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Routine doctor’s appointments might just seem like something you need to check off your to-do list, but if you go through them on auto-pilot, you’re doing yourself a disservice. Paying attention to exactly what your doctor is saying and asking the right questions is super-important—especially if you have any health concerns like high cholesterol.
“Heart disease is the number one killer of all people across the world, and 80 percent of the time it’s preventable,” says Suzanne Steinbaum, D.O., a preventive cardiologist based in New York City. “A big way to prevent heart disease is to have an open conversation with your doctor. This helps you understand what your own risk factors are and know what you can do about them.”
So what should you ask? Here are six heart health questions you should know the answers to before you leave your next appointment.
1. How can I keep my heart healthy?
Everyday habits like the food you eat and how much you move are crucial to keeping your cardiovascular system in top form, so go over your lifestyle with your doctor and see what you could be doing differently.
“Prevention is so important. You can help prevent heart disease with basics like eating a healthy diet,” Dr. Steinbaum says. “The Mediterranean Diet is a great approach. It’s rich monounsaturated fat found in almonds, avocados, and olive oil, and high in soluble fiber found in foods like peas, legumes, apples, oranges, pears, berries, broccoli, and oatmeal,” Dr. Steinbaum says.
Exercise is also a major factor in prevention, Dr. Steinbaum adds. She supports and emphasizes the current American Heart Association and American College of Cardiology recommendations to get at least 40 minutes of moderate- to vigorous-intensity exercise or activity three to four times per week. If you don’t enjoy things like running or biking, make exercise part of your daily routine by taking the stairs instead of the elevator or briskly walking as you do errands.
2. Do I have any risk factors for heart disease?
According to Dr. Steinbaum, the major risk factors for heart disease include:
- Smoking
- High blood pressure
- A family history of premature coronary heart disease
- Low high-density lipoprotein cholesterol (aka HDL-C, good cholesterol)
Other things like age, weight, diet, activity level, and stress, can also play a role. Knowing if you’re high-risk or not can help you figure out the right screening schedule and best preventive steps to take (like if you need to add in more exercise or work on reducing stress).
3. Do I need my cholesterol checked?
“The thing with high cholesterol is you wouldn’t know you have it without getting it tested,” says Dr. Steinbaum. “It’s often called the ‘silent killer’ due to its lack of symptoms.”
The reason having too much cholesterol (especially low-density lipoprotein cholesterol, aka LDL-C, which is the more dangerous form) is so bad is that it raises your risk of developing plaque in your arteries, which can lead to a heart attack or stroke.
Starting at age 20, you should be getting your cholesterol checked every four to six years—more often if you have a family history of it.
4. If my LDL-C is too high, what can help lower it?
“Modifying your diet and adding exercise can improve your cholesterol in as little as six weeks,” says Dr. Steinbaum. “But if your LDL-C stays elevated after three months or so of lifestyle changes, your doctor will likely talk to you about something called a statin.”
A statin is a medication that shuts off the production of cholesterol in the liver, and aids in removing excess bad cholesterol from the blood to help bring your levels down. It is a critical part of achieving lower cholesterol levels and can help patients reach their treatment goals. “There are a number of statins available, but not all statins are the same, and your doctor will recommend which would be best for you,” says Dr. Steinbaum.
For example, for certain appropriate patients, like those managing and taking medications for other conditions as well (think: calcium channel blockers for high blood pressure) your doctor may recommend the statin LIVALO® (pitavastatin). Due to the way LIVALO is broken down in the body, there is less potential for certain drug interactions when taking multiple medications. Every patient is different and you should talk to your doctor about appropriate treatment options.
LIVALO is not right for everyone. Do not take LIVALO if: you have a known allergy to LIVALO or any of its ingredients, you have active liver problems, including some abnormal liver test results, you are nursing, pregnant or may become pregnant, as it may harm the baby, or you are currently taking cyclosporine or gemfibrozil.
5. Do statins replace eating well and exercising?
The short answer is no. When it comes to lowering your cholesterol, statins are never a replacement for exercise and a heart-healthy diet, Dr. Steinbaum says. However, they may help lower cholesterol as part of a holistic treatment regimen when it can’t be managed with diet and exercise alone, she adds. Remember: High cholesterol should always be managed with an individualized treatment plan created in partnership with a doctor.
6. Will I stay on a statin forever?
It depends. Statins are introduced when diet and exercise alone aren’t successful in lowering cholesterol levels. It’s important to think of a statin as another tool to help to lower cholesterol (in addition to a heart-healthy diet and regular exercise). It’s imperative to take a serious and dedicated approach to do everything you can to reduce the risk of coronary heart disease and this may include taking medication regularly as directed by your doctor.
It’s important to keep an open dialogue with your healthcare provider about your heart health and your current cholesterol medications. If you want to speak to your provider about your treatment options, this customizable doctor discussion guide can help you begin the conversation.
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