Wednesday, March 2, 2011

Breaking Down the Good, the Bad and the Ugly of Cholesterol

In the world of heart health, cholesterol is a dirty little word. If it’s too high, doctors cringe. If it’s too low, doctors cringe. There’s LDL, HDL, triglycerides, good cholesterol, bad cholesterol -- what does it all mean? We asked Dr. Nikki Waddell, an internist on Sentara Potomac Hospital’s medical staff, about the good, the bad and the ugly of cholesterol and here’s what she said:

Q. What is cholesterol and why is it so bad?
Dr. Waddell: Cholesterol is a waxy substance in your bloodstream that your body needs to produce cell membranes and some hormones. However, too much cholesterol in your system greatly increases your risk for heart disease and stroke because it forms a thick plaque in your arteries that may block blood flow to your heart or brain.

Q. What’s the difference between good and bad cholesterol?
Dr. Waddell:
HDL is considered good cholesterol because high levels of HDL may protect against heart disease. Conversely, high levels of LDL, or bad cholesterol, increase heart disease risk because LDL is what causes plaque build-up in the arteries. So, the goal is to have a high number when measuring HDL and a low number when measuring LDL.

Q. How do I know if my HDL and LDL measurements are too high or too low?
Dr. Waddell: Your doctor will explain your cholesterol test results and what you can do to improve your numbers, but the current guidelines are: total cholesterol should be less than 200; LDL (bad) should be less than 100; HDL (good) levels above 60 give some protection against heart disease; and triglycerides should be less than 150.

Q. What are triglycerides?
Dr. Waddell: Triglyceride is a form of fat that’s made in the body. Many people who have elevated triglyceride levels also have high cholesterol. Most people with heart disease have high triglyceride levels – commonly due to obesity, smoking, low physical activity or a high cholesterol diet.

Q. How can you lower your cholesterol and triglyceride levels?
Dr. Waddell: The best way to lower cholesterol is by making permanent changes to your diet. You should discuss low cholesterol diet options with your doctor – he or she may refer you to a nutritionist or another healthcare professional to help you make the best nutritional choices. Another great source for those who wish to change their diet is the American Heart Association (

Q. So, all I have to do is eat right?
Dr. Waddell: Well, not exactly. While good nutrition plays a vital role in good health, regular exercise for weight control is equally as important. It’s recommended that everyone exercise for at least 30 minutes on most days. Taking a brisk, 30-minute walk every day will not only improve your cholesterol, it will provide many other health benefits as well.

For most people, changes in diet and exercise are enough to bring your cholesterol down to a reasonable level, but for some, medication may be needed. Either way, making sure your cholesterol is at a desirable level is the smart thing to do.

To find out more about Sentara Potomac Hospital physicians, please call our Health Connection at 703-221-2500 or online at