High cholesterol, or hyperlipidemia, runs in the Dean Mastrojohn family. When the Maywood, New Jersey resident’s doctor encouraged him to make some lifestyle changes to reduce his risk, he took the guidance seriously.
“My doctor – the same one my parents have – kept an eye on me and urged me to lose weight and exercise as much as possible to avoid medication,” said Mastrojohn, 47, senior vice president at Goodfuse. a communications company in New York City. “I lost nearly 20 pounds and exercised regularly – lifting weights, playing pickup basketball games, etc. – and was very fit.”
But after losing the recommended amount of weight to control his cholesterol, Mastrojohn received surprising news: his LDL (“bad”) cholesterol and triglycerides were up.
“It was right there [my doctor] told me my condition was clearly genetic and he strongly suggested that I start taking a statin, ”says Mastrojohn. “I’ll never forget it. I couldn’t believe it.”
What Causes High Cholesterol?
For anyone diagnosed with high cholesterol or recommended by a doctor to lower their numbers, the information can be overwhelming.
Cholesterol is a waxy substance in the blood that is used to build healthy cells, but when levels get too high – due to poor diet and other lifestyle habits, existing medical conditions, genetics (as in the case of Mastrojohn), or a combination of these factors – that Risk of heart disease increases. This is because high cholesterol levels cause fat deposits in the blood vessels that over time narrow and suddenly stop blood flow to the arteries to form a clot, causing a heart attack or stroke.
The Centers for Disease Control and Prevention recommends keeping your total cholesterol levels below 200 milligrams per deciliter (mg / dL).
“Cholesterol is the sum of LDL cholesterol, HDL (“good”) cholesterol, and triglycerides, calculated using a formula, ”explains Robert Greenfield, MD, cardiologist, lipidologist, and internist at the MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, California. “Knowing every component of total cholesterol is important because knowing total cholesterol – especially if it’s high – doesn’t tell why it’s high, which is so important when planning a treatment strategy.”
How to treat high cholesterol
Dr. Greenfield says there is no single approach to treating high cholesterol patients. “I see high cholesterol all the time and every day,” he says, and each case needs to be assessed individually.
A cholesterol treatment plan takes into account a variety of factors including age, lifestyle, and personal and family history. In addition to diet, exercise, and weight, your doctor will consider other habits such as smoking and alcohol consumption.
Eating a heart-healthy diet and exercising plan is always part of a high cholesterol treatment, says Greenfield. “But if a person is at high risk, for example with a history of the heart or risk factors like diabetes or high blood pressure, the medication should be started along with lifestyle changes,” he says.
When lifestyle changes are not enough to lower cholesterol
Mastrojohn was stunned when his doctor informed him that his cholesterol levels did not reflect the efforts he had put into changing his lifestyle. “After all the hard work, I was shocked when I was told my condition was worse,” he says.
He had followed the doctor’s instructions to exercise as much as possible. Mastrojohn had started running and walking more and generally kept moving. “I used to go to the gym regularly and I lost weight,” he explains. “I was always athletic, from elementary school to college, and played several sports, but honestly, I was never particularly thin – and I wasn’t terribly overweight either.”
Experts often cite weight as a possible risk factor for high cholesterol levels. The American Heart Association (AHA) says that being overweight or obese can raise bad cholesterol and lower good cholesterol, and a 5 to 10 percent weight loss can help improve those numbers. But there are other factors that contribute.
“It’s not just about losing weight; it’s the makeup of your diet, too, “said Nieca Goldberg, MD, medical director of the Women’s Heart Center at NYU Langone and radio host of Beyond the Heart on Doctor Radio SiriusXM. “A good example is the keto diet. It is effective for weight loss, but because it is high in saturated fat, it can increase LDL cholesterol. “
Dr. Goldberg recommends a Mediterranean diet with little red meat and sweets; focuses on plant-based foods; and contains healthy fats that are rich in omega-3 fatty acids, such as olive oil and fish.
Cholesterol Lowering Drugs: A Necessary Next Step
Since weight loss and exercise weren’t enough to determine Mastrojohn’s cholesterol levels, medication was the next step.
According to Greenfield, statins are the most widely prescribed drug used to treat high cholesterol and can help people who have been unable to lower their numbers through lifestyle changes alone.
“Although some people fear drugs, the drugs we have today are safe and life-saving,” says Greenfield.
Medication wasn’t an instant, easy solution for Mastrojohn, but after some trial and error, he found the right drug for his health needs. “I actually had to change my medication a couple of times due to some side effects like muscle pain, but recently I found one that wasn’t causing me any problems,” he says. “The drug has a huge impact on my cholesterol. I am now in a normal, acceptable range. “
Go for good heart health
Ten years after starting the medication, Mastrojohn is effectively managing his numbers and maintaining his healthy habits.
Greenfield agrees with this approach. “Today’s drugs are so good that they can return to normal [a person’s] Cholesterol levels per se, but good lifestyle [habits]that include eating a healthy diet, getting enough exercise, getting enough sleep, and reducing stress should always be included. ”In addition to lowering cholesterol, a healthy lifestyle has many other health benefits, he adds.
In addition to sticking to the exercise routine his doctor suggested, Mastrojohn recently added a new walking regimen that has made a huge difference in his overall health and wellbeing.
“I’ve been working from home since March 2020 and I knew I couldn’t sit inside all day without moving,” he says. “My daily commute from New Jersey to New York City was a lot of exercise – walking to the office, running to catch a subway – but the pandemic changed all of that.”
Mastrojohn’s goal is to run 5 miles a day at least four days a week, and he’s stuck to it. “I’m usually outside for 1.5 hours every time I walk, in rain, sun, snow, sleet and hail,” he says. “It’s hard to tell how walking affected my numbers and the medication, but it gave me so much more energy and it definitely doesn’t hurt my numbers – it probably just helps!”
According to the Cleveland Clinic, aerobic exercise like walking increases HDL cholesterol and lowers triglycerides; When combined with weight loss and a healthy diet, it can also help lower LDL cholesterol. The AHA recommends at least 30 minutes of aerobic exercise most days of the week.
“Walking is a great exercise because it’s aerobic, easy, and accessible. You don’t need a gym, ”says Goldberg. Other options she suggests are running, swimming, and dancing.
Dealing with cholesterol is a lifelong process
Mastrojohn knows his cholesterol management will be a lifelong process, but it’s a process he’s invested heavily in. He takes his medication regularly and has blood tests done every six months to make sure his levels stay within an acceptable range.
“I know a lot of people shy away from taking medication every day like I was, but some things are out of our control and you just have to do what you have to do,” he says. “I am grateful that these drugs exist to extend people’s lives.”
Mastrojohn hopes that others can learn from his experiences and continue to educate themselves in order to stay healthy. “The problem with high cholesterol is that you don’t really” feel “it, and unfortunately some people notice it when it’s too late,” he says. “It doesn’t matter if you are thin, overweight, in shape or out of shape – it can happen to anyone.”
Mastrojohn knew early on that he had to monitor his cholesterol levels based on family history, and he encouraged others to do the same. “I can’t emphasize this enough, especially if you know you have high cholesterol in your family: visit your doctor regularly, get checked-up and treat accordingly,” he says. “And move, move, move. Do not be sedentary! I’m not only doing this for myself, but also for my family. “