Cholesterol Archive

Treating heart disease is expensive. Adopting heart-healthy habits can save money as well as lives.

If you exercise, eat right, and follow other heart-friendly habits, you're probably less likely to end up in the hospital with a heart problem. And — no surprise here — that translates to far lower health care costs. The average hospital charge for a heart operation or related procedure is about $85,000 (see "The price of treating heart disease").

A recent report shed light on the magnitude of the savings realized from heart disease prevention strategies. The study, published in the Feb. 1, 2017, Journal of the American Heart Association, focused on Medicare claims for more than 6,200 people over age 65. Health care costs were about $5,000 less per year in people with the most heart-healthy factors compared with those with the least number of factors. If all Medicare beneficiaries followed five of seven key heart-healthy habits (see "Life's Simple 7") to reduce cardiovascular disease, it would save more than $41 billion a year in Medicare costs, the study authors estimated.

Research we're watching

Dietary supplements made from red yeast rice contain substances called monacolins, which are similar to the active ingredient in cholesterol-lowering statin drugs. And like statins, red yeast rice products may cause rare but serious side effects, such as muscle injury and liver damage, as noted in a study published online January 19, 2017, by the British Journal of Pharmacology.

The study, based on a review of 13 years of patient data by Italian researchers, notes that people who can't tolerate statins often take red yeast rice supplements. But there are no studies testing the safety of red yeast rice compared with statins. In the United States, the FDA considers red yeast rice products that contain more than trace amounts of monacolins to be unapproved new drugs and therefore illegal to sell. Yet dozens of these unregulated products remain on the market.

Almost one-third of older adults take statins to help lower cholesterol levels, but new guidelines and research have restarted the conversation on the role statins play in your health.

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Since they were introduced two decades ago, statins have been touted as a driving force in helping many older men reduce their risk of heart attack and stroke.

New research even suggests these drugs might treat other conditions, like Alzheimer's disease, and lower your risk of death from cancer (see "Other statin uses?").

People with an inherited form of high cholesterol, known as familial hypercholesterolemia, may be both underdiagnosed and undertreated for the condition, which can cause heart attacks and stroke at an early age.

The overall message on "bad" LDL cholesterol is much the same as it has been: Lower is better and how low your level should be depends on your cardiovascular risk factors.

But the standard for what low LDL means keeps on getting lower. While  an LDL level under 70 is still the usual goal for people at the highest risk for cardiovascular disease perhaps that is still too high.

Certain cholesterol-lowering medications—namely, ezetimibe (Zetia) and drugs known as bile acid binders—also appear to be effective at lowering cholesterol and reducing the risk of serious cardiovascular events. 

Research suggests that raising good cholesterol beyond a certain point doesn't offer any extra benefit for the heart.

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When it comes to cholesterol, it's mostly about the numbers. You want less of the "bad" low-density lipoprotein (LDL) cholesterol and more of the "good" high-density lipoprotein (HDL) kind. This combination is often associated with a lower risk of cardiovascular disease. Sounds simple—and it is, for the most part. But while most attention is spent on driving down bad LDL, you still have to keep your eyes on the good HDL, as some research suggests that after a certain threshold, higher levels don't offer extra protection.

The role of cholesterol

The ideal numbers

Fasting for eight to 12 hours before a cholesterol test doesn’t seem to be necessary. But for now, people should continue to follow their physicians’ advice on this matter.

What to do when routine test results are at the high or low end of the acceptable range.

Catching early changes in blood work may help prevent chronic disease, such as diabetes. 
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As a smart medical consumer, you know it's important to look over the results of your routine blood work, even when the numbers are all within the normal range. But what if you notice that some results are at the high or low end of that range? Should you be concerned about this?