Page 10 - Valley Life & Health

10 SATURDAY, APRIL 27, 2019 THE MORNING CALL

WHAT YOUR

HDL cholesterol

IS TELLING YOU — AND HOW TO CHANGE IT

f you’re one of the 102 million Americans diag- risk factor for cardiovascular mortality. So when “Dyslipidemia is not just based on any single
nosed with high cholesterol, it’s likely that your someone has a very low amount of good choles- number like LDL cholesterol alone, but that’s all
Iphysician has spoken to you about managing your terol in the setting of elevated bad cholesterol, you hear about – ‘My LDL was this high,’ or, ‘My
LDL (low-density lipoprotein), the “bad choles- the risk of dying from a cardiovascular disease is triglyceride was this high.’ Triglyceride reduction has
terol” that can lead to buildup in your arteries. As substantially high.” not shown any independent benefit to cardiovascular
a result, you may have been less concerned about Let’s back up to the basics: Blood cholesterol mortality,” Dr. Gangar explains.
your HDL (high-density lipoprotein), which acts as can be used to estimate an individual’s risk for heart
a cleanser of sorts and removes cholesterol from disease, which involves looking at the ratio of total Statins: The cholesterol-lowering drugs
the arteries, delivering it to the liver for elimination cholesterol level to the level of HDL. Total cholesterol Of the 102 million Americans with high choles-
from the body. includes not only LDL and HDL levels, but also ac- terol, more than 73 million of them meet the guide-
It seems simple, right? The directive to lower counts for levels of triglycerides and VLDL (Very Low lines that suggest their cholesterol could potentially
your cholesterol means lowering the overall number. Density Lipoprotein) – calories consumed that are be lowered by taking a statin. Statins are drugs that
Not so fast. There are a number of reasons burned off and are instead converted into fat. work by primarily lowering bad cholesterol as well as
why cholesterol treatment isn’t ‘one size fits all.’ The An easy way to determine your heart health risk is moderately increasing HDL , thus reducing vascular
focus, says Jinal Gangar, MD, MPH at Steward Medi- to use the ASCVD (Atherosclerotic Cardiovascular events – and are part of the complexities of medicine
cal Group’s Easton Hospital, should primarily be on Disease) Risk Calculator, which was developed as where there is a bottomless pit of research and
reducing cardiovascular mortality. a companion tool to the 2013 American College of refined clinical questions put into them.
“There is more consistency, more clinical trials, Cardiology/American Heart Association Guideline on As with any prescription, taking a statin as
and more focus on the LDL. Once we lower the the Assessment of Cardiovascular Risk. The calculator a primary prevention should be a collaborative,
LDL, you have a mortality benefit. Anything in includes age, sex, race, total cholesterol, HDL choles- personalized decision between doctor and patient,
medicine that has a mortality benefit is your top terol, systolic blood pressure, blood pressure lowering
priority,” says Dr. Gangar. “HDL is an independent medication use, diabetes status, and smoking status. HDL CHOLESTEROL PAGE 11