Recently released cholesterol guidelines from the American Heart Association and the American College of Cardiology include the usual call for lifestyle changes that can often prevent heart disease and strokes.
But the guidelines now encourage doctors to keep an eye on this earlier than usual.
KERA's Sam Baker talked about this with Dr. Owais Idris, an interventional cardiologist and the co-medical director of Texas Health Frisco's Cardiac Cath Lab.
Dr. Idris: As technology's getting better, we're getting more evidence into earlier and more aggressive cholesterol control. We're looking not just here and now or two years down the road, we're looking at 10 to 30 years down the road, which is what I tell my patients.
Baker: So, whereas we were looking at people in their 50s or 60s, now the emphasis seems to be on our 30s?
Dr. Idris: A lot of us are so busy in our lives with our families, with everybody in our thirties that we put our health to the back end and now we're seeing that that actually has a much higher harmful risk even in your forties and fifties and so you know the earlier we start looking at that the better from a lifetime risk perspective.
Baker: And since 2018, we now have better technology and ways to measure what's going on.
Dr. Idris: Earlier screening. Even in childhood we're looking at disease preventions and things that we can do.
Baker: There are two biomarkers that these guidelines are encouraging you to look at more?
Dr. Idris: The biggest one is obviously the LDL, which is the bad cholesterol. That is the one that deposits in our arteries that leads to plaque and then, you know, eventually heart attacks and strokes. So, that is the number that, you know, we focus on because that is something that we can treat.
The other is lipoprotein (a), little a, which is a genetic risk marker. And that is something that people are essentially born with. We don't have anything to treat that.
But if that number is elevated, that is something that makes people more at a higher risk, even with normal cholesterol levels.
Baker: Beyond getting screenings regularly, what is it in these new guidelines that the public can do or should be doing?
Dr. Idris: There's data now that shows about a 45 to 50% higher risk of stroke and heart attacks in people that used more packaged foods, more sodas, more processed meats, obviously fast food.
So really anything high in sugar, salt, unhealthy additives increases the risk of not just high blood pressure, but also heart attacks, strokes, among other things.
That is something that people can start doing here and now, and a lot of the health conscious people have already been ahead of the game for a while when it comes to these sort of things.
Baker: Since the last set of guidelines in 2018, have we gotten any better about maintaining good numbers?
Dr. Idris: I feel like COVID set us back a few years, decades on that front, because a lot of people that were trying to be active and stuff with COVID and with all the restrictions during that time, a lot people became more sedentary, which has led to more obesity, insulin resistance, high blood pressure.
We're seeing a lot of 30, 40, 50-year-olds having heart disease now that is severe that we used to see in people that are in their 50s and 60s.
And obviously, stress is the one X factor that we don't know about.
I think we were trending in the right direction, but with all these changes that have happened in the last six, seven years. I think we've definitely taken a few steps back on that front.
Baker: The main takeaway for the public from this and these new guidelines is what?
Dr. Idris: Essentially, that if it comes in a package and if it lasts for months, it is not really a food that you want for your body.
The one thing that you stay away from most definitely that has been associated with every sort of cardiovascular disease and cancer is smoking.
Alcohol? When it comes to living, if you love having one drink a day, try to limit it to once a week or once a month.
Focus more on fruits and vegetables, whole grains, nuts, those sort of things, and less on the processed meats, the sugary drinks, especially the packaged snacks.
Heart disease does not start in your 60s. It starts in your 20s and 30s and 40s. The earlier we act on cholesterol, the more heart attacks and strokes we prevent.
RESOURCES:
New guidelines: Circulation 2026
New guidelines: JACC (Journal of the American College of Cardiology)
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