Hypertension increases the risk for having a heart attack or stroke. If a patient has additional risk factors, then it is even more likely that the individual will have a negative event. This means that evaluating all the risk factors is important. Some of these risk factors are genetic, some are behavioral and some are biochemical. For example, a diabetic individual with hypertension is more likely to have a bad outcome than someone with hypertension alone, so a fasting blood glucose level is checked.

Lipids are also a risk factor that needs to be addressed. A simple blood test can check cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) levels, thereby allowing a cardiac risk index to be calculated. The cardiac risk index is one way to predict if you might have an increased risk of having a heart attack. The specific level of total cholesterol and LDL that is acceptable will be dependent upon all the risk factors that an individual has. In general, the more risk factors that a person has, the lower the total cholesterol and LDL need to be.

Patients should be aware of the terms used by their health care providers: total cholesterol is just that…all the cholesterol in the bloodstream, both “good” and “bad”. LDL refers to “bad” cholesterol, as this is the cholesterol that is absorbed from the diet through the intestines. HDL is referred to as “good” cholesterol because it is cholesterol that is being moved from fat stores to the liver where it is used to build healthy tissue. LDL can be lowered by removing cholesterol from the diet. HDL can be increased by removing cholesterol from the diet and by exercising.