As you likely know, cholesterol levels are directly linked to heart disease risk, and the higher your cholesterol, the higher your risk. While there is a genetic component to serum cholesterol that is out of your control, there are still some ways you can lower your cholesterol. The first is simply knowing your numbers.

Start by planning to get your cholesterol checked during Memorial Regional Health’s March into Health event — an annual offering of low-cost lab tests and health screens. If you learn your cholesterol is above 200, it’s time to take action. According to the Mayo Clinic, total cholesterol levels should ideally be below 200 mg/dL. Borderline high runs from 200-239 mg/dL, and high cholesterol is 240 mg/dL or above.

According to Harvard Health, approximately 14 percent of Americans fall into the high category. By taking medication and/or making dietary and exercise changes, you can lower your cholesterol levels. Harvard Health states that, for every 10 percent drop in your cholesterol level, you decrease your risk for a heart attack by 20 to 30 percent. That, alone, makes it worth the effort.

Routine lab tests measure total cholesterol, HDL and triglyceride levels. The LDL cholesterol number is then calculated from those. The goal is to keep your LDL, or bad cholesterol level, low, and boost your HDL, or good cholesterol level, as best you can.

Lifestyle changes to lower cholesterol

Eating a healthy diet that is low in salt; high in fruits, vegetables and whole grains; high in good fats — including healthy oils, nuts and seed — and limited in animal fats helps lower your LDL. Other ways to lower your LDL cholesterol are maintaining a healthy weight, drinking in moderation and not smoking. High blood pressure also plays a role in heart disease.

“Exercise and surprisingly, alcohol — as in 2 ounces of hard liquor or eight ounces of wine each day — are two ways to raise your good HDL cholesterol,” said Dr. Gerald Myers, MRH cardiologist. “Exercise also helps the heart cope with the effects of coronary artery disease.”

How cholesterol creates plaque

You may wonder how cholesterol and heart disease are related. Cholesterol is a waxy substance that transports the fats in your blood. Your body produces some cholesterol. Other cholesterol you get from food. Some cholesterol is beneficial, but too much can help create fatty deposits in your blood vessels. These deposits are called plaque. As plaque builds up, it blocks your arteries and limits blood flow to your heart, brain and other vital organs.

“With less than a 70 percent narrowing of blood vessels, the heart is capable of extracting enough blood to meet its needs, so there are no symptoms related to heart disease. Beyond 70 percent, people experience symptoms, usually during times of extreme stress,” Myers said.

According to the Mayo Clinic, heart disease due to plaque build-up in your arteries can cause shortness of breath, chest tightness, pressure or pain, pain or numbness in your arms and legs, and pain in your back, abdomen, throat, jaw and neck. If you experience any or some of these symptoms, your doctor might recommend a nuclear stress test, which can be done at MRH.

“We used to think that the formation of plaque was solely based on cholesterol causing the deposition of fat along the inner lining of blood vessels. Now, we’ve learned that almost 50 percent of the time, it’s due to systemic inflammation. Inflammation promotes the formation of plaque. That means if you have a chronic inflammatory process, such as rheumatoid arthritis, lupus, allergies and asthma, your risk for heart disease may be greater,” Myers said.

The genetic equation to cholesterol

Myers also suspects individuals are genetically programmed to produce certain levels of cholesterol in their blood. If that’s the case, consuming less cholesterol-rich food would not be effective in keeping the levels low, since your body will tend to make up the difference by manufacturing more internally. That’s where medication comes in.

“I call it your body’s ‘cholesterolstat’, like a thermostat or a rheostat,” Myers said. “It’s the level of cholesterol that your body naturally seeks to maintain. Statins are unique medications that block the body’s ability to manufacture cholesterol in the liver. That’s how they help lower the levels.”