September is National Cholesterol Education Month in the U.S. This is an opportunity for doctors, nurses, and other healthcare professionals to encourage patients to know their cholesterol levels – and take safe, smart, and proactive steps to prevent or reduce high cholesterol.
However, it is not just healthcare professionals who can be part of the awareness-raising effort. Employers have a pivotal role to play when it comes to helping employees separate facts from fiction about cholesterol. As noted by internal medicine specialist Spencer Kroll, MD, PhD, “I’ve been studying cholesterol and lipid disease and spreading awareness for many years, and I’ve seen many misunderstandings and misconceptions about high cholesterol.”
Below we debunk nine enduring cholesterol-related myths. We encourage employers to share this information with their workforce to support their efforts during National Cholesterol Education Month and as part of their ongoing commitment to help employees enjoy healthier, happier lives.
Myth #1 : High cholesterol isn’t that common compared to other illnesses like cardiovascular disease and cancer.
Fact: High cholesterol, or hyperlipidemia, is defined as having low-density lipoprotein (LDL) cholesterol (sometimes called “bad” cholesterol) greater than 190 mg/dL. Nearly 94 million U.S. adults aged 20 or older have total cholesterol levels higher than 200 mg/dL, and 28 million adults in the U.S. have total cholesterol levels higher than 240 mg/dL.
Myth #2: High cholesterol isn’t that dangerous.
Fact: Too much LDL cholesterol, or not enough (high-density lipoprotein) HDL cholesterol (“good” cholesterol) increases the risk that cholesterol will slowly build up in the inner walls of the arteries that feed the heart and brain. This can narrow the arteries and make them less flexible, a condition known as atherosclerosis. If a blood clot forms and blocks one of these narrowed arteries, the result can be a heart attack or stroke. Having high blood cholesterol raises the risk for heart disease (i.e., the number one cause of death) and stroke (i.e., the fifth-leading cause of death).
Myth #3: It is easy to tell if someone has high cholesterol based on the symptoms.
Fact: Similarly to high blood pressure, high cholesterol typically has no symptoms — and as such, many people do not know that their cholesterol is too high. There is an opportunity to tackle hyperlipidemia by helping people understand their cholesterol.
Myth #4: There is no connection between high blood pressure and high cholesterol.
Fact: Individuals with high cholesterol can develop fatty deposits in their blood vessels. When the body can’t clear cholesterol from the bloodstream, the excess cholesterol can deposit along artery walls. When arteries become stiff and narrow from the deposits, the heart has to work overtime to pump blood through them. This causes blood pressure to go up. 63% of people with high blood pressure also have high cholesterol.
Myth #5: Only overweight and obese people need to worry about high cholesterol.
Fact: People of any body type can, and do, have high cholesterol. It’s also important to be aware of risk factors for high cholesterol unique to women, such as pregnancy-related high blood pressure and gestational diabetes, as well as understand that:
- Women with diabetes are more likely than men with diabetes to develop high cholesterol and heart disease.
- Stress and depression have a stronger effect on women’s hearts than on men’s.
- Smoking is a stronger risk factor for high cholesterol in women than in men.
- Menopause significantly increases women’s risk of developing high LDL cholesterol and heart disease.
- A family history of early-onset heart disease may be a stronger risk factor for women than for men.
Myth #6: What is considered a healthy cholesterol level is the same for women and men.
Fact: The healthy level of HDL cholesterol is 40 mg/dL or higher in men and 50 mg/dL or higher in women. Women naturally have estrogen in their body. Estrogen acts on the liver to cause an overall reduction in the total amount of cholesterol in the body, an increase in the amount of HDL cholesterol, and a decrease in the amount of LDL cholesterol. Women’s cholesterol levels generally change as their hormones change, which is especially important to be aware of when pregnant or going through menopause.
Myth #7: If a nutrition label says that a product has no cholesterol, then it must be healthy.
Fact: Many “no cholesterol” foods are very high in other types of “bad” fats, such as saturated and trans fats.
Myth #8: Individuals who have high cholesterol do not need statins or other medicines. Instead, they can manage cholesterol with diet and exercise.
Fact: While it is true that making dietary changes and exercising can help, some people still need statins or other medicines to lower their cholesterol levels. Although nearly 86 million U.S. adults could benefit from taking medicine to manage their high LDL cholesterol, only about half (55%) are doing so.
Myth #9: Cholesterol is not an expensive condition to treat.
Fact: Treating cholesterol is extremely costly. Between January 1, 2002, and December 31, 2018, an average of 21.35 million statins were purchased each year, with an average total annual cost of $24.5 billion.
Closing the Knowledge Gap in Cholesterol
Cholesterol is often misunderstood. During National Cholesterol Education Month, employers are urged to share resources and tools with their workforce, so that dangerous myths are replaced with helpful facts.
One way to help support employees’ heart health is by providing a digital therapeutic that empowers them to manage conditions like high cholesterol and high blood pressure, the leading risk factors for heart disease. Newly launched this month, Hello Heart’s ‘My Cholesterol’ feature provides users with clarity on their cholesterol and triglycerides trends through personalized insights and coaching to help them manage their cholesterol levels.
Hello Heart’s digital coaching app provides gender-specific ranges to help employees understand if their cholesterol levels are in a risky range based on their gender at birth. This unique aspect is critical, given that many ranges and general explanations fail to take gender differences into account.
In addition, employees can import lab results, store medical data from multiple sources directly in the app, and view a simple graph of the data to clearly understand trends over time.
Championing Whole-Heart Health in Your Workforce
Understanding cholesterol is complex, and managing high cholesterol is vital. Employers have an important role to play – and National Cholesterol Education Month is a perfect time to lean in and find more ways to support your employees’ wellbeing and heart health.
1. Gazit T, Gutman M, Beatty AL. Assessment of Hypertension Control Among Adults Participating in a Mobile Technology Blood Pressure Self-management Program. JAMA Netw Open. 2021;4(10):e2127008, https://doi.org/10.1001/jamanetworkopen.2021.27008. Accessed October 19, 2022. (Some study authors are employed by Hello Heart. Because of the observational nature of the study, causal conclusions cannot be made. See additional important study limitations in the publication. This study showed that 108 participants with baseline blood pressure over 140/90 who had been enrolled in the program for 3 years and had application activity during weeks 148-163 were able to reduce their blood pressure by 21 mmHg using the Hello Heart program.) (2) Livongo Health, Inc. Form S-1 Registration Statement. https:/www.sec.gov/Archives/edgar/data/1639225/000119312519185159/d731249ds1.htm. Published June 28, 2019. Accessed October 19, 2022. (In a pilot study that lasted six weeks, individuals starting with a blood pressure of greater than 140/90 mmHg, on average, had a 10 mmHG reduction.) NOTE: This comparison is not based on a head-to-head study, and the difference in results may be due in part to different study protocols.
2. Validation Institute. 2021 Validation Report (Valid Through October 2022). https://validationinstitute.com/wp-content/uploads/2021/10/Hello_Heart-Savings-2021- Final.pdf. Published October 2021. Accessed October 19, 2022. (This analysis was commissioned by Hello Heart, which provided a summary report of self-fundedemployer client medical claims data for 203 Hello Heart users and 200 non-users from 2017-2020. Findings have not been subjected to peer review.)