Good fats should be checked

Having high levels of high-density lipoprotein cholesterol — the so-called “good” cholesterol — is usually positive. But this might not be true for everyone, according to the American Heart Association. September is Cholesterol Awareness Month, and Tennova Healthcare is using the occasion to spotlight the latest research related to women and heart disease.

A recent study of nearly 1,400 postmenopausal women found those with higher HDL levels were more likely to show “plaques” in their carotid arteries. Those arteries supply blood to the brain — and plaque buildup signals an increased risk of both stroke and heart disease.

The findings, published in the July 19 issue of Arteriosclerosis, Thrombosis, and Vascular Biology, a journal of the American Heart Association, add to the evidence that when it comes to HDL, there can be too much of a good thing.

“Cholesterol is a waxy, fat-like substance found in the bloodstream and in all your body’s cells,” said Janet L. Eichholz, M.D., an interventional cardiologist with Tennova Heart and 2018 chair of the American Heart Association’s Go Red for Women campaign in Knoxville.

“Your body makes all the cholesterol it needs. Additionally, the saturated fats, trans fats and cholesterol you eat can raise your blood cholesterol. Having too much cholesterol in your blood may lead to increased risk for heart disease and stroke.”

According to Eichholz, the new study brings into question the current use of HDL cholesterol in a common equation designed to predict heart disease risk, particularly in women. Previous research has demonstrated the heart-protective features of HDL. This good cholesterol carries fats away from the heart, reducing the build-up of plaque and lowering the potential for cardiovascular disease.

Researchers looked at the number and size of the HDL particles. A higher number of small HDL particles was linked with a lower risk of atherosclerosis in postmenopausal women, while a higher number of large HDL particles was tied to a greater risk of atherosclerosis, especially in women close to menopause. The study did not look at women’s rates of heart attack or stroke.

“During the menopause transition, women see a sharp drop in estrogen, which is considered to be a heart-protecting hormone,” Eichholz said. “Women also go through changes in body fat distribution, blood fats and other metabolic processes. Combined, this can lead to chronic inflammation that could alter the quality of HDL particles. So, a higher HDL level may not be as heart-protective, but it’s not necessarily a bad thing either.”

Eichholz advises that women never ignore a high LDL level just because their HDL level is also high. “It’s important to look at the whole picture,” she said. “Women should pay attention to maintaining a healthy lifestyle as they go through menopause.”

If you have high cholesterol, your doctor may prescribe medication to treat the condition. In addition, you can lower your cholesterol levels through lifestyle changes:

• Eat a healthy diet. Cut down on food high in saturated fat and cholesterol. Instead, choose fat-free and low-fat milk products, lean meats and poultry without skin, fatty fish and nuts and seeds in limited amounts. Be sure to include a variety of fruits and vegetables, whole grains and grain products, beans, peas and legume.

•  Get fit. Do moderate intensity physical activities, such as brisk walking, at least 30 minutes on most or all days for a total of at least 150 minutes each week.

• Maintain a healthy weight. Losing weight can help lower your LDL (bad) cholesterol and total cholesterol level, and raise your HDL (good) cholesterol level.

• Don’t smoke. Smoking can raise LDL cholesterol and lower HDL cholesterol, and quitting often improves those numbers. Breathing second-hand smoke every day also can raise levels of bad cholesterol.

• High cholesterol usually doesn’t have any symptoms,” Eichholz said. “As a result, many people don’t know that their cholesterol levels are too high.”

For more information or a referral to a heart specialist, call 1-855-TENNOVA (836-6682) or visit

Tennova Healthcare offers cardiology services at North Knoxville Medical Center, Physicians Regional Medical Center, Turkey Creek Medical Center, Jefferson Memorial Hospital, Lakeway Regional Hospital, LaFollette Medical Center and Newport Medical Center. With more than 30 cardiologists, cardiothoracic surgeons and other specialists at multiple locations throughout the region, the health system is dedicated to offering better ways to treat and beat heart disease—close to home.