High Cholesterol in Older Adults
Cholesterol levels tend to peak in older adults around age 60. Patients with two or more chronic conditions must maintain good health overall, and be mindful of decreasing high cholesterol levels. Particularly, older adults at higher risk for heart disease, taking measures to lower cholesterol is the best approach to lowering the risk for peripheral vascular disease, heart attack, or stroke. High cholesterol is caused by a variety of things, including foods with saturated fats or trans fats, certain meats, cheese and eggs, being overweight and having low activity levels. High cholesterol can also be hereditary, and age and sex also play a role.
Cholesterol is a waxy, sticky substance found in all cells of the body. Only 25% of blood cholesterol is actually ingested as dietary cholesterol. The other 75% is produced in the liver which makes all the cholesterol that’s needed and circulates it throughout the body. This cholesterol helps us make some hormones, vitamin D and other substances that help us properly digest food. Too much cholesterol in the arteries can build up as plaque, which can slow or block blood flow altogether. Should buildup occur in the coronary arteries not enough blood can get through to the heart.
Not all cholesterol, however, is bad. There are three types of cholesterol to keep in mind:
- LDL: Low-density lipoproteins are known as “bad” cholesterol as it clogs the arteries. The higher the level of LDL in your blood, the greater your chances are of getting heart disease. Levels above 70 mg/dl need to be actively treated.
- HDL: High-density lipoproteins are known as “good” cholesterol, and can help the body by attaching to the LDL, pushing it to the liver to be filtered out of the body. HDL levels should be at 60 mg/dl or higher.
- Triglycerides: Triglycerides are not actually cholesterol, but are a form of fat that needs to be monitored, as it can also clog arteries and damage the cardiovascular system. Levels should be kept below 150 mg/dl.
Having high cholesterol generally means that we need to lower our LDL level and to increase our HDL level. Often high cholesterol can be controlled by diets rich in fruits and vegetables with an emphasis on green and leafy vegetables such as broccoli, cabbage, and cauliflower. Higher fiber foods can reduce overall caloric intake and lower LDL. Similarly, eating carbohydrates such as whole wheat bread and some pasta, bran, brown rice, and oatmeal provides fiber. Omega-3 fatty acids, found in cold-water fish like salmon and tuna but also present in flax seed, are known to increase HDL. While nutrition is important sometimes it may not be enough. Medication may also be needed to improve cholesterol profiles, as well as uniquely prescribed diets to maintain weight.
Chronic Care Management (CCM) care teams can help patients and their healthcare providers monitor various factors that determine high cholesterol. Care Managers can remind patients of the best ways to lower cholesterol and improve heart health such as avoiding a sedentary lifestyle, staying active, and being mindful of weight gain or sudden weight loss. Care Managers can also monitor medication adherence and share care plans with a physician to help older adults stay as healthy as possible.
About the Author
Joseph F. West, ScD, is a population health and data analytics leader with over 10 years of research and enterprise consulting experience. He is a recognized leader in the development of outcomes-based healthcare. Joseph has served as Chief Population Health Officer, Senior Epidemiologist, Program Director, and Adjunct Assistant Professor. As a consultant and content creator, his current work focuses on population health management (PHM), health information technology (HIT), care coordination innovation, and healthcare risk management.