Cholesterol and Heart Health: What Caregivers Should Know — About Themselves

Attention to cholesterol can increase health and potentially minimize the risk of heart disease and stroke — that was this article's message in 2015, and it's even more pointed for caregivers today, because caregivers are less likely than others to get preventive health services like checkups, and chronic stress raises cardiovascular risk on its own.^[4]

Cholesterol explained

Cholesterol is a type of fat found in all animal cells, essential for hormone and bile production and for using vitamin D. Your liver makes all the cholesterol your body needs, and it travels through the blood in carriers called lipoproteins — which is where the "good/bad" distinction comes from:

• LDL (low-density lipoprotein) — the "bad" cholesterol. High LDL can lead to plaque buildup in your arteries and result in heart disease or stroke.^[1]
• HDL (high-density lipoprotein) — the "good" cholesterol, which helps remove cholesterol from the bloodstream. Higher HDL can lower your risk of heart disease and stroke.^[1]

The problem is scale and silence: from 2017 to 2020, 86.4 million U.S. adults age 20 or older had high or borderline-high cholesterol, and because high cholesterol has no symptoms, many people don't know their levels are high.^[1]

Get tested — it's the only way to know

The only way to know whether you have high cholesterol is a simple blood test called a lipid profile, which measures LDL, HDL, triglycerides, and total cholesterol. You may need to fast for 8 to 12 hours beforehand, depending on the test.^[1]

Current screening guidance:

• All adults 19 and older should have a lipid panel.^[2]
• Most healthy adults should have their cholesterol checked every 4 to 6 years; people with heart disease, diabetes, or a family history of high cholesterol need checks more often.^[1]
• The American Heart Association now recommends every adult get their Lp(a) tested at least once in a lifetime — it's a mostly inherited cholesterol-carrying particle that raises heart disease and stroke risk when high, and a single test tells you where you stand.^[2]
• For men 40+ and women 45+, a coronary artery calcium (CAC) scan can help decide whether to start cholesterol-lowering medication when the choice is unclear.^[2]

Diet tips to help reduce cholesterol

The 2015 list holds up well, with current guidelines' emphasis added:

• Increase the amount and variety of fresh fruit, vegetables, and whole-grain foods you eat each day.^[3]
• Choose lean meats, and leaner sandwich meats like turkey breast or cooked lean chicken.
• Eat fish (canned or fresh) twice a week.
• Include foods rich in fiber and healthy fats — nuts, legumes, and seeds.^[3]
• Limit processed meats like salami and sausages, deep-fried takeout, chips, cakes, and pastries — the current Dietary Guidelines now explicitly advise avoiding highly processed foods.^[3]

Lifestyle tips

• Don't smoke — smoking increases LDL's ability to get into your cells and cause damage.
• Exercise regularly — activity raises HDL and lowers LDL, and federal guidelines recommend 150–300 minutes of moderate aerobic activity a week.^[5]
• Watch excess body fat, which can contribute to elevated LDL.
• Control blood sugar if you have diabetes — high blood sugar is linked to increased atherosclerosis risk.
• Limit alcohol and avoid binge drinking.

Then make the appointment. Caregivers put their own screenings off — it's one of the most common and costly patterns in caregiver health.^[4] A cholesterol check takes one blood draw every few years. Put your own name on the calendar you keep for everyone else.