Cholesterol myths and heart health

Research and guidelines show a strong relationship between high cholesterol and increased risk for heart attack or stroke. That’s why it’s important to go over your cholesterol levels with your doctor. 

There are several cholesterol numbers to be aware of — “good” cholesterol (HDL), “bad” cholesterol (LDL) and triglycerides. A few myths have caused confusion about what these numbers mean. Below are four common myths about cholesterol and why they’re not true.

Myth #1: Only total cholesterol matters

Fact: Total cholesterol is the total of your “good” and “bad” cholesterol. Numbers above 200 are associated with an increased risk for heart attack and stroke. But it may not tell the full story. Current guidelines now recommend a full cholesterol panel to assess risk.

Myth #2: Your LDL isn’t important

Fact: In 2013, the American College of Cardiology and the American Heart Association published guidelines that changed the focus of treatment for high cholesterol.

The focus is now on using statin medications to lower the long-term chances of heart disease. Earlier guidelines focused on lowering the bad cholesterol by a certain amount. That said, the level of LDL is still very important in risk assessment.

The higher the LDL cholesterol, the higher your chances of heart attack and stroke. Treatment strategies aim to lower LDL by at least 50% in high-risk individuals.

Myth #3: High HDL outweighs “bad” cholesterol

Fact: Research indicates that lower levels of good cholesterol increase your chances of having a heart attack or stroke. But there isn’t enough evidence at this time to show that raising good cholesterol lowers the chances of heart attack and stroke. 

Also, having naturally high levels of good cholesterol may not protect you from heart attack or stroke if you have other risk factors. Instead, try to live a healthy lifestyle:

• Don’t smoke.
• Exercise 30 minutes at least five times a week.
• Eat heart-healthy foods, including healthy fats in moderation (walnuts, fish oil and avocados).
• Don’t eat trans fats (artificial fats).

Myth #4: High triglycerides don’t matter

Fact: Triglycerides are a kind of fat in the blood. They come from fats in the food you eat. Conditions that can increase the chances of high triglycerides include obesity (being seriously overweight), diabetes and low thyroid levels. 

Other factors associated with high triglycerides include:

• Some medications
• Alcohol overuse
• Heredity
• Certain kidney diseases

High triglycerides are associated with an increased risk of clogged arteries and heart disease. Very high triglycerides (more than 1,000) raise your chances of sudden inflammation of the pancreas, a potentially serious condition. 

When triglycerides are higher than 200, the non-HDL measurement is a better measure of the “bad” lipids in the blood. Non-HDL cholesterol is your total cholesterol minus the HDL cholesterol. 

By Elizabeth Chan, MD, FACC

The information provided is for general informational purposes only and is not intended to be medical advice or a substitute for professional health care. You should consult an appropriate health care professional for your specific needs.