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Good and Bad Cholesterol: What You Need to Know  

Dec. 8, 2014
Health, Medical Costs
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The good, the bad and your heart are the three main concepts you have to keep straight to understand cholesterol and its potential risk to your heath.

What is cholesterol?

Cholesterol is a waxy substance composed mainly of fat and protein. It’s necessary for producing hormones and vitamin D and aiding in digestion. But like many things in life, too much can be bad for you. In this case, high levels of the wrong kind of cholesterol can increase greatly your risk for a heart attack or stroke.

Cholesterol, which is found in foods we eat and made by the body as well, travels through your bloodstream in tiny bundles called lipoproteins.

The difference between LDL (bad) and HDL (good) cholesterol

Low-density lipoproteins, known as LDLs or “bad” cholesterol, tend to stick to the walls of the arteries as plaque, which over time chokes off blood flow to the heart. That is a condition known as coronary artery disease — which can cause a heart attack or stroke, according to the National Heart, Lung and Blood Institute.

However, high-density lipoproteins, or HDLs, are considered “good” bundles and carry cholesterol to your liver, which removes it from your body and actually helps to prevent plaque buildup in your arteries.

What’s the ideal cholesterol level?

Your cholesterol level, assessed through a simple blood test after fasting, provides a snapshot of the relative amount of good and bad cholesterol in your system. A combined level of less than 200, a measure of milligrams of cholesterol per deciliter of blood, is considered best. The National Institutes of Health says an LDL (bad cholesterol) level of less than 100 is optimal while an HDL (good cholesterol) level of more than 60 is seen as ideal.

Why is high cholesterol dangerous?

Cholesterol is considered a silent killer—there are normally no symptoms tipping you off that it’s too high until the resulting plaque sparks a coronary event, such as a heart attack. Some 50 million people in the United States are afflicted with high cholesterol, the Harvard Medical School estimates. Men over the age of 45 and women 55 and older are considered at higher risk, according to the NIH.

The Centers for Disease Control and Prevention says major factors that can cause a spike in LDL, or bad cholesterol, include smoking cigarettes, a poor diet, diabetes, a lack of exercise and your genes—since heredity and family history does play a role.

How to control your cholesterol levels with lifestyle

The ideal way to control your cholesterol level is to take control of your diet by avoiding foods high in cholesterol and saturated fat. Exercising regularly and keeping your weight down also are key factors in lowering bad cholesterol and raising good cholesterol levels.

Medications for high cholesterol

If diet and exercise alone are not enough for achieving ideal cholesterol levels, a physician may decide to prescribe medication, known as statins, which normally bring the condition under control. Brand names include Lopid, Crestor and Lipitor. However, brand-name statins can cost in excess of $500 a month, Harvard Health Publications reports. Many, though, are available in generic forms that cost $12 a month or less.

Health insurance and your cholesterol medications

If you are prescribed cholesterol-lowering medication, a good health insurance plan can assure your monthly out-of-pocket costs remain reasonable—in the $5 to $25 range, even in the case of brand-name products. That’s important, because having options matters. Depending on your body chemistry, some statins will work better than others and have fewer side effects, which can include rare but serious muscle, kidney and liver problems.

Depending on your risk factors, you may need to have your blood tested periodically to monitor cholesterol levels as well as a statin’s effect on your body. Also pay attention to any side effects while taking the medication.

Given the very real risk high cholesterol poses, it simply makes sense to get your levels checked. The American Heart Association recommends doing so beginning in your 20s, to establish a baseline, and rechecking every four to six years.

The bottom line: Ignorance may be bliss, but in the case of cholesterol, it can prove to be deadly.

Image of good vs. bad via Shutterstock.