Better Nutrition January 2020




The Cholesterol Question

What is high cholesterol? The answer can be confusing because it depends

on an individual’s overall health situation. Cholesterol is one of the markers

used to estimate risk for cardiovascular disease, but its impact on your

health depends on additional factors.

If you’ve already had a heart attack or stroke, or have stents, your cholesterol

status must be evaluated by a doctor. Otherwise, if you’re between the ages

of 40 and 79, there’s a formula—created by the American Heart Association

and the American College of Cardiology—to calculate whether your cholesterol

level is unhealthy.

The formula uses age, gender, race, cholesterol and blood pressure readings,

diabetes status, and smoking status to produce an atherosclerotic cardiovascular

disease (ASCVD) score. This score estimates your risk of heart disease

or stroke in the next 10 years. For example, a score below 5 means low

risk—odds of less than 5 in 100. But a score over 20 means high risk.

Depending on your ASCVD score, plus family history and other health

conditions, your cholesterol level may or may not need lowering. For example,

if your father had coronary artery disease before age 55, or your mother

did before age 65, or if you have an inflammatory disease, kidney disease,

or metabolic syndrome, risk is higher, even if the ASCVD score is low.

If a cholesterol-lowering drug is indicated, medical guidelines call for

doctors to discuss individual risk, lifestyle, ways to improve health, and a

patient’s preferences before writing a prescription.

How to Calculate Your Score

Online calculators are designed for

people between the ages of 40 and

79 who haven’t had a heart attack or

stroke and whose total cholesterol is

not above 320. The simplest one to use

can be found at

You’ll need to know:





Your total cholesterol level

Your HDL cholesterol level

Your systolic blood pressure number

Your diastolic blood pressure



Whether or not you have diabetes

Tests to determine these factors are

routinely performed during health


Photo: ivector/

8 • JANUARY 2020

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