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Helen Dandurand (Host): Welcome back to the Well Within Reach podcast. I'm your host, Helen Dandurand. And today, I'm going to be joined by nurse practitioner Katie Van Hoveln, a family medicine provider at Riverside's Watseka campus to talk about everything you need to know about cholesterol.

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Host: And we're back with Katie Van Hoveln. Thanks for joining me today.

Katie Van Hoveln: Thank you for having me.

Host: Of course. So, I know you've been on the podcast before, but could we get started by having you tell the listener a little bit about yourself?

Katie Van Hoveln: Like you said, my name is Katie Van Hoveln. I'm a family nurse practitioner and I work at the Riverside office in Watseka. I've been a nurse since 2013 and a nurse practitioner since 2019.

Host: Awesome. Okay. So, let's just jump on into the topic today. Like I said, we're talking about cholesterol. Could you start by giving us just a brief overview of what cholesterol is and the role that it plays in our health?

Katie Van Hoveln: So, cholesterol is a natural substance in the body. It's a waxy, fat-like substance and it is found in all the cells of our body. We use it in our body to make hormones, vitamin D, and other substances that we use to digest food. Our body makes cholesterol naturally and it is also found naturally in certain foods, like eggs.

Host: Cool. So with that being said, though, I've heard a lot about good cholesterol versus bad cholesterol. I've seen it like on my test results and I've always been a little bit confused as to, like, what the difference is. I think that's HDL and LDL. Could you tell me about that?

Katie Van Hoveln: Yeah, you're right. Those are the two main types of cholesterol that you'll see on your cholesterol panel. HDL is what we call good cholesterol. That stands for high-density cholesterol. And this one carries cholesterol to our liver for removal from our body. So, we consider that a good thing. LDL stands for bad cholesterol or low-density cholesterol. And this is the one that can lead to buildup of plaque in our arteries and plaque causes things like heart disease.

Host: That makes sense. That makes sense. So, what would you say are the key risk factors that contribute to high cholesterol? And how does like family history play a role in determining like the risk factors as well?

Katie Van Hoveln: So, there's three risk factors that we can control as a person, and the first one would be unhealthy eating habits. So, that's eating a lot of processed foods or trans or saturated fats. The second one is lack of physical activity, so never exercising, being sedentary in our everyday lives. And the third one is smoking. You brought up family history. Genetics can also cause high cholesterol, and that's something that we can't necessarily control. It's something that can be inherited.

Host: Gotcha. Interesting. So, I was going to ask, my next question was going to be a little bit about how much diet and lifestyle choices influence that. And you kind of mentioned that they really do. That's one of the higher risk factors. What would you say are some practical tips for maintaining a healthy lifestyle?

Katie Van Hoveln: So, the first one, of course, is a heart healthy diet. So, that means eating non-processed fruits and vegetables, trying to stay away from those trans and saturated fats. The second one is weight management, trying to get down to normal BMI, or even just losing weight if you are in that overweight category, any weight loss counts. And then, the third one is regular physical activity.

Host: Got it. Cool. We're going to take a quick break and we're going to talk a little bit about primary care.

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All right. So for individuals with high cholesterol, if you know that that is something you have, what are the treatment options available?

Katie Van Hoveln: So, the first thing your provider will always talk to you about is lifestyle changes, like we mentioned before. So, that's changing your diet, possibly losing weight, starting regular physical activity. The second one will be medications, the most common of which is the statin class of medications, and those do work well. Your provider will talk to you about a 10-year risk of heart attack and stroke. They'll calculate that and let you know what that is. If that risk is above 7.5%, they're most likely going to recommend a medication along with lifestyle changes. So, that's something you can discuss with your provider once they get your lipid panel back.

Host: Gotcha. Are there symptoms of high cholesterol that someone would maybe need to be on the lookout for? Or is that something that you just get screened for regularly and that's how you know?

Katie Van Hoveln: There really is not symptoms of high cholesterol and it is something that's why you need to be screened, because really a blood test is the only thing that can give you those results.

Host: Gotcha. Good to know. Good to know that we need to be prioritizing that for sure. How often should people get their cholesterol levels checked then? Is that annually? And what should they expect from a screening?

Katie Van Hoveln: So, younger adults really can expect a screening maybe every five years. Men that are age 45 to 65 and women age 55 to 65 should expect an annual screening or one every other year. And the screening is really just a blood test that your doctor will order. There's nothing out of the normal for it. If you do know that you have that family history of high cholesterol, especially if your relatives were being diagnosed with high cholesterol at a younger age, you're going to want to talk to your provider about that and see if you can be screened even earlier.

Host: Got it. That makes sense. Would you say there are any, like, myths surrounding cholesterol that you hear patients maybe talking about, like misconceptions?

Katie Van Hoveln: The biggest misconception that I hear, and I know my colleagues here as well, is that statin medications are not safe. A lot of people are afraid to take those. I think one of the reasons for this is because some statins do cause muscle pain in a certain population of people, and just know that if this does happen, you can always talk to your provider about the pain that you're experiencing, and we can try a different type of statin medication. A lot of times, that's the only thing that we need to change and then you're able to take the statin without any issues.

Host: Got it. I didn't know anything about that, so good to know. What advice would you have for listeners who want to proactively manage their cholesterol levels?

Katie Van Hoveln: So, make sure that you have a PCP, a primary care provider that you can talk with and that you trust and bring it up to them that you are wondering about getting screened, see if they would recommend it now or if they have a plan for it in the future. And that can just open up the doors to making sure that you're screened and you know what your levels are.

Host: Awesome. Well, it was great having you today. Thank you so much for being on.

Katie Van Hoveln: Thank you for having me.

Host: Of course, and thank you listeners for tuning into the Well Within Reach podcast brought to you by Riverside Healthcare. For more information, visit riversidehealthcare.org/primarycare.