If you have high cholesterol, you probably know you should take steps to reduce it. But some people have additional risk factors for heart disease that make it even more important to focus on cholesterol health. What Your Risks Mean Elevated cholesterol levels contribute to plaque buildup in the arteries, called atherosclerosis. This buildup can slowly harden and narrow the arteries, increasing the risk for heart attack and stroke. Having additional risk factors doesn’t necessarily mean you will develop serious heart problems. But it does mean you may need to be more aggressive in managing your cholesterol to prevent them. In addition to making important lifestyle changes such as eating a diet low in saturated fat and cholesterol, exercising regularly, losing weight, and not smoking, your doctor may recommend a lower target for your LDL, or “bad,” cholesterol. Those at high risk for heart disease should aim for an LDL of 70 mg/dL. Some risk factors for heart disease that may affect your cholesterol management plan include the following: Diabetes The risk for heart disease and stroke among people with diabetes is the same as for someone who is already diagnosed with cardiovascular disease. As a result, lowering LDL cholesterol—which is a major factor for atherosclerosis—is key for people with diabetes. Diabetes poses a big risk for heart disease because it can offset the balance of good and bad cholesterol in your body. This condition, called diabetic dyslipidemia, can contribute significantly to clogged arteries. The good news is that by aggressively lowering LDL levels, a person with diabetes can reduce his or her risk of heart complications by 20% to 50%. Age As we get older, the likelihood of developing heart disease increases. This is especially true for men older than age 45 and women who have gone through menopause, which is usually around age 55. Women’s risk for heart disease increases at this time because their estrogen levels drop. If women go through menopause earlier, they may also develop heart disease earlier. In addition to an increased risk for heart disease, the likelihood of developing health conditions that contribute to the disease also creeps up with age. These include high cholesterol, high blood pressure, and diabetes. Keep in mind that developing high cholesterol and other risk factors isn’t inevitable. There are healthy lifestyle habits like good diet, exercise, and keeping your weight down that can reduce your risk as you age. It’s also wise to work closely with your doctor and keep tabs on these risk factors. For example, experts recommend getting cholesterol levels checked every five years beginning at age 20. High Blood Pressure Just like high cholesterol, high blood pressure is a major risk factor for heart disease. High blood pressure damages the lining of the arteries, making it more likely you’ll develop atherosclerosis. When you have high cholesterol and high blood pressure at the same time, you have a much greater risk for heart attack and stroke. But keep in mind, you may have elevated blood pressure and not even know it. Just like high cholesterol, high blood pressure creates no symptoms. Make sure you know your blood pressure number. If it’s 140/90 mm/Hg or greater, talk with your doctor about steps you can take to keep it under control. Family History of Heart Disease If heart disease runs in your family, you have a greater chance of having it, too. This is especially true if family members developed the disease at an early age. There is a greater chance that you will develop heart disease if your father or brother had a heart attack before age 55, or if your mother or sister had one before age 65. Although you can’t change your family’s health history, you can control other risk factors for heart disease. By reducing high cholesterol through lifestyle changes and possibly medication, you can greatly reduce your likelihood of developing heart problems. Smoking Smoking is the main preventable cause of death in the U.S., and is a major risk factor for heart disease. The harmful chemicals in tobacco damage the arteries and blood vessels. This damage opens the door to arthrosclerosis because plaque begins to build in damaged areas of the artery. When smoking is combined with other risk factors, the likelihood of developing heart disease is even greater. One of the best things you can do to for your health is to quit smoking. Help is available at www.smokefree.gov. Obesity Roughly one-third of all Americans are overweight or obese—a major problem in the fight against heart disease. Obesity raises blood cholesterol and contributes to conditions such as high blood pressure and diabetes. Together, these conditions dramatically increase the likelihood of heart attack and stroke. Although losing weight isn’t always easy, it’s one way you can take control of your health and reduce your risk of heart disease. Losing just 5% to 10% of your body weight can help. Weight loss can lower your cholesterol, reduce your blood pressure, and improve glycemic control. That's a triple payoff! Taking the Next Step If you have one or more of these risk factors, make sure you discuss them with your doctor. It’s important your physician understands your total risk for heart disease in order to create the best treatment plan for you. Key Takeaways: Some people have risk factors for heart disease that make it especially important to focus on cholesterol health. The risk for heart disease and stroke among people with diabetes is particularly high, so lowering LDL cholesterol is key. Men older than 45 and women who have gone through menopause are at increased risk for heart disease. Having high cholesterol and high blood pressure at the same time leads to a greater risk for heart attack and stroke. If heart disease runs in your family, you have a greater chance of having it, too.