September is designated National Cholesterol Education Month by the National Heart, Lung and Blood Institute (NHLBI).  It is a good time to learn about cholesterol and lipid profiles, to get your blood cholesterol checked, to take steps to lowering it if it is high, and to learn about food and lifestyle choices that can help you reach your personal cholesterol goals.

High blood cholesterol affects over 65 million Americans and I am one of those people...so are each of my parents.  In July, my rheumatologist prescribed a statin medication (a cholesterol-lowering drug).  Often genetic, high cholesterol is a serious condition that increases one’s risk for heart disease.

The higher the cholesterol level, the greater the risk for developing cardiovascular disease.  In RA patients, that increased risk may even be more significant.  We already know that just living with rheumatoid arthritis raises your risk of heart disease two to three times.

What is Cholesterol?

Cholesterol is a soft, waxy substance among the lipids (fats) found in the bloodstream and in all body cells. It is used to form cell membranes, produce hormones, and for other bodily functions.  Fats, including cholesterol, cannot dissolve in blood and are transported by lipoproteins.  Too much cholesterol in the blood (hypercholesterolemia) is a major risk factor for coronary heart disease.

Before having your blood drawn for a cholesterol check, do not eat any food.  Drinking water is ok, but food will skew the test results.  In the United States, cholesterol levels are measured in milligrams per deciliter (mg/dL) of blood.  In Canada and the UK, they are measured in millimoles per litre (mmol/L).

High-Density Lipoprotein (HDL) or “Good” Cholesterol

Where “good” cholesterol is concerned, higher is better.  HDL levels in the average man range 40-50 mg/dL. In the average woman, they range 50-60 mg/dL.  A low HDL level, which is less than 40 mg/dL for men or less than 50 mg/dL for women, increases the risk of cardiovascular disease.  Conversely, an HDL cholesterol of 60 mg/dL or higher gives some protection against heart disease.

Increasing physical activity and losing weight can help to raise HDL levels.

Low-Density Lipoprotein (LDL) “Bad” Cholesterol

We want to get our “bad” cholesterol levels as low as possible.  The lower the level, the lower the risk of heart attack and stroke.  The American Heart Association states that LDL cholesterol is a better gauge of risk than total blood cholesterol.

  *  less than 100 mg/dL is optimal ( < 2.59 mmol/L)
  *  100-129 mg/dL is “near optimal” (2.59-3.34 mmol/L)
  *  130-159 mg/dL is borderline high (3.37-4.12 mmol/L)
  *  160-189 mg/dL is high (4.15-4.90 mmol/L)
  *  above 190 mg/dL is very high ( >4.92 mmol/L)