Medically Reviewed by Vincenta Faulkner, RD, CNSC, CCTD
In the U.S., heart disease is the leading cause of death — someone dies around every 36 seconds from cardiovascular disease, and someone has a heart attack about every 40 seconds.
What is one of the first things that comes to mind when you think of a risk factor for a heart attack?
If you said cholesterol, you’re not alone. In general, there is a connection between high cholesterol levels and heart attack occurrences.
If your lipid panel results come back and your doctor responds with a plan for how to lower your LDL or bad cholesterol levels, they are likely concerned about your risk for a heart attack occurrence.
What is the connection between cholesterol and risk of heart disease, and will lowering your LDL cholesterol levels prevent a heart attack or heart failure from happening? Let’s explore with Zizi.
What Is High Cholesterol?
High cholesterol, or too much cholesterol volume circulating in your bloodstream, varies depending on your age, weight, and assigned biological sex at birth. In general, though, you can consider your cholesterol level to be healthy if it reads under 200 mg/dL.
This range becomes more specific depending on your sex assigned at birth — if you were assigned female at birth and are aged 20 or older, your total cholesterol should lie between the 125 to 200 mg/dl range, according to general guidelines.
This means that your LDL should fall below 100 mg/dL, and your HDL should be 50 mg/dL or higher. These numbers are almost the exact same if you were assigned male at birth, with the exception of your HDL levels: they should be anywhere from 40 mg/dL or higher.
Cholesterol levels also depend on your specific age and weight in addition to your sex assigned at birth. If you are older and or weigh more, your levels may be more likely to fall within the higher range.
Furthermore, whether you already have heart disease or other contributing risk factors also affects whether your cholesterol levels are high or even borderline high.
You can still have an LDL reading that falls within the normal average limits when it comes to cholesterol levels, yet your doctor might classify this reading as high cholesterol for you if you have other contributing risk factors for heart disease, such as smoking or high blood pressure.
So, what constitutes high cholesterol depends on you as a unique individual and your lifestyle, diet, genetics, and other underlying risk factors.
You can use our recommended target cholesterol levels as a guide and discuss your lipid results further with your doctor or healthcare professional before deciding on whether your levels are high or not.
What Is the Connection Between Cholesterol and Heart Attacks?
Your body naturally produces cholesterol in the liver and releases it into your bloodstream, where different proteins pick up and transport this waxy lipid to various places throughout your body.
Certain proteins, in particular high-density lipoproteins (HDL), deposit cholesterol in good places that positively contribute to your health; cholesterol helps your cells carry out their normal functions and processes, including hormone synthesis and membrane structural support.
However, other proteins, like low-density lipoproteins (LDL), deposit cholesterol along your artery walls, which negatively contributes to your health. This plaque buildup on artery walls, also known as atherosclerosis, can lead to blockages and, ultimately, heart attacks.
When your blood cholesterol levels are too high, you may increase your risk for atherosclerosis and subsequently for developing coronary heart disease.
Can You Have Normal Cholesterol Levels and Still Have a Heart Attack?
This is where the situation gets a little sticky because the answer is yes — you can still have cholesterol levels within normal limits and experience a heart attack.
This means that you can not only have normal cholesterol levels and have a heart attack but that you could also have elevated cholesterol yet still have a healthy heart.
Indeed, some studies even show that sometimes people with high LDL cholesterol experience heart attacks less often than those with low LDL levels.
What gives, then? The answer is that many other factors can contribute to your risk for heart attacks.
This does not mean that if you have high cholesterol levels, you are not at risk for heart disease — high cholesterol levels remain a leading risk factor for decreased heart health! It does mean, however, that if you have high cholesterol you might indeed still not be at an increased risk for heart disease, so you should look at other risk factors before you decide your overall risk for a heart attack.
Let’s look at some of these other risk factors below.
What Are Some Risk Factors for Heart Attack?
As we said, you should decide whether you are more prone to a heart attack based on your overall heart attack risk, which means that your decision should reflect other factors besides your cholesterol levels.
You might have normal levels but have a family history of heart attacks, which means that you are at a greater risk for heart disease even despite your levels, for example.
We recommend that you chat with your physician to help determine your overall heart attack risk. You can also keep the following additional risk factors, other than cholesterol, in mind to help guide that discussion.
If you have a family history of coronary heart disease, then you are at an increased risk for heart disease. Your physician usually asks about your family coronary history at an early age: pediatricians start to test kids’ cholesterol at the age of 9!
If you are a smoker or have been a smoker in the past, then your heart’s health has likely been negatively impacted and you are at an increased risk for coronary heart disease.
Nutrition & Diet
Unhealthy diets that lack sustaining, nutritious foods are another leading cause of heart disease. If your diet includes a lot of saturated and trans fats, as well as a lot of refined and processed carbohydrates, then you should try to change your eating habits and food choices.
Instead, opt to consume more whole grains, nuts, seeds, legumes, unsaturated fats, fruits, and vegetables. A heart-healthy diet, like the Mediterranean diet high in fish, omega-3 unsaturated fats, vegetables, and other monounsaturated fats such as olive oil, is a great place to start. You should also make an effort to limit your alcohol consumption, as well as other sugary beverages, which can increase heart disease risk and risk of a heart attack.
Eating too much of certain foods, like red meat, can increase your risk for high triglycerides, blood clots, and other health issues.
Obesity is another leading threat to your heart health. Dropping even a small amount of weight can significantly lower your risk of cardiovascular disease, and if you are more obese, then you should develop long-term goals for larger amounts of weight loss so that you can efficaciously decrease your risk for a heart attack.
Physical Activity Level
Physical inactivity can be a leading cause of an unhealthy heart. Staying active ties into several other leading risk factors for heart disease, including obesity and cholesterol levels. Exercising just two or three hours a week may be enough to lower your LDL cholesterol levels and promote weight loss!
Blood Pressure & Blood Sugar Level
If you have high blood pressure and or high blood sugar (diabetes), then you are at an increased risk for heart disease.
How Can I Prevent Heart Attacks?
Unfortunately, there is not a single, uniform answer to this question, because as we have seen, heart attacks often stem from many contributing, intermingling factors. True, maintaining healthy cholesterol levels is important to maintaining a healthy heart. It is true, too, that lowering your cholesterol levels is a huge way to reduce your risk for heart disease.
However, while high LDL cholesterol levels are associated with higher rates of heart attacks, they are not a direct cause. This means that while lowering your cholesterol levels will certainly help contribute to preventing heart attacks, it will not guarantee to prevent you from experiencing a heart attack.
There are many factors at play that contribute to why you might experience a heart attack or not, such as your genetics and family history, your lifestyle and food choices, and your health history regarding blood pressure, blood sugar, and underlying conditions.
Fortunately, when you do lower your cholesterol levels, you also address many of the other risk factors that contribute to a heart attack. The primary ways to naturally lower your cholesterol levels without medication include altering your diet and your physical activity levels, which in turn help lower your risk for obesity.
So, lowering your cholesterol levels is a great way to start when it comes to preventing heart attacks and may even cross off several other risk factors at once when it comes to heart disease. Heart health is made easy with Zizi, too — you can lower your cholesterol levels from the comfort of your own home.
Wherever you are in your heart health journey, Zizi is here to support and guide you through the process!
Learn more about lowering your cholesterol in 30 days with Zizi’s Heart Health Reset program here, or your money back.
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