Heart Health Blog

You have probably had your cholesterol checked at some point during a routine physical or wellness visit. Your doctor may have mentioned terms like LDL, HDL, and triglycerides, along with a set of numbers that can be difficult to interpret without context. Understanding what those numbers mean — and why they matter — is one of the most important steps you can take toward protecting your cardiovascular health.

The Basics: What Is Cholesterol?

Cholesterol is a waxy, fat-like substance that circulates in your blood. Your body needs cholesterol to build healthy cells, produce hormones, and synthesize vitamin D. However, when certain types of cholesterol reach elevated levels, they can accumulate in the walls of your arteries, forming plaques that narrow and stiffen the vessels over time — a process known as atherosclerosis. This is the underlying mechanism behind most heart attacks and strokes.

A standard lipid panel measures four key components: total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. Each tells a different part of the story about your cardiovascular risk.

LDL Cholesterol: The Primary Target

Low-density lipoprotein (LDL) cholesterol is often called "bad" cholesterol because elevated levels are directly associated with plaque buildup in the arteries. For most adults, an LDL level below 100 mg/dL is considered optimal. For patients who already have coronary artery disease or are at high cardiovascular risk, we often target an LDL below 70 mg/dL — and in some cases, even lower.

LDL is the single most important number on your lipid panel when it comes to predicting and preventing heart disease. If your LDL is elevated, your cardiologist will work with you to bring it down through a combination of dietary changes, exercise, and — when appropriate — statin therapy or other lipid-lowering medications.

HDL Cholesterol: The Protective Factor

High-density lipoprotein (HDL) cholesterol is considered "good" cholesterol because it helps remove LDL from your arteries and transport it back to the liver for disposal. Higher HDL levels are associated with lower cardiovascular risk. Generally, an HDL level above 40 mg/dL for men and above 50 mg/dL for women is considered acceptable, though higher is better.

Regular aerobic exercise, maintaining a healthy weight, and avoiding trans fats are among the most effective lifestyle strategies for raising HDL levels.

Triglycerides: The Overlooked Risk Factor

Triglycerides are another type of fat in your blood that can contribute to cardiovascular risk when elevated. A normal triglyceride level is below 150 mg/dL. Levels above 200 mg/dL are considered high and warrant attention. Elevated triglycerides are commonly associated with obesity, poorly controlled diabetes, excessive alcohol consumption, and diets high in refined carbohydrates and sugar.

When to Get Tested

The American College of Cardiology recommends that all adults over age 20 have their lipid panel checked at least every four to six years. If you have additional risk factors — such as a family history of premature heart disease, diabetes, hypertension, obesity, or smoking — more frequent monitoring may be appropriate. If you are unsure when your last lipid panel was or have questions about your numbers, we encourage you to schedule a preventive cardiology visit so we can assess your complete cardiovascular risk profile.

Heart disease remains the leading cause of death for both men and women in the United States. One of the most dangerous aspects of cardiovascular disease is that it can develop silently over decades, producing few or no symptoms until a serious event like a heart attack occurs. However, the body often provides subtle warning signs that something is not right. Recognizing these signs early can be the difference between early intervention and a life-threatening emergency.

1. Chest Discomfort or Pressure

Chest pain or discomfort is the most well-known symptom of heart disease, but it does not always present as the dramatic, crushing pain portrayed in movies. Many patients describe the sensation as tightness, pressure, squeezing, or heaviness in the center of the chest. It may come and go, or it may be triggered by physical exertion or emotional stress. Some patients mistake it for indigestion or heartburn. Any new or unexplained chest discomfort warrants medical evaluation — do not wait to see if it goes away on its own.

2. Shortness of Breath

If you notice that you are becoming winded during activities that previously did not cause you difficulty — such as climbing a flight of stairs, walking across a parking lot, or carrying groceries — this could be a sign of underlying heart disease. Shortness of breath can occur when the heart is not pumping efficiently enough to meet the body's oxygen demands, or when fluid is backing up into the lungs due to heart failure. Shortness of breath that occurs while lying flat or that wakes you from sleep is particularly concerning and should be evaluated promptly.

3. Unusual Fatigue

Persistent, unexplained fatigue — especially if it represents a change from your normal energy level — can be an early indicator of heart disease. Women, in particular, are more likely than men to experience fatigue as a primary symptom of cardiac problems. If you find yourself exhausted after routine activities or unable to get through the day despite adequate sleep, it is worth discussing with your cardiologist.

4. Heart Palpitations or Irregular Heartbeat

Occasional heart palpitations — the sensation of your heart racing, fluttering, or skipping beats — are common and often harmless. However, frequent or sustained palpitations, especially when accompanied by dizziness, lightheadedness, or fainting, may indicate an arrhythmia such as atrial fibrillation. Untreated atrial fibrillation significantly increases the risk of stroke and heart failure. If you are experiencing recurrent palpitations, an evaluation with an electrophysiologist can determine whether treatment is needed.

5. Swelling in the Legs, Ankles, or Feet

Edema, or swelling in the lower extremities, can be a sign that your heart is not pumping blood effectively, causing fluid to pool in the tissues. While leg swelling can have many causes — including venous insufficiency, kidney disease, or prolonged standing — new or worsening swelling should be evaluated to rule out heart failure or other cardiac conditions.

When to Seek Care

If you are experiencing any of these symptoms, do not delay seeking medical attention. For sudden, severe chest pain, difficulty breathing, or symptoms suggestive of a heart attack or stroke, call 911 immediately. For less acute but persistent symptoms, schedule an appointment with a cardiologist for a thorough evaluation. Early detection and treatment can dramatically improve outcomes for nearly all forms of heart disease.

Diet is one of the most powerful tools available for preventing and managing heart disease. The foods you eat every day directly influence your cholesterol levels, blood pressure, blood sugar, inflammation, and body weight — all of which are major determinants of cardiovascular risk. Yet with so much conflicting nutrition advice in the media, many patients feel confused about what they should actually be eating. As a preventive cardiologist, I want to share straightforward, evidence-based dietary guidance that you can put into practice today.

The Mediterranean Diet: Gold Standard for Heart Health

Among all dietary patterns studied for cardiovascular benefit, the Mediterranean diet has the strongest and most consistent evidence base. This eating pattern emphasizes fruits, vegetables, whole grains, legumes, nuts, seeds, olive oil, and moderate amounts of fish and poultry. It limits red meat, processed foods, refined sugars, and saturated fats. The landmark PREDIMED trial demonstrated that a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of major cardiovascular events by approximately 30 percent compared to a low-fat diet.

Focus on Healthy Fats

Not all fats are created equal. Replacing saturated fats (found in red meat, butter, cheese, and processed foods) with unsaturated fats (found in olive oil, avocados, nuts, and fatty fish like salmon and mackerel) can significantly improve your cholesterol profile. Omega-3 fatty acids, found in fatty fish, walnuts, and flaxseeds, have anti-inflammatory properties and have been shown to reduce triglyceride levels and lower the risk of arrhythmias.

Trans fats — found in many processed and fried foods — should be avoided entirely. They raise LDL cholesterol, lower HDL cholesterol, and increase inflammation, making them one of the most harmful dietary components for cardiovascular health.

Reduce Sodium Intake

Excess sodium is a major contributor to high blood pressure, which in turn is one of the leading risk factors for heart disease and stroke. The American Heart Association recommends limiting sodium intake to no more than 2,300 milligrams per day, with an ideal limit of 1,500 milligrams for most adults. The majority of dietary sodium comes not from the salt shaker, but from processed and restaurant foods. Reading nutrition labels, cooking at home more frequently, and using herbs and spices in place of salt are practical strategies for reducing sodium intake.

Increase Fiber Intake

Dietary fiber, particularly soluble fiber found in oats, barley, beans, lentils, and certain fruits, has been shown to lower LDL cholesterol by binding to cholesterol in the digestive system and removing it from the body. Aim for at least 25 to 30 grams of fiber per day from food sources. In addition to its cholesterol-lowering effects, a high-fiber diet supports healthy blood sugar regulation and weight management.

Practical Steps You Can Take Today

You do not need to overhaul your entire diet overnight. Start with small, sustainable changes: add an extra serving of vegetables to your dinner plate, swap white bread for whole grain, snack on a handful of almonds instead of chips, choose grilled fish over fried options when dining out, and replace sugary beverages with water or unsweetened tea. Over time, these incremental changes add up to meaningful improvements in your cardiovascular health. If you would like personalized dietary guidance as part of a comprehensive heart risk assessment, our preventive cardiology team is here to help.