What Is Cholesterol?
Many people are surprised to learn that cholesterol isn’t necessarily bad. In fact, it is one of many substances created and used by our bodies to keep us healthy. However, excess cholesterol can form plaque between layers of artery walls, making it harder for your heart to circulate blood. Plaque can break open and cause blood clots, putting you at risk for a stroke or heart attack.
Good vs. Bad Cholesterol?
There is good cholesterol and bad cholesterol. Too much of one type or not enough of another can put you at risk for coronary heart disease, a heart attack, or a stroke.
LDL (Bad) Cholesterol
LDL cholesterol is considered bad because it contributes to plaque, leading to a condition known as atherosclerosis. Another condition that can develop is peripheral artery disease, when plaque buildup narrows an artery supplying blood to the legs.
HDL (Good) Cholesterol
HDL cholesterol is considered good because it helps remove LDL cholesterol from the arteries. One-fourth to one-third of blood cholesterol is carried by HDL. A healthy level of HDL cholesterol has been shown to protect against heart attack and stroke.
What Is Lipoprotein(a) [Lp(a)]?
Lipoprotein(a) is a type of cholesterol-carrying particle in your blood. It looks a lot like LDL (“bad cholesterol”), but it carries an extra protein called apolipoprotein(a). This structure makes Lp(a) both artery-clogging (pro-atherogenic) and clot-promoting (pro-thrombotic).
Why Lp(a) Matters
- Independent risk factor: Elevated Lp(a) increases your risk for heart attack, stroke, and narrowing of the aortic valve (aortic stenosis)—even when your LDL is otherwise well controlled.
- Mostly genetic: About 80–90% of your Lp(a) level is inherited. Levels are generally stable throughout life and can vary by ancestry.
- Common and often silent: Roughly 1 in 5 people have high Lp(a). You can’t feel it, and a standard cholesterol panel doesn’t routinely report it—so targeted testing is important.
How Lp(a) Differs From LDL and HDL
- LDL-C measures the cholesterol carried by LDL particles. Lp(a) is a distinct LDL-like particle with apolipoprotein(a) attached.
- HDL helps remove cholesterol from arteries, but it does not offset the risk of high Lp(a).
- You can have a “normal” LDL-C and still have high Lp(a)–related risk.
Diagnosis & Monitoring of Cholesterol
Usually, there are no symptoms, so many people don’t realize their cholesterol is too high. It’s important to have your cholesterol levels checked by your doctor. When you visit, we will help you create a plan to make healthy lifestyle changes. Sometimes, medication is needed in addition to a healthy diet and lifestyle.
Understanding Your Risk
LDL cholesterol is produced naturally by the body, but many people inherit genes that cause them to make too much. Eating foods with saturated fat or trans fat increases the amount of cholesterol in your blood. If high blood pressure runs in your family, lifestyle modifications may not be enough to help lower your LDL blood cholesterol.
Prevention & Treatment
There are several things you can do to lower your cholesterol and reduce your risk of heart disease and stroke. Working with your doctor is the most important thing you can do. We can help you determine your risk and develop a health plan that will work for you.
Treatment may include:
- Lifestyle changes, such as diet, physical activity, and quitting smoking
- Knowing which fats are good and which are bad
- Understanding drug therapy options
