What do I need to know about lowering my cholesterol

The Doctor’s Note: Cholesterol: know your number, know your risk

Did you know elevated cholesterol contributes to nearly half a million heart attacks annually? That is a staggering number. For most of us, heart attacks and stroke can be prevented and our overall quality of life improved and lengthened with a balance of diet, exercise and treatments. Prevention starts with knowing your number and your risk.

For the most accurate results, work with your primary care provider to get a cholesterol, or lipid panel, test done in a lab. This will allow for you to know the total cholesterol and break down of good and bad cholesterol, as well as triglycerides (fats). After getting your cholesterol/lipids lab, your doctor should discuss your results with you.

When getting ready for lipid testing, avoid all food and drink (except water) for 10-12 hours prior to the testing. You’ll also want to avoid overly strenuous exercise prior to testing since this can cause a falsely elevated HDL (good cholesterol).

Based on your numbers, your doctor also will want to discuss your heart disease and stroke risk factors. Your risk can be low, moderate or high depending on several factors. Some of the common risks are smoking, lack of exercise and poor diet. Another risk factor could be your family history. For example, if your father, mother, brother or sister had a heart attack or stroke, your risk can be high. Additional risks include your age and gender.

The good news is you can change a few of your risks by adopting healthier behaviors:

  • Exercise
  • Eat right
  • Maintain a healthy weight
  • Quit smoking
  • Reduce stress
  • Take medication as prescribed

In the past, some of my patients were curious about home cholesterol testing kits. My recommendation is to not bother with home testing for cholesterol because you really need to know the overall cardiovascular risk. Cholesterol is not like blood sugar; it does not fluctuate that much and does not need monitored like blood sugar in people with diabetes. The home cholesterol tests don’t provide enough detail to glean health risks.

Cholesterol has been linked to heart attack and stroke risk for many years. We used to talk more about raising HDL as a way to improve your risk. While this is still important, more recent evidence shows it is just as important to lower LDL (bad cholesterol), and to do this aggressively in higher risk patients.  Patients with diabetes, hypertension, family history and/or prior known heart attacks or strokes will be higher risk and likely need more aggressive treatment.

Remember: Know your number. Know your risk. Knowledge is power!

  • Total cholesterol: Less than 200 is desirable
  • Triglycerides: Aim for less than 150
  • LDL: Less than 100 is optimal
  • HDL: Men should aim for above 40 mg/dl, Females should aim for above 50 mg/dl

Reliable resources to obtain additional information about this and similar topics can be found at Consumer Reports, the American Heart Association, and the National Heart, Lung and Blood Institute.


Daryl Callahan, D.O., joined BCBSKS in 2017 with 28 years of experience in the medical profession. He is board certified in family practice, and served as a family physician at the Phillips County Hospital and physician partner of HealthCare Associates Medical Center in Phillipsburg. Dr. Callahan served 30 years in the National Guard. He retired as a colonel and was the state surgeon for the Kansas Army National Guard.

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