New York Cardiology Chief Explains How Your Cholesterol Level Affects Your Heart

Posted on: January 13, 2014

Learning About Cholesterol Can Mean Living Longer

By Robert Pilchik, MD, Chief of Cardiology at Northern Westchester Hospital

High cholesterol is a major risk factor for cardiovascular disease – including heart attack and stroke — which will affect half of all men and one-third of all women. Understanding cholesterol and its role in heart disease, and taking simple steps to achieve safe levels, are vital investments in your heart’s health and your own longevity. It’s never too early, or too late, to take charge of this key aspect of your health. What’s important is to start today.

Cholesterol is a type of fat. With all the grim news about it, you may be surprised to learn it’s naturally produced by your body, and required for essential bodily functions, such as building cells. Your second source of cholesterol is the foods you eat, mainly animal fats.

Cholesterol is carried through your body by little packages of protein and cholesterol, called lipoproteins. There are two types: high-density lipoprotein (HDL), often called “good” cholesterol; and low-density lipoprotein (LDL), often called “bad” cholesterol. Over time, if too much LDL cholesterol is circulating in your body, it starts to build up in the form of a hard structure called plaque, in the walls of arteries throughout the body, but mostly in arteries by the heart and those that feed the brain. Plaque causes artery walls to thicken – leading to a condition called atherosclerosis (ath-er-o-skler-O-sis) or hardening of the arteries. As artery walls thicken, the vessels narrow restricting the flow of oxygen-rich blood to the heart or brain. Atherosclerosis is THE leading cause of heart attacks and stroke. Here’s what happens…

If an artery becomes 100 percent blocked, blood supply is cut off, and the portion of the heart muscle that relies on that artery dies – this is a heart attack. The same process leads to a stroke, except in this case, the total blockage occurs in the carotid artery which supplies blood to the brain.

By contrast, HDL cholesterol helps the body get rid of excess LDL cholesterol. It actually neutralizes the toxicity that makes LDL so damaging to your arterial walls.

Think of it this way: LDL is a delivery truck bringing all those nasty fats to your arteries. HDL is the garbage truck that comes and takes all the bad stuff away.  

You can have dangerously high LDL cholesterol and be symptom-free. Here’s why: Plaque builds up in artery walls slowly, starting as early as age 20. But you don’t begin to develop symptoms of chest discomfort – angina – until the blood vessel is 70 percent blocked. So your vessel can be 65 percent blocked, but because it’s not causing enough restriction of the blood to the heart– you don’t know it, and neither does your doctor.

Plaque caused by high LDL is called unstable. It is vulnerable to rupture at any time, breaking open and releasing its contents into the bloodstream. Now the contents of the plaque – all that cholesterol and other fats – form a blood clot in the artery wall. And the patient instantaneously goes from let’s say, 65 percent blockage to 100 percent blockage causing a massive heart attack. One minute, the patient had absolutely no idea anything was wrong. The next minute, he’s fighting for his life.

How can you help prevent this life-threatening scenario from ever happening to you or a loved one?  Check back soon to read Part Two of this three-part series where I explain when to get tested for cholesterol, which numbers matter, and I identify healthy cholesterol ranges. In Part Three, I will offer diet and exercise recommendations for keeping your cholesterol at safe levels.

Editor’s Note:
Recover faster after heart disease…
You’ve had a heart attack or heart surgery, or you need to manage risk factors linked to heart disease, such as high cholesterol, high blood pressure or being overweight…AND you’re rarin’ to get back to your life. Our nationally recognized Cardiac Rehabilitation Program offers the “full package,” including medically-monitored exercise customized to your needs, counseling with dieticians, and support for you and your family. You will not only recover faster, you’ll learn how to maintain good heart health for the rest of your life.

Benefit from a Higher Standard of Rehab Care
Northern Westchester Hospital’s comprehensive cardiac rehabilitation program has been recognized by the American Association of Cardiovascular and Pulmonary Rehabilitation for enhancing standards of care. Read more about our Cardio-Pulmonary Rehab Program in Northern Westchester here.