stands for therapeutic lifestyle changes and consists of diet, exercise and watching your weight.

"Exercise is one of the most important things you can do to keep your cholesterol under control," Dr. Effron says. "If you walk every day for 30 minutes at a moderate pace – three miles per hour – it can help lower your cardiac risk by 30 percent."

Get diagnosed – University Hospitals offers a non-invasive diagnostic test called coronary artery calcium score that screens for early-stage heart disease. Using a CT scanner to take pictures of your heart, the test reveals the presence and extent of calcium deposits in plaque on the walls of your heart’s arteries. The more calcium build-up you have, the higher your risk of a heart attack.

Armed with the data from the screening, you'll learn how to make changes to avoid a heart attack.

Barry Effron, MD is a cardiologist and associate chief of UH Harrington Heart & Vascular Institute at University Hospitals Cleveland Medical Center. You can request an appointment with Dr. Effron or any other University Hospitals doctor online.