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Your Guide to Lowering High Cholesterol

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PHYSICIAN VOICES
Managing High Cholesterol: What I Want My African American Patients to Know

Medically Reviewed By Alana Biggers, M.D., MPH
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As the medical director of the University Hospitals Center for African American Health, one of my focuses is to improve the health and wellbeing of the African American community. A key way to address health disparities is to start with high cholesterol. We know people who have had heart attacks, strokes, and circulation problems often have cholesterol that has built up in their blood vessels. In order to prevent these issues and stay healthy, managing high cholesterol is crucial. Here’s what I want my African American patients to know.

1. Follow a healthy diet

We know that diet and genetics are the two things that contribute to high cholesterol. For some people, high cholesterol is hereditary, and there is not much you can do as far as lifestyle changes. You can take medication and it’s always helpful to live a healthy life, but it doesn’t have as much to do with diet. However, for many people, it’s all about diet. 

Some foods are naturally high in cholesterol, like eggs. Keeping egg consumption down can be helpful if you’re trying to lower your cholesterol. But typically, people have high cholesterol because they’re eating too much fast food, too much fried food, and other foods with high fat content. 

It can be difficult in some neighborhoods to find fresher, healthy food. Often, if you go into predominantly African American neighborhoods, you’ll see billboard after billboard for fast food and alcohol. There may be more fast food restaurants and fewer grocery stores with fresh food. It can be hard to make healthy choices in these situations, but it’s still possible. Choose a lean steak over a fatty steak or hamburger. Choose olive oil over other options, and minimize the reuse of cooking oils. Reused cooking oil is worse for your health than fresh oil. If you buy a salad, choose a low fat dressing option rather than high fat dressing like ranch or French.

As a physician, I often refer my patients to dietitians, who are trained to help people make realistic meal plans that help them stay healthy. Everyone needs some guidance sometimes, and often, a dietitian office visit is covered by insurance. A dietitian can recommend simple adjustments that can significantly lower your cholesterol. Ask your doctor if you can talk to a dietitian to help get you started.

2. Connect with the right doctor

I find that a lot of people settle for the doctor they end up with, even if they’re unhappy with that physician and they don’t trust what they say. That means the patients may not get their prescriptions filled or get the screening test that was ordered, and they probably avoid going to their appointments. 

I want patients to know that not every doctor will be the right fit for them; just because that person is a doctor doesn’t mean they have a good connection with you. You want to find someone who you can trust, who you feel you click with. 

The problem with high cholesterol is there are no symptoms, often until it is too late and you have a heart attack, stroke, or circulation problems. Many patients are skeptical when told that their cholesterol is high and accepting this news may be difficult. That’s why it’s important to find someone who you’re comfortable with and who you can be honest with. 

Often, we want to see doctors that look like us. Unfortunately, there aren’t enough Physicians of Color out there, so that means patients should try to find someone with cultural humility. That means you’re seeing a doctor who acknowledges that there are things about your cultural background that they don’t understand, but they’re committed to being open-minded, expanding their education, and seeing you as an individual rather than a stereotype. 

African Americans in particular have the highest stroke rate, the highest heart attack rate, and the highest rate of poor circulation in the legs of any racial or ethnic group, so connecting with a doctor you trust is the first step towards avoiding these outcomes by knowing your cholesterol levels and if they are high, getting them treated.

3. Take your medications as prescribed

A crucial thing I want people with high cholesterol to know is that they shouldn’t be afraid of the best class of medications that lower high cholesterol: statins. Sometimes, I find that I’ll prescribe a statin to a patient, and they just don’t end up filling the prescription or taking it. Especially in the African American community, I hear a lot of talk about how statins have horrible side effects. However, in reality, statins have saved many lives, and they’ve been available for a very long time, so we know a lot about their potential side effects. 

Statins have been proven to be safe and effective for decades, and they can make a huge difference in your health. If you try a statin and experience a side effect you can’t tolerate, talk to your doctor about it. It’s likely that either the side effect is temporary, or there’s another type of statin you can try that you’ll tolerate better. There are also newer medications to consider.

There is a lot you can do to manage your high cholesterol and live a healthier and longer life. Connecting to a doctor you trust is key, because they can play a big role in helping you make positive adjustments to your diet and guide you as you take medications. You’re not alone dealing with this challenge, and it’s worth the work to feel better and live healthier.

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Medical Reviewer: Alana Biggers, M.D., MPH
Last Review Date: 2023 Oct 31
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