75-year-old Kathleen Davister says her high cholesterol was caught during an annual physical more than 25 years ago. She was put on a statin, medication that lowers the level of cholesterol in the blood by reducing the production of cholesterol by the liver. She recently asked her doctor if she could cut back on her medication.
“My doctor told me no, it could creep back up,” Kathleen says. “Also, I have a history of migraines and high cholesterol, so I am a prime candidate for stroke or heart attack.”
Kathleen’s cholesterol is under control – now. But when it wasn’t, she had no signs or symptoms of a problem.
No Symptoms
Kathleen is a patient of Dr. Seth Vining at Atrium Health Primary Care Carolina Lakes Internal Medicine. He says you won’t necessarily feel sick if your cholesterol numbers are up.
“You usually don’t have symptoms that indicate your cholesterol is too high. The only way to know is to get a blood test to see what your cholesterol level is,” Vining says. “One of the thoughts of heart disease is when we are born, we have perfect hearts and perfect vessels and then as we get older, we have these injuries to the blood vessels. Every time there is an injury to the vessel the body tries to fix it. Cholesterol in your blood creates plaques on the blood vessels. These plaques can rupture which causes heart attacks and strokes. Cholesterol lowering medication reduces these plaques, as well as stabilizing them from rupture.”
No Magic Number
Your body has two types of cholesterol, high density lipoprotein (HDL) and low-density lipoprotein (LDL). HDL is good cholesterol, with 60 milligrams per deciliter (mg/dL) and higher the better. LDL is referred to as bad cholesterol. So, a lower LDL count is better, meaning a healthy range is 100 or lower. But Vining says there is no magic number that determines if a patient needs a statin or not. It’s based on the individual’s overall health and requires unique attention to figure out the best decision for each patient, like Kathleen.
“Someone who is 40 who doesn’t smoke, doesn’t have high blood pressure, doesn’t have diabetes and is otherwise healthy except their cholesterol is high…their risk is lower compared to someone who is 65 with diabetes and who is a smoker,” says Vining. “You want to be more aggressive with that second person’s cholesterol than the first person,” Vining explains. “So that 40-year-old who has no other health problems, they may be okay with an LDL of near 150, whereas the 65-year-old with diabetes and tobacco use is more at risk with an LDL of 150.”
Prevention is Key
Living a healthy lifestyle will help keep your cholesterol in a healthy range. According to the Centers for Disease Control (CDC), make healthy food choices. Limit saturated fats and eat more fruits and vegetables. In addition, maintain a healthy weight, exercise, quit smoking and limit alcohol. Vining says those ages 35 to 40 should start getting screened anywhere from one to every five years, and at least every five years. And if you are prescribed medication, stay on it. By putting patients like Kathleen on a statin, it reduced her risk of heart disease by 25%.
“The management of high cholesterol in older adults still represents a challenge for primary care physicians because high cholesterol does not cause any symptoms,” Vining says. “It can be difficult for someone to understand why lowering their cholesterol is beneficial for them.”
Kathleen agrees it’s important to be proactive, especially in her golden years. Periodic check-ups with Vining are vital in keeping her cholesterol numbers in check.
Primary care is your first step to good health. From everyday concerns and preventive care to urgent or unexpected issues, primary care providers help you feel your healthiest now and for years to come. We have internal medicine doctors who specialize in adult primary care and family medicine doctors who provide primary care for all ages. Call us 24/7 at 1-844-235-6997 or make an appointment online.
