What is cholesterol?

Cholesterol is a waxy, fat-like substance found in whole-milk dairy products, eggs, animal fats and meat. It belongs to a family of chemicals called lipids, which also includes fat and triglycerides. It is found in cell walls or membranes throughout the human body and is used to produce hormones, vitamin D and the bile acids that aid the digestion of fat. Your body is able to meet all these needs by producing cholesterol in the liver.

What is the connection between cholesterol and heart disease?

Over the years, excess cholesterol and fat are deposited in the inner walls of the arteries that supply blood to the heart. These deposits make the arteries narrower, contributing to atherosclerosis and, if the process is unchecked, heart attack.

Why should I worry about cholesterol—aren't women protected from heart disease?

No. Cardiovascular disease, which includes diseases of the heart and blood vessels such as stroke, is the leading cause of death in women, accounting for over 500,000 deaths a year. Though women, in general, seem to develop heart disease later in life than men, typically after menopause, the time to worry about your heart's health is NOW. Talk to your health care professional for guidance.

What is the difference between "good" cholesterol and "bad" cholesterol?

"Bad" cholesterol comes in the form of low-density lipoprotein (LDL). This is the primary type of cholesterol in the blood and contributes to heart disease. High-density lipoprotein (HDL) is often called "good" cholesterol because it transports cholesterol from the body to the liver, which helps remove it from the body and prevents it from clogging arteries.

How are cholesterol levels tested?

A lipoprotein profile is a blood test usually administered after fasting for 12 to 14 hours. It measures LDL cholesterol, total cholesterol, HDL cholesterol, and triglyceride levels. It is the preferred test for measuring cholesterol levels.

What should my cholesterol levels be?

If you do not have any risk factors for heart disease, the ranges below are important numbers to know. If you have heart disease or risk factors for heart disease (diabetes, previous heart attacks) your health care professional will recommend different ranges than those listed below and will likely choose a more aggressive approach to getting your cholesterol ranges under control:

Total blood cholesterol levels

LDL blood cholesterol levels

HDL blood cholesterol levels

Triglyceride levels

Normal: less than 150 mg/dL
Borderline high: 150 to 199 mg/dL
High: 200 to 499 mg/dL
Very high: 500 mg/dL or higher

What can I do to reduce my cholesterol level without taking medications?

Talk to your health care professional for the best strategy based on your personal and family health history. Lifestyle changes—including weight loss, exercise and a healthy diet—are just as effective as medication in lowering cholesterol for most people.

What drugs are available to lower high cholesterol?

Six medications in the statin class of drugs are available, including atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol) and simvastatin (Zocor). These drugs are highly effective, typically cuting LDL cholesterol 30 to 63 percent, while increasing HDL cholesterol somewhat and lowering triglycerides. Statins are the most frequently prescribed cholesterol-lowering drugs, but there are other types of cholesterol-lowering drugs available, including bile acid sequestrants, fibrates and cholesterol absorption inhibitors.

Isn't niacin just a vitamin I can take without a prescription?

The amount of niacin, or nicotinic acid, needed to reduce cholesterol levels is higher than the recommended amount in vitamins. You shouldn't attempt to take cholesterol-reducing quantities without a recommendation from your health care professional health care professional—the drug can have severe side effects, including liver problems, gout and high blood sugar. If you have diabetes, you should check with your doctor because niacin can have a modest impact on blood sugar.

Is there any nutritional supplement or alternative medication that will do the trick?

Omega-3 and omega-6 fatty acids have been publicized for cholesterol-lowering effects. Ask your health care professional for more information about fish oil supplements that may help to reduce cholesterol.