Prevention For Healthy Living

A big, juicy 8-ounce steak and mashed potatoes loaded with butter, bacon and sour cream represent a night of decadent indulgence for most Americans. This tasty meal also represents something else: high cholesterol content.

Many people associate cholesterol with negative health consequences. It blocks the arteries, and can cause heart attacks and strokes.

Yet cholesterol is actually produced by the human body and is critical to the manufacture of hormones, vitamin D and the bile acids that help in fat digestion. It’s also an essential building block of every cell’s membrane.


Cholesterol is a waxy, fat-like substance produced primarily in the liver. Because cholesterol cannot dissolve in the blood, it must be transported throughout the body with carriers called lipoproteins. The proportion of lipids to proteins determines whether the cholesterol package is a high-density lipoprotein (HDL) or a low-density lipoprotein (LDL). HDL has higher protein content and behaves very differently from the LDL.

“People know LDL as the bad cholesterol, and HDL as the good cholesterol. I like to think of LDL as the garbage pail and HDL as the sanitation truck,” says Robert Greenfield, M.D., medical director of noninvasive cardiology and cardiac rehabilitation at the MemorialCare Heart & Vascular Institute at Orange Coast Medical Center. “When in excess, LDL will deposit cholesterol in the artery walls. HDL actually takes cholesterol out of the blood vessel wall and transports it back to the liver where it can be used. You need both, but in the right amounts.”

The body makes all the cholesterol it needs, but disease and diet can contribute to a cholesterol overload. Over time, this extra cholesterol is being deposited within the artery walls, triggering an inflammatory response. To protect itself, the body sends white blood cells called monocytes. These monocytes become macrophages in the blood vessel wall and migrate to the site of inflammation, engulfing the cholesterol. As they collect, they combine with calcium and other blood compounds to form plaque.

The plaque continues to build, narrowing the arteries and restricting the flow of oxygen-rich blood. If the plaque weakens and ruptures, a blood clot may form and the flow of blood through that artery may be completely blocked. If this occurs in a coronary artery in the heart, the result may be a heart attack. In an artery that supplies blood to the brain, it may result in a stroke. In the legs, a blockage can cause peripheral artery disease (PAD) or gangrene, and in the kidneys, the result is usually chronic kidney disease.


According to the Centers for Disease Control and Prevention, about 70 million American adults have high LDL. Only one in three have had it identified and controlled. With heart disease being the number one killer in the United States, prevention and early diagnostic tools, such as the ones offered at the MemorialCare Heart & Vascular Institute at Orange Coast Medical Center, are lifesaving.

“The problem is if you’re not diagnosed, you’re not getting treated,” says Dr. Greenfield. “And high cholesterol levels typically don’t present with any signs or symptoms until it’s too late.”

A basic lipid panel is a blood test that measures your total cholesterol, along with the amount of HDL, LDL and triglycerides, which is a type of fat found in the blood. With this information, the leading team of heart specialists at the MemorialCare Heart & Vascular Institute develops a comprehensive health plan that reduces a patient’s risk for heart disease and other complications.

“Whether it’s about making dietary changes, or the need for medications, the old adage about ‘an ounce of prevention’ goes a long way here,” says Dr. Greenfield. “One screening can make all the difference in someone’s life.”

Discuss the importance of cholesterol screenings with your physician. For more information about Orange Coast Medical Center's comprehensive heart care services, please visit our section on Heart and Vascular Care.