Cholesterol is a waxy substance your body needs to build cells, but too much low-density lipoprotein (LDL) can stick to artery walls and form plaque. Over time this narrows arteries, reducing blood flow to your heart and brain, increasing risk of heart attack and stroke. Knowing your numbers—total, LDL, HDL, and triglycerides—lets us create a personalized plan to protect your long-term health.

Adults 20 and older should have a fasting lipid panel at least every 5 years if results are normal and risk is low. If you have borderline-high LDL, diabetes, high blood pressure, or a family history of early heart disease, we recheck annually—or every 3–6 months after starting or adjusting medication. Kids with risk factors should be screened as early as age 9.

For primary prevention we aim for LDL below 100 mg/dL, HDL above 40 mg/dL (men) or 50 mg/dL (women), triglycerides under 150 mg/dL, and total cholesterol under 200 mg/dL. If you already have heart disease or diabetes, we often target LDL below 70 mg/dL. These goals are individualized based on your overall 10-year cardiovascular risk score, which we calculate at every visit.

Adopting a Mediterranean-style diet—rich in vegetables, fruits, whole grains, beans, nuts, olive oil, and fatty fish—can drop LDL by 10–15%. Aim for 150 minutes of moderate exercise weekly to raise protective HDL and lower triglycerides. Losing 5–10% of body weight, quitting smoking, and limiting alcohol to one drink a day (women) or two (men) further improve your lipid profile and overall heart health.

We follow ACC/AHA guidelines: statins are advised if your 10-year atherosclerotic cardiovascular disease risk is 7.5% or higher, LDL is 190 mg/dL or above, you have diabetes aged 40–75, or you’ve already had a heart attack or stroke. We discuss benefits versus rare side effects like muscle aches or elevated liver enzymes, and we monitor you with blood work 4–12 weeks after starting or adjusting any dose.

Yes—about 5–10% of patients report muscle discomfort. We first check vitamin D and thyroid levels, then try a lower dose, switch to a different statin, or move to alternate-day dosing. If symptoms persist, ezetimibe, PCSK9 inhibitors, or bempedoic acid can provide comparable LDL reduction. Our clinical pharmacist can also review interacting medications or supplements that might increase statin levels and worsen side effects.

Red yeast rice contains naturally occurring lovastatin, but concentration varies widely between brands and some are contaminated with citrinin, a kidney toxin. Large trials show modest LDL drops of 15–25%, usually insufficient for high-risk patients. We recommend FDA-approved generics first—costing as little as $4/month—because potency and safety are guaranteed. Always tell us about any supplements so we can monitor for interactions and liver effects.

Annual lipid screening is a preventive service fully covered by ACA-compliant plans with no copay. Most generic statins, ezetimibe, and fenofibrate are on the lowest formulary tier, typically $0–$10 per month. For newer agents like PCSK9 inhibitors we work with your insurer and specialty pharmacy to obtain prior authorization; manufacturer copay cards can reduce out-of-pocket costs to as little as $5 per month if you qualify.