Optimal cholesterol levels don’t always translate to perfect heart health, based on a recent study that found half of healthy patients with normal cholesterol levels have dangerous plaque build-up in their arteries.
Published in the Journal of the American College of Cardiology, this study took a deeper look into patients with seemingly healthy hearts. The goal was to see how well current definitions identify patients with truly low risk for heart disease.
The analysis included more than 4,100 participants from the PESA (Progression of Early Subclinical Atherosclerosis) study, which tracks the health of healthy employees from the Santander Bank in Madrid, Spain. At the start of the study, participants were 40–54 years old and had ideal health, which was defined as being a non-smoker and having optimal blood pressure, blood sugar, and cholesterol.
After conducting thorough medical exams at the start of the study, researchers found that 50% of participants had significant plaque build-up in their arteries. Plaque build-up was measured using detailed heart imaging (ultrasound or cardiac CT). It is an early sign of heart disease, even in patients with no symptoms.
Researchers also found that patients with higher low-density lipoprotein cholesterol, often referred to as LDL or “bad” cholesterol, were more likely to have plaque build-up than those with lower cholesterol levels. That means that even among healthy patients with “normal” cholesterol levels, higher LDL cholesterol levels may be associated with increased heart risks.
According to authors, findings suggest that even patients with optimal heart health may benefit from prevention efforts. While the cutoffs for high cholesterol are based on reliable evidence, experts note that they’re not an exact science. As a result, not all patients with “normal” cholesterol have the same exact risk for developing heart disease. As this study shows, it’s important that even the healthiest patients take steps to promote better health and reduce risk for heart disease.