UConn Health Cardiologist: ‘Everyone’ Needs to Know Their Cholesterol

Lipid panels, calcium scores, and more tools to stay on top of your health

3D illustration shows how cholesterol can build-up and block an artery of the heart (Adobe Stock Image)

High cholesterol is one of the major risk factors for the development of heart disease. Persistently elevated levels of cholesterol in our bodies can lead to a build-up of plaque in our blood vessels, potentially leading to a heart attack or stroke.

“Every adult needs to have their cholesterol checked to determine their baseline risk of heart disease, “ recommends Dr. John Glenn Tiu, a preventive cardiologist at the Pat and Jim Calhoun Cardiology Center. The frequency of checking your cholesterol depends on a number of factors, including your baseline risk and whether you are taking cholesterol-lowering medications.

The blood test, called a “lipid panel,” is comprised of 4 main components:

  • Total cholesterol – Ideally should be below 200
  • LDL cholesterol – Or so-called “bad cholesterol”; ideally should be less than 100
  • HDL cholesterol – Or so-called “good cholesterol”; low levels (<40 in men and <50 in women) imply increased risk
  • Triglycerides – Ideally should be below 150; higher values confer increased risk

Based on these results and factoring in your other medical issues, your doctor or cardiologist can determine whether you are at low, intermediate or high risk of heart disease.

“In general, we recommend lifestyle changes alone for individuals at low risk and cholesterol-lowering medications for individuals at high risk,” says Tiu, “for individuals at intermediate risk, we have a discussion regarding the potential benefit of cholesterol-lowering therapies.”

For intermediate risk individuals who are unsure about starting medications, there are specialized blood tests and tools such as a coronary artery calcium score that can help further refine their individual risk.

“A calcium score is a CT scan that can quantify the amount of calcium build-up in the blood vessels of your heart,” explains Tiu. “It is quick, has low radiation exposure, and does not require the use of contrast.” Individuals with a score of zero may choose to defer starting medications for the time being, while individuals with a score greater than 100 will most likely benefit from cholesterol-lowering therapy. Of note, this test is generally not covered by insurance at this time and a fee of roughly $125 is usually charged for this test.

Tiu emphasizes that a calcium score cannot specifically determine whether an individual has a blockage in their blood vessels. He recommends talking to your doctor or cardiologist to properly interpret the results and institute a personalized treatment plan.

Heart disease remains the leading cause of death in U.S. adults, and estimates show that over 80% of cases are preventable with lifestyle changes such as consuming a heart-healthy diet, regular exercise, weight loss, smoking cessation, and adequate control of an individual’s risk factors.

“I encourage everybody to take charge of their heart health,” says Tiu, “and getting your cholesterol checked is a good first step in the right direction.”