But Arthur Agatston, M.D., a cardiologist at the University of Miami Miller School of Medicine/South Beach Preventive Cardiology, PA in Miami Beach, Fla., told Scharf he had a bigger problem to deal with. "The total cholesterol is a very poor predictor of future heart attack and stroke in individuals." Dr. Agatston told Ivanhoe.
But he says knowing the size of your cholesterol is also important. If good, HDL particles are small, they're not as efficient, and if bad, LDL particles are small, they slip into vessel walls more easily. "It's also oxidized more easily, which is part of what cases the plaque buildup," Dr. Agatston says.
He warns even if your cholesterol is normal, you can still have dangerously small particles. "In this country, actually more people have heart attacks with cholesterols less than 200 than with cholesterols over 300," Dr. Agatston says.
You can increase your cholesterol size with a healthy diet, exercise, and medication. "There's absolutely something you can do about it," Dr. Agatston says.
Scharf changed his diet, increased his exercise, lost 25 pounds and dropped his cholesterol from 247 to 135. A blood test shows both his good and bad cholesterol particles are bigger. "I feel pretty good," Scharf says. "I mean, I feel lighter."
With a healthier future, Scharf now has a new focus. "I'm supposed to be getting married pretty soon, and I promised my fiancée that I'd be around 50 years from now to celebrate an anniversary, so that's my goal," Scharf explains. And that's a goal worth toasting to.
Dr. Agatston says small cholesterol size is associated with pre-diabetes, diabetes and also belly fat. Most major labs can do the test and most insurance companies cover it; but it's not standard -- you do have to ask your doctor for it.
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University of Miami Miller School of Medicine