{"id":2264,"date":"2025-08-11T21:21:45","date_gmt":"2025-08-12T03:21:45","guid":{"rendered":"https:\/\/drakarlacastolo.com\/?p=2264"},"modified":"2025-08-13T20:39:27","modified_gmt":"2025-08-14T02:39:27","slug":"cholesterol","status":"publish","type":"post","link":"https:\/\/drakarlacastolo.com\/en\/blog\/lifestyle-prevention\/cholesterol\/","title":{"rendered":"Cholesterol and triglycerides: how to understand and control them"},"content":{"rendered":"<p>The <strong>cholesterol<\/strong> and the <strong>triglycerides<\/strong> are fats that are necessary for body functions; when elevated, they increase the risk of <strong>infarction<\/strong> y <strong>stroke<\/strong>. The good news: with lifestyle changes and, if appropriate, treatment, it is possible to reduce that risk safely and sustainably.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What are they and why do they matter?<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>LDL-c (\"bad cholesterol\")<\/strong>when it is high, it tends to accumulate in the arteries.<\/li>\n\n\n\n<li><strong>HDL-c (\"good cholesterol\")<\/strong>helps to transport cholesterol out of the arteries.<\/li>\n\n\n\n<li><strong>Triglycerides (TG)<\/strong>reserve energy; high levels are associated with cardiometabolic risk and, if very high, with pancreatitis.<\/li>\n<\/ul>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>In cardiovascular prevention, <strong>lower LDL-c<\/strong> is the priority. The guidelines recommend intensive reductions in people at high or very high risk.<\/p>\n<\/blockquote>\n\n\n\n<h2 class=\"wp-block-heading\">Reference values (help to interpret your lab)<\/h2>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><thead><tr><th>Parameter<\/th><th>Desirable<\/th><th>High limit<\/th><th>High \/ Very high<\/th><\/tr><\/thead><tbody><tr><td>LDL-c<\/td><td>&lt; 100 mg\/dL<\/td><td>100-129<\/td><td>\u2265 130<\/td><\/tr><tr><td>HDL-c<\/td><td>\u2265 40 (H) \/ \u2265 50 (M)<\/td><td>-<\/td><td>-<\/td><\/tr><tr><td>Triglycerides<\/td><td>&lt; 150 mg\/dL<\/td><td>150-199<\/td><td>\u2265 200 \/ \u2265 500 (very high)<\/td><\/tr><tr><td>No-HDL-c<\/td><td>&lt; 130 mg\/dL<\/td><td>130-159<\/td><td>\u2265 160<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p><em>Goals may be more stringent depending on your risk. Your cardiologist will adjust personal goals.<\/em><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Cholesterol and triglyceride raising factors<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Diet rich in <strong>ultra-processed<\/strong> and added sugars.<\/li>\n\n\n\n<li><strong>Sedentary lifestyle<\/strong> and excess weight.<\/li>\n\n\n\n<li><strong>Smoking<\/strong> and alcohol in excess (raises triglycerides).<\/li>\n\n\n\n<li><strong>Hypothyroidism<\/strong>diabetes, some drugs (e.g., corticosteroids).<\/li>\n\n\n\n<li><strong>Family history<\/strong> of hypercholesterolemia.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">How is it diagnosed and how often to measure?<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Fasting and non-fasting lipid profile<\/strong> (as indicated).<\/li>\n\n\n\n<li>Repeat every <strong>1-5 years<\/strong> in adults without high risk; <strong>more frequent<\/strong> if you have hypertension, diabetes, smoking, coronary heart disease or are undergoing treatment.<\/li>\n\n\n\n<li>You can calculate the <strong>10-year risk<\/strong> (in consultation) to decide intensity of management.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Risk-based goals and strategies<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>High \/ very high risk<\/strong> (e.g., coronary artery disease, diabetes with factors, very high LDL): the following are sought <strong>lower LDL \u2265 50 %<\/strong> and\/or achieve <strong>LDL &lt; 70 mg\/dL<\/strong>In very high risk, some European guidelines propose <strong>&lt; 55 mg\/dL<\/strong>.<\/li>\n\n\n\n<li><strong>Intermediate risk<\/strong>: lowering LDL <strong>\u2265 30-49 %<\/strong> and approach <strong>&lt; 100 mg\/dL<\/strong>.<\/li>\n\n\n\n<li><strong>Triglycerides \u2265 500 mg\/dL<\/strong>requires priority management to prevent pancreatitis.<\/li>\n<\/ul>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>Goals are individualized. Dr. Karla Castolo will explain what yours is based on your medical history and studies.<\/p>\n<\/blockquote>\n\n\n\n<h2 class=\"wp-block-heading\">What you can do today (changes with the greatest impact)<\/h2>\n\n\n\n<p><strong>1) Cardioprotective feeding (DASH\/Mediterranean type).<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Plus: vegetables, fruits, legumes, whole grains, fish, olive oil, nuts.<\/li>\n\n\n\n<li>Minus: processed meats, fried foods, pastries, sugary drinks, excessive alcohol.<\/li>\n\n\n\n<li>Practical objective: <strong>25-30 g of fiber\/day<\/strong>; change sausages for legumes 2-3 times\/week.<\/li>\n<\/ul>\n\n\n\n<p><strong>2) Regular physical activity<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>150 min\/week<\/strong> moderate (brisk walking, swimming, biking) <strong>o 75 min\/week<\/strong> vigorous + <strong>2<\/strong> strength sessions.<\/li>\n\n\n\n<li>Add steps: climbing stairs, short and frequent walking distances.<\/li>\n<\/ul>\n\n\n\n<p><strong>3) Healthy weight and waistline<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Lose <strong>5-10 weight %<\/strong> improves LDL and TG.<\/li>\n\n\n\n<li>Watch waist circumference: &lt; 88 cm (M) \/ &lt; 102 cm (H) as a general reference.<\/li>\n<\/ul>\n\n\n\n<p><strong>4) No smoking and alcohol moderation<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Tobacco lowers HDL and damages the arterial wall.<\/li>\n\n\n\n<li>Alcohol raises triglycerides; moderate or avoid if already high.<\/li>\n<\/ul>\n\n\n\n<p><strong>5) Sleep and stress<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Sleep <strong>7-8 h<\/strong> and practicing breathing\/relaxation techniques helps to sustain habits.<\/li>\n<\/ul>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p><strong>Suggested iconography:<\/strong> Mediterranean plate, slippers, tape measure, \"no smoking\" symbol, crossed out cup, moon\/star.<\/p>\n<\/blockquote>\n\n\n\n<h2 class=\"wp-block-heading\">Treatment: when to consider drugs<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Statins<\/strong>first line to lower LDL-c and reduce cardiovascular events.<\/li>\n\n\n\n<li><strong>Ezetimibe<\/strong>is added if goals are not reached with statin.<\/li>\n\n\n\n<li><strong>iPCSK9<\/strong> (injectables): for very high risk or familial hypercholesterolemia when the target is not yet achieved.<\/li>\n\n\n\n<li><strong>Persistent high TG<\/strong>Prioritize lifestyle; in selected cases, <strong>icosapent ethyl<\/strong> or fibrates (according to clinical assessment).<\/li>\n<\/ul>\n\n\n\n<p>Do not adjust or discontinue medication on your own; any changes are decided in consultation.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions<\/h2>\n\n\n\n<p><strong>Do I need to fast for the study?<\/strong><br>Not always. For very high TG or diagnostic doubts, fasting is preferred; your doctor will indicate.<\/p>\n\n\n\n<p><strong>Can I eat eggs if I have high cholesterol?<\/strong><br>In general, the focus is on the <strong>dietary pattern<\/strong>The total amount of saturated and ultra-processed fats weighs more than an isolated food.<\/p>\n\n\n\n<p><strong>How long does it take to lower LDL?<\/strong><br>With statin, the effect is usually seen in <strong>4-12 weeks<\/strong>With diet and exercise, the changes are gradual and sustainable.<\/p>\n\n\n\n<p><strong>What about the \"good fat\"?<\/strong><br>Upload <strong>HDL<\/strong> is not a direct goal; what is important is <strong>lower LDL<\/strong> y <strong>reduce overall risk<\/strong>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">When to consult?<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Repeated high LDL, <strong>TG \u2265 200 mg\/dL<\/strong>family history of early myocardial infarction, diabetes or hypertension.<\/li>\n\n\n\n<li>If you want a <strong>customized plan<\/strong> and exercise with cardiologic follow-up, schedule an assessment.<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">Reference sources<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>ACC\/AHA<\/strong>. Multisociety Guideline on the Management of Blood Cholesterol (updates 2018-2022).<\/li>\n\n\n\n<li><strong>ESC\/EAS<\/strong>. European dyslipidemia guideline 2019 with update 2023 (targets by risk).<\/li>\n\n\n\n<li><strong>AHA<\/strong>. Physical activity recommendations for adults.<\/li>\n\n\n\n<li><strong>ADA<\/strong> 2024. Lipid management in diabetes (criteria and goals in diabetic population).<\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>El colesterol y los triglic\u00e9ridos son grasas necesarias para funciones del cuerpo; cuando se elevan, aumentan el riesgo de infarto y derrame cerebral. La buena noticia: con cambios de estilo de vida y, si procede, tratamiento, es posible reducir ese riesgo de forma segura y sostenida. \u00bfQu\u00e9 son y por qu\u00e9 importan? En prevenci\u00f3n cardiovascular, [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":2311,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[39],"tags":[],"class_list":["post-2264","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-prevencion-estilo-vida"],"acf":[],"_links":{"self":[{"href":"https:\/\/drakarlacastolo.com\/en\/wp-json\/wp\/v2\/posts\/2264","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drakarlacastolo.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drakarlacastolo.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drakarlacastolo.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/drakarlacastolo.com\/en\/wp-json\/wp\/v2\/comments?post=2264"}],"version-history":[{"count":0,"href":"https:\/\/drakarlacastolo.com\/en\/wp-json\/wp\/v2\/posts\/2264\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drakarlacastolo.com\/en\/wp-json\/wp\/v2\/media\/2311"}],"wp:attachment":[{"href":"https:\/\/drakarlacastolo.com\/en\/wp-json\/wp\/v2\/media?parent=2264"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drakarlacastolo.com\/en\/wp-json\/wp\/v2\/categories?post=2264"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drakarlacastolo.com\/en\/wp-json\/wp\/v2\/tags?post=2264"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}