Cholesterol After 65: What You Need to Know

When I talk with my patients about cholesterol, I start with this: Not all cholesterol is bad. Your body needs it to work the right way.

Any problems with your cholesterol that come up can be different and completely unique to you.

It is important to remember that as we get older, cholesterol becomes one part of our overall health. It can affect your heart over time, but it’s not the only thing that matters. My goal here is to help you understand your cholesterol numbers and what they mean for you.

Why cholesterol matters

Cholesterol is a waxy substance in your blood that can be harmful to your overall health. However, it is also a substance that your body uses for many important functions, including:

• Maintaining the health of individual cells
• Helping with the digestion and absorption of necessary molecules
• Making of Vitamin D
• Producing steroid hormones
• Metabolism

Over time, when cholesterol levels are too high, it can lead to buildup (sometimes called plaque) in your blood vessels. This can raise your risk for heart attack or stroke.

Even though high cholesterol is not the only factor, managing your cholesterol is still an important way to protect your health over time.

Understanding your numbers

You may want to know if there is a specific number you should aim for with your cholesterol. When you get your lab results, here is what you should look for:

• Total cholesterol: Aim for under 200 mg/dL
• Low-Density Lipoprotein (LDL): Often referred to as bad cholesterol, your goal is lower is better (often under 100)
• High-Density Lipoprotein (HDL): Often referred to as good cholesterol, your goal is the higher the better (at least 40 for men and 50 for women)
• Triglycerides (a type of fat in the blood): Aim for under 150

Each number tells us something different. For older adults, the emphasis often shifts to lowering LDL cholesterol and keeping HDL levels high since these factors more directly influence risks related to heart disease and stroke. It is important to remember to look at your results based on your age, your health, and your personal risk. You should talk with your primary care doctor or advanced practice provider* (APP) about what cholesterol numbers you should be targeting.

Habits to help keep your cholesterol levels in the right range

While genetics may play a role, your daily habits significantly influence cholesterol levels. Here are some ways to help:

• Stay active: You don’t need a hard workout. Walking is one of the best things you can do. If you stay consistent, it can make a big difference in not just your cholesterol numbers but your overall mental and physical health.
• Eat mostly whole foods: Try to eat foods that are less processed. This includes fruits, vegetables, whole grains, and lean proteins like chicken or fish. You can also add foods that help support healthy cholesterol, like:

                                    - Oatmeal and beans

                                    - Fish like salmon

                                    - Nuts and seeds

                                    - Healthy fats like olive oil or avocado

You don’t have to eat perfectly or give up your favorite foods. Just try to enjoy them in smaller amounts. Consider trying the Mediterranean or DASH diet to help in choosing the right foods to stay healthy.

• Keep it realistic: You don’t have to be perfect to improve your health, and you do not have to drastically change your lifestyle overnight. Small, consistent changes overtime compound if you maintain these changes. Talk with your doctor or APP about helpful changes that will help you over the long run. These changes, if maintained, can help not only with the longevity of your life but also with the quality.

How medicine can help

Sometimes, healthy habits are not enough, especially if cholesterol runs in your family.

Your doctor or APP may prescribe medications to help lower your cholesterol. Today, we have many terrific options you and your doctor or APP can consider. The goal is to find the best option for you based on your comfort level and risk factors. The same medication is not right for every patient. Some medicines are given through injections given every two weeks while some medications are given through pills taken daily. For some patients, more than one medication may be necessary to reach their cholesterol goals. The most important part of cholesterol management is to have a conversation with your doctor or APP and find the treatment plan that works best for you.

It is important to remember that as you get older, treatment plans may change. For younger people, your doctor or APP may treat cholesterol more aggressively. For older adults, they may focus more on strength, comfort, and quality of life.

The most important thing is that you make decisions together with your doctor or APP. Your care should fit your life, your goals, and what matters most to you. Make sure to talk to them about any questions or concerns you may have about your cholesterol or treatment plan, so changes can be made if needed.

Cholesterols connection with other health issues

Cholesterol is just one part of your overall health. It works together with other conditions like:

• Diabetes
• High blood pressure

These conditions can affect your blood vessels and make it easier for buildup to happen over time.

When these conditions happen together, they can raise your risk for heart disease, heart attack or stroke. That’s why it is important to focus on your overall health and not just one lab result.

If you haven’t had an appointment recently with your primary care doctor or APP to check your cholesterol, it may be time to schedule a visit.

Most adults should have their cholesterol checked yearly, but it may need to be checked more frequently based on your health and risk factors. Talk to your doctor or APP to determine how often you should have it checked. These visits will help them track your numbers and make changes if needed.

Even if your cholesterol numbers are not where you want them to be, there are steps you can take to improve them. Remember, managing your cholesterol is not about being perfect. It’s about making small, smart choices and staying consistent over time. Doing that can help you feel better and stay healthy as you age.

*An advanced practice provider includes a nurse practitioner or physician assistant.

To schedule an appointment with Dr. Micah Bosley, please contact Village Medical – Jersey Village at 713-466-0197 or visit us at 17347 Village Green Drive, Suite 106, Jersey Village, TX 77040. We look forward to caring for you and supporting your health every step of the way.