What is the connection between high cholesterol and heart disease? It seems that every other commercial on TV promotes a new miracle cholesterol-smashing solution. But what does science and experience tell us? Let’s take a few minutes to sort out the facts – and dispel the myths – about the impact of elevated cholesterol on our hearts, our health, and living a longer life.
Identifying the Root Causes of High Cholesterol
According to the U.S. National Library of Medicine, cholesterol is a waxy substance found in every cell in the body. Without enough cholesterol, your body wouldn’t be able to produce the right hormones, Vitamin D, and other materials that make digestion possible.
However, a variety of factors may conspire to raise cholesterol to unhealthy levels. High cholesterol means the amount in the body has gone from helpful and necessary to potentially dangerous. Major causes of elevated cholesterol include:
- An unhealthy diet. The three major diet-driven risk factors are foods that contain:
o saturated fats (from animal protein)
o trans fats (commonly found in baked goods and microwave popcorn)
o foods that have a lot of cholesterol (like red meat and high-fat dairy products)
- Being overweight. Obesity can skyrocket cholesterol to unhealthy levels.
- Not enough exercise. Working out builds HDL, also known as “good” cholesterol. Inactivity has the opposite effect.
- Smoking. Smoking doesn’t just impact your lungs. It also wreaks havoc on blood vessel walls, effectively making it easier for fatty deposits to move in.
- Old Age. The aging process reduces the body’s ability to maintain healthy cholesterol levels.
- Diabetes. High blood sugar promotes another form of bad cholesterol called VLDL (very-low-density lipoprotein). High blood sugar may also harm the lining of your arteries.
When all is said and done, many of the causes of high cholesterol are within our control. It’s within our power to choose what we eat, how much we exercise, whether or to not smoke (or to quit, if we do) and whether we embrace a healthy lifestyle. (Well, we said it’s a choice – not that it’s all that easy!)
In many cases, we can stop chronic diseases like diabetes from developing. Other factors like age and genetics are out of our control. The trick is to tackle the things we can and to be mindful of the things we can’t.
How Cholesterol Paves the way to Heart Disease
Trouble starts when cholesterol reaches unsafe levels in our blood. When this happens, it begins sticking to artery walls. The more cholesterol builds up, the narrower our arteries become. This condition is referred to as atherosclerosis.
Over time, the flow of blood to the heart slows down. Since oxygen reaches your heart via your blood, your heart can be deprived of vital oxygen. You could begin feeling symptoms like chest pain. Eventually, blood flow can be totally blocked from reaching the heart. That's when heart attacks happen.
Every year, more than 17 million deaths worldwide are related to heart disease. While this is a shocking number, another statistic is more important: About 80% of heart disease deaths are preventable. Eight out of ten lives lost – that’s over 13 million deaths each year – could be avoided with proper education, lifestyle changes, and treatment.
Next, let’s consider some proven ways to lower cholesterol, avoid heart disease, and even save lives.
The Low-Down on Lowering Cholesterol
From medication to meditation, from dietary changes to exercise regimens and breathing techniques, there are many ways to reduce the risk of heart disease. If you or a loved one must manage high cholesterol, the most effective method will depend on how high your cholesterol is, your overall health and lifestyle, and hereditary factors.
Here are three approaches to consider with your care team:
1. Is medicine the best medicine?
While prescriptions and other medical approaches involving medication may not be your first choice, sometimes it’s the quickest way to get cholesterol under control. Effective cholesterol-lowering drugs have been around for decades. Popular methods include:
- Statins. This is a type of drug that prevents the liver from producing cholesterol.
- Bile acid sequestrants. These limit fat absorption from the food we eat.
- Cholesterol absorption inhibitors. These lowers triglycerides and limits cholesterol absorption
- Niacin. This is a supplement that brings down LDL (“bad” cholesterol) and triglycerides while boosting healthy LDL cholesterol. (Please note: Niacin can be purchased without a prescription, but should not be taken before consulting with your health care provider. Niacin can be effective but there can be significant side effects.)
- PCSK9 inhibitors. This class of drug assists the liver in removing LDL cholesterol.
- Fibrates. This medication is shown to lower triglycerides while building good cholesterol.
- Red yeast rice, flaxseed and garlic. These over-the-counter supplements are also gaining popularity. However, there is no convincing evidence yet that these methods are effective for cholesterol reduction. It’s best to speak with your health provider before taking any of these supplements, some of which can produce unwanted side effects.
2. Alcohol and cholesterol: think before you drink.
Can happy hour lead to a healthier heart? That depends on how often you drink, how much you drink, and to some extent what kind of adult beverages you are consuming. Let’s review the do’s, don’ts, and disclaimers before you uncork the bottle and drink to your health.
As stated above, your body produces all of the cholesterol you’ll need to be healthy. The foods you eat do not need to supply any cholesterol at all. So, the first piece of promising news is that beer, wine, and liquor don’t contain any cholesterol. However, be mindful of what you mix with your drink. For instance, sodas and sweet liqueurs can be loaded with sugar.
Let’s take a quick look at three major booze groups:
- Beer. Like other forms of alcohol, beer is free from cholesterol. However, it does contain carbs, which can elevate triglycerides. Beer also has some plant sterols, which can flush cholesterol from your system. But the amount of plant sterols are too low to have much of an impact on cholesterol.
- Liquor. Hard liquors such as vodka, gin, tequila, and whisky are not a source of cholesterol. But flavored varieties often have sugar, which along with alcohol, can trigger excess triglycerides.
- Wine. Unlike beer, which contains very low amounts of plant sterols, a plant sterol in red wine called resveratrol might be helpful for reducing inflammation and to prevent clotting. While these effects are short term, they might help boost “good” cholesterol. More research is needed, but sipping your favorite Malbec in moderation might lessen the risk for certain heart issues.
So, what does “drinking in moderation” mean? According to the National Institutes of Health, moderation means one drink a day for women and two drinks a day for men. Older adults who follow this guideline are less prone to a heart attack than seniors who drink heavily. If this limit is exceeded, drinking can wind up increasing cholesterol and triglyceride levels.
3. Heart healthy diets: Add these foods to lower cholesterol.
Much has been shared about heart-healthy diets. But if you’re short on time (or patience), just grab this shopping list:
- Oats. What you’ve heard is true: A hearty bowl of oatmeal or an oat-based breakfast cereal provides heart-healthy soluble fiber.
- Whole grains. Whole grains such as barley and oat bran also give you heart disease fighting soluble fiber.
- Beans. Beans offer many benefits. Along with being loaded with soluble fiber, they contain cholesterol-free protein and can be helpful when you’re trying to lose weight.
- Nuts. Consuming a handful of nuts every can reduce LDL (“bad” cholesterol) while providing other heart-protective nutrients.
- Fruit. Pectin-rich fruits such as apples, grapes, and citrus may help reduce LDL cholesterol.
- Fatty fish. Planning a meal around fish a couple of times a week provides healthy Omega-3 fats which can help lower bad cholesterol, lower triglycerides, and even help your heart rhythm stay normal.
- Fiber supplements. While not as tasty as naturally-occurring fiber, a couple of tablespoons of psyllium each day delivers around four grams of soluble fiber.
Check out this article for more information on developing heart healthy habits.