A Heart-to-Heart with a Canadian Endocrinologist on Heart Disease

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(NC) Dr. Stephanie Kaiser, endocrinologist, Queen Elizabeth II Health Sciences Centre answers patients' questions on cholesterol and heart disease.

Q: I have been told I have high cholesterol, but I'm not even sure what cholesterol is, please explain.

A: Cholesterol is a soft, fat-like substance found in the body's cells and bloodstream. Excess cholesterol in the blood can settle on the inside of the blood vessels. Over time, fatty deposits called plaque build up in the blood vessels, clogging them so blood can't flow properly. This narrowing of arteries can increase your risk of having a heart attack and/or stroke.

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Q: My doctor has mentioned LDL and HDL when referring to cholesterol, what does this mean?

A: LDL, which stands for low-density lipoprotein, is the major cholesterol carrier in the blood. LDL cholesterol is often called the "bad" cholesterol because it can build up in artery walls, causing them to harden and narrow. HDL or high-density lipoprotein transports cholesterol to the liver, where it may be broken down and excreted by the body. HDL is often called "good" cholesterol because higher levels are associated with a lower risk of heart disease. LDL and HDL combined make up your total cholesterol.

It's important to also know your ratio of total cholesterol to HDL. The Canadian cholesterol guidelines indicate a low risk patient to be less than 6.0, a moderate risk patient to be less than 5.0, and a high risk patient to be less than 4.0.

Q: How can I lower my cholesterol?

A: Diet and exercise are the two recommended ways to lower cholesterol. However, if these lifestyle changes are not enough to meet target levels as recommended in the Canadian cholesterol guidelines after three months, the addition of cholesterol-lowering medication is recommended. Statins, such as Crestor

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