Home Cellular health When it comes to heart disease, how much cholesterol is *too*?

When it comes to heart disease, how much cholesterol is *too*?

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Thinking of starting to take medication to lower your cholesterol? Read this first.

Person love to get a blood test (or at least very few of us do), but having your cholesterol checked is an integral part of an annual physical exam, and for good reason: it’s one of the most important markers when this is to assess your overall health. Yet, understanding the role cholesterol plays in the body and how different types of cholesterol affect how your body functions can be confusing.

Katie spoke with beloved Dr. O aka J. Nwando Olayiwola, MD, MPH, FAAFP, the Director of Health Equity for Humana Inc. Here she explains how cholesterol plays in diseases heart rate, how much exercise do you really need to help you prevent heart disease and the health crisis that particularly affects black women.


Tell us about the role of cholesterol in heart disease. How often should you have it checked? And what should your numbers be, ideally?

Cholesterol is interesting because it is not an inherently bad substance. If you look scientifically at cholesterol, you will see different types of it: HDL — high density lipoprotein — the “good” cholesterol, the “bad” LDL cholesterol, and the fatty triglycerides. Cholesterol is important for our body: we need it for cell development, we need it for vitamins and we need it for other hormones. But too much cholesterol begins to clog the arteries that carry blood throughout the body and the arteries that supply blood directly to the heart.

Cholesterol numbers are complicated, but if you take a blood test and look at your lab report, it will show you normal ranges, and staying within those ranges is a very important strategy for protecting your heart health.

Some people take medicine to lower their cholesterol, but there are other things you can do too, like diet and exercise, right?

The advantage of cholesterol is that there is often a parcel you can do. Some genetic problems make it difficult to control cholesterol and may require medication, but for most people with high cholesterol, there are many things you can do. The first is to establish healthy eating, like getting more of those fresh foods we talked about and limiting fast food. Regular exercise, cutting down on smoking, and all the habits that can get you out of a sedentary lifestyle are really good for your cholesterol levels. These are things I would recommend first, before start taking medication.

How much exercise do we need to make sure we keep our heart healthy?

Exercise is very, very important and getting at least two and a half hours of moderate exercise a week is a good start. People are sometimes surprised at some of the things that count as exercise; if you’re in the Midwest, shoveling snow is actually pretty good for your heart. Otherwise, there’s walking, cycling, swimming, or even moderate-intensity gardening. And there are different ways to fit exercise into your life, like taking the stairs instead of the elevator, if you’re physically able, or parking a little further from the entrance to the bank or a post office.

Let’s talk about women of color. Are there any particular risks they face when it comes to heart disease?

Women of color in particular have higher rates of heart disease and tend to have more sudden onset of heart disease at a younger age. Preeclampsia, for example, is one such condition that occurs during pregnancy and can lead to persistent cardiovascular symptoms later in life. Black women are the most likely group of women to have preeclampsia – significantly higher than any other group. Preeclampsia is that constellation of symptoms that occurs during pregnancy, including high blood pressure, blurred vision, low platelet count, liver problems, and sometimes even seizures. If this happens before you finish with a baby, he may be in labor prematurely. And while the condition may go away when you give birth, it still puts women at high risk for cardiovascular disease later in life.

Additionally, higher levels of toxic stress have been associated with people from ethnic minorities, but also in lower socio-economic neighborhoods and zip codes, areas with high crime, or low education or low economic mobility. These factors lead to increased cortisol levels throughout life, and higher cortisol levels are associated with higher blood pressure, putting you at increased risk for heart disease. But black women are the least likely to know they are at risk for heart disease. This is why education and awareness are so important