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Cholesterol - what to ask your doctor

Hyperlipidemia - what to ask your doctor; What to ask your doctor about cholesterol

Your body needs cholesterol to work properly. When you have extra cholesterol in your blood, it builds up inside the walls of your arteries (blood vessels), including the ones that go to your heart. This buildup is called plaque.

Plaque narrows your arteries and slows or stops the blood flow. This can cause a heart attack, stroke, or other serious heart disease.

Below are some questions you may want to ask your health care provider to help you take care of your cholesterol.

Questions

What is my cholesterol level? What should my cholesterol level be?

  • What are HDL ("good") cholesterol and LDL ("bad") cholesterol?
  • Does my cholesterol need to be better?
  • How often should I have my cholesterol checked?

What medicines am I taking to treat high cholesterol?

  • Do they have any side effects?
  • What should I do if I miss a dose?
  • Are there foods, other medicines, vitamins, or herbal supplements that may change how well my cholesterol medicines work?

What is a heart-healthy diet?

  • What are low-fat foods?
  • What types of fat are OK for me to eat?
  • How can I read a food label to know how much fat there is?
  • Is it ever OK to eat something that is not heart healthy?
  • What are some ways to eat healthy when I go to a restaurant? Can I ever go to a fast-food restaurant again?
  • Do I need to limit how much salt I use? Can I use other spices to make my food taste good?
  • Is it OK to drink any alcohol?

What can I do to stop smoking?

Should I start an exercise program?

  • Is it safe for me to exercise on my own?
  • Where should I exercise, inside or outside?
  • Which activities are better to start with?
  • Are there activities or exercises that are not safe for me?
  • Can I exercise most days?
  • How long and how hard can I exercise?
  • What symptoms may I need to watch out for?

References

Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2960-2984. PMID: 24239922 www.ncbi.nlm.nih.gov/pubmed/24239922.

Genest J, Libby P. Lipoprotein disorders and cardiovascular disease. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 48.

Heimburger DC. Nutrition's interface with health and disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 213.

Mozaffarian D. Nutrition and cardiovascular and metabolic diseases. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 49.

Ridker PM, Libby P, Buring JE. Risk markers and the primary prevention of cardiovascular disease. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 45.

Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2889-2934. PMID: 24239923 www.ncbi.nlm.nih.gov/pubmed/24239923.

    • Understanding cholesterol results

      Animation

    •  

      Understanding cholesterol results - Animation

      LDL cholesterol has gotten a bad reputation, and for very good reason. Having too much of this fatty substance in your blood can clog up your arteries, preventing blood from getting to your heart and out to where it's needed in your body. Checking your LDL levels can help your doctor spot high cholesterol before it can cause a heart attack or stroke. Let's talk today about LDL tests. LDL stands for low-density lipoprotein. Lipoprotein is a type of protein that transports cholesterol, as well as fats called triglycerides and lipids, in your blood. When you eat too many fatty, cholesterol-rich foods, LDL cholesterol can start to collect in your artery walls. That's one collection you don't want, because if a chunk of that gunk breaks loose and gets lodged in a blood vessel, you could end up having a heart attack or stroke. To check your LDL cholesterol level, you'll need to have a blood test. Your doctor may tell you not to eat or drink anything for 8 to 12 hours before the test, so you can get an accurate reading. During the test, your doctor will draw blood from one of your veins. The needle might sting a little bit, but the feeling shouldn't last for any more than a few seconds. So, how do you know that you have high LDL cholesterol? Well, your LDL cholesterol level (think L for Lousy) will usually be measured along with your HDL, or good cholesterol (think H for Healthy), as well as your triglycerides and your total cholesterol level. Together, these measurements are called a lipid panel. You want your LDL level to be at least below 130 mg/dl, but ideally less than 100 milligrams per deciliter. If you're at high risk of heart disease, it should be even lower than that - less than 70 milligrams per deciliter. And for folks of average risk of getting heart disease, anything over 160 is considered a high LDL level. If you do have LDL cholesterol, you could be at risk for heart disease. Now, some folks have high cholesterol because they have an inherited condition that causes high cholesterol. If your LDL is low, it may be because you're not eating a well-balanced diet or your intestines aren't absorbing the nutrients from the foods that you eat. Ask your doctor how often you should have your LDL, and total cholesterol levels, checked. Depending upon your heart disease risks, you may need to be tested more often. If your LDL cholesterol is high, ask your doctor about cholesterol-lowering medications, diet, and other ways to bring it back down into a normal range.

    • Plaque buildup in arteries

      Plaque buildup in arteries - illustration

      A heart attack or stroke may occur when an area of plaque (atherosclerosis) ruptures and a clot forms over the location, blocking the flow of blood to the organ's tissues.

      Plaque buildup in arteries

      illustration

    • Understanding cholesterol results

      Animation

    •  

      Understanding cholesterol results - Animation

      LDL cholesterol has gotten a bad reputation, and for very good reason. Having too much of this fatty substance in your blood can clog up your arteries, preventing blood from getting to your heart and out to where it's needed in your body. Checking your LDL levels can help your doctor spot high cholesterol before it can cause a heart attack or stroke. Let's talk today about LDL tests. LDL stands for low-density lipoprotein. Lipoprotein is a type of protein that transports cholesterol, as well as fats called triglycerides and lipids, in your blood. When you eat too many fatty, cholesterol-rich foods, LDL cholesterol can start to collect in your artery walls. That's one collection you don't want, because if a chunk of that gunk breaks loose and gets lodged in a blood vessel, you could end up having a heart attack or stroke. To check your LDL cholesterol level, you'll need to have a blood test. Your doctor may tell you not to eat or drink anything for 8 to 12 hours before the test, so you can get an accurate reading. During the test, your doctor will draw blood from one of your veins. The needle might sting a little bit, but the feeling shouldn't last for any more than a few seconds. So, how do you know that you have high LDL cholesterol? Well, your LDL cholesterol level (think L for Lousy) will usually be measured along with your HDL, or good cholesterol (think H for Healthy), as well as your triglycerides and your total cholesterol level. Together, these measurements are called a lipid panel. You want your LDL level to be at least below 130 mg/dl, but ideally less than 100 milligrams per deciliter. If you're at high risk of heart disease, it should be even lower than that - less than 70 milligrams per deciliter. And for folks of average risk of getting heart disease, anything over 160 is considered a high LDL level. If you do have LDL cholesterol, you could be at risk for heart disease. Now, some folks have high cholesterol because they have an inherited condition that causes high cholesterol. If your LDL is low, it may be because you're not eating a well-balanced diet or your intestines aren't absorbing the nutrients from the foods that you eat. Ask your doctor how often you should have your LDL, and total cholesterol levels, checked. Depending upon your heart disease risks, you may need to be tested more often. If your LDL cholesterol is high, ask your doctor about cholesterol-lowering medications, diet, and other ways to bring it back down into a normal range.

    • Plaque buildup in arteries

      Plaque buildup in arteries - illustration

      A heart attack or stroke may occur when an area of plaque (atherosclerosis) ruptures and a clot forms over the location, blocking the flow of blood to the organ's tissues.

      Plaque buildup in arteries

      illustration

    Talking to your MD

     

    Self Care

     

    Review Date: 7/25/2018

    Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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