Lowering LDL cholesterol to reduce heart risk
August 5, 2021
About 80% to 90% of cardiovascular disease is preventable. Treating abnormalities of cholesterol production and metabolism becomes the foundation of prevention guidelines.
Here are answers to some common questions about high cholesterol, prevention and treatment.
Who is at risk for high cholesterol and when should they get treatment?Many patients come to my clinic because someone in their family had a heart attack, stroke or premature death and they want to prevent the same thing from happening to them. People who smoke, or who have diabetes or high blood pressure, often come to the clinic if they can’t tolerate statins to lower their cholesterol. Also, we see patients who already had a heart attack or stroke and still need additional treatment of their cholesterol abnormalities to achieve their lower cholesterol goals. A patient who has had a heart attack or stroke is considered very high risk and is treated to achieve a very, very low LDL cholesterol level.
Is high cholesterol genetic?We see patients who have inherited high cholesterol, known as familial hypercholesterolemia (FH). This is a genetic disorder that causes a defect in the way LDL cholesterol is cleared from the blood, and leads to early heart disease. FH is inherited as a dominant gene, and patients’ parents, siblings and children should be screened as they each have a 50/50 chance of having the same defect. Once diagnosed, it important for patients — even children — to start cholesterol-lowering treatment.
What is cholesterol?Cholesterol is a fat that is an essential molecule for life. Our bodies require cholesterol to develop cell membranes and important life sustaining hormones. Although we now know the negative impact high cholesterol can have on us as adults, it is essential in developing cells. We are born with very low levels of cholesterol (less than 100), and the high cholesterol levels we see in adults represent an excess of cholesterol. We can live longer and healthier lives with low levels of cholesterol, and that becomes our goal for treatment.
What’s the difference between HDL and LDL cholesterol?Most people refer to HDL cholesterol as the good cholesterol and LDL cholesterol as the bad cholesterol, but that may be overly simplistic. High HDL cholesterol is associated with increased risk of atherosclerosis, which can lead to heart attacks and strokes. However, LDL particles usually carry the largest percentage of cholesterol, and therefore are most responsible for the development of atherosclerosis. Lowering LDL cholesterol is by far the most proven, and generally easiest, way to reduce risk of heart disease.
Who needs to be aware of their cholesterol level?Everyone should keep an eye on their cholesterol. However, statistically, African Americans have some of the highest rates of heart disease, and studies have shown they are an undertreated population for prevention of heart disease and strokes.
What is your expertise in this area?As a clinical cardiologist for more than 30 years, my job is to prevent cardiovascular disease. I realized after practicing cardiology for many years that the ability to successfully treat abnormal levels of cholesterol and lipids was of paramount importance. I was one of the first physicians in the country to receive Diplomate status with the Accreditation Council for Clinical Lipidology (ACCL), and I also was named a Clinical Lipid Specialist by the National Lipid Association. Currently, my practice is at the Center for Advanced Care at UChicago Medicine Orland Park, specializing in preventive and noninvasive treatments for a wide range of heart conditions, including high cholesterol.
Cardiologist Kathleen Drinan, DO, leads the Lipid Clinic at UChicago Medicine. To make an appointment, call 1-773-702-9461.
Kathleen Drinan, DO
Kathleen Drinan, DO, FACC, FACOI, is a highly skilled clinical cardiologist with over 30 years of cardiac experience. Dr. Drinan is trained in preventive and non-invasive treatments for a wide range of heart conditions, including understanding the difference between heart disease in men and women.Learn more about Dr. Drinan
University of Chicago physicians are world renown for their research into cholesterol and the genetics of lipid disorders, or high cholesterol problems that run in families. Lipid Clinic physicians offer specialized tests to evaluate suspected lipid disorders, including familial hypercholesterolemia.Learn more about our lipid clinic
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