Neurology Insights

Cholesterol and Stroke Risk: Do You Know Your Numbers?

Healthy Foods

Every year almost 1,000,000 people suffer a stroke, or “brain attack”. This is caused by loss of blood and oxygen to the brain, and there are number of risk factors. These include high blood pressure, atrial fibrillation (an irregular heartbeat), HIGH CHOLESTEROL, diabetes, circulation issues, and carotid artery disease.

What is cholesterol, how do we control it?

Cholesterol is a lipid, which is a soft waxy fat that is in the bloodstream and is found throughout the body. We need cholesterol to form cell membranes, some of our hormones, and vitamin D. We take in cholesterol from foods such as egg yolks, liver, and foods fried in animal fats or tropical oils. If cholesterol levels rise, the fatty, waxy substance can clog arteries by forming a plaque. It can block the smallest blood vessels in the brain, leading to a loss of blood flow and oxygen, thereby causing a stroke. It can also cause occlusion in the carotid arteries, those arteries leading from the heart up to the brain, which can lead to a significant stroke. The plaques can also cause blockage of arteries in the heart, leading to heart disease and high blood pressure.

Are there different types of cholesterol?

Since cholesterol does not get to cells and structures on its own, it has to be delivered to and transferred from cells; it does this by using particles called lipoproteins. There are two types, low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL cholesterol, also known as “lousy” cholesterol, haartery-cloggingng properties. It brings the cholesterol into the bloodstream and helps to cause plaque buildup. The HDL cholesterol, called “happy” cholesterol, carries the cholesterol from the tissues to the liver, where it can be filtered. High levels of HDL can be protective from stroke and heart attack.

So, what are the right cholesterol levels?

Total Blood Cholesterol Levels:
Under 200 mg/dl: The Best 200-239mg/dl: borderline high 240mg/dl or higher: Too high

LDL Cholesterol Levels:
Under 100 mg/dl: desirable 100-129mg/dl: slightly above optimal 130-159mg/dl: slightly high 160mg/dl and higher: Too high

HDL Cholesterol levels: 60mg/dl and higher: Good 40-60mg/dl: not bad
Less than 40mg/dl: Bad

If you have ever had diagnostic testing such as x-rays, ultrasounds, CAT scans, or MRIs, it is extremely helpful to have the reports and to also have copies of the studies. All diagnostic centers will be glad to copy your results on a CD for your treating physicians to review themselves. Physicians like to use their own diagnostic abilities to look at scans and interpret those in combination with the radiology reports.

Also, there is no better historian of your healthcare then you! Keeping a simple, one page chronological summary of your past healthcare is extremely helpful.

I often recommend to my patients that they get an old folder, with many tabs like they used in high school for the different subjects. However, now they will use each tab for every doctor they have seen, reports of each surgery they have had, diagnostic testing, and medications (this includes over-the-counter and natural ingredients as well as prescription medicines).

As I review their one-page summary I can ask for more information and they can go to the tab, for example, Dr. X, and show me that physician’s records. This way I get to review the specifics for the information that I need to obtain. Constantly updating the one-page summary is extremely important to keeping your healthcare information current.

What will raise my cholesterol?

We’ve all heard so many stories about things that will affect cholesterol, but the following certainly will have an adverse impact on your cholesterol:

  • eating foods high in saturated fat
  • carrying excess body weight
  • not exercising
  • strong family genetics of high cholesterol
  • gender (women in menopause have increased cholesterol)

How can I reduce my cholesterol and my risk for stroke?

  • First, must have your cholesterol levels checked. Adults 20 years and older should have the cholesterol levels checked every five years. And men 45 years and older it should be done more frequently and this applies to women older than 55 as well. Cholesterol is checked by a simple laboratory blood test.To take control of your cholesterol, the first thing to do is to eat a healthy diet. Reducing saturated fat, increasing vegetables, fruits, and lean meats (fish, chicken) can help. Adding fiber in the form of whole-grain bread and dried beans may help reduce cholesterol significantly. Changing the way food is prepared, to include baking, boiling, steaming, and grilling and avoiding frying foods will help as well.The next step is to exercise. Regular exercise, 30 minutes or more every day at your target heart rate, can slow down the fatty deposits, increase the blood flow, and significantly reduce stroke risk. Simple activities such as doing the stairs rather than the elevator, parking further way to walk a little bit more, walking the golf course instead of taking a cart, or taking a brisk walk with a friend can all be effective.


Sometimes, even with the best habits, diet, and lifestyle, some individuals are just genetically pre-wired to have higher cholesterol levels. For those individuals, as well as for individuals who are starting on a comprehensive total program to reduce cholesterol, medicines be necessary. If this is the case, you must work with your physician, take the medicine as directed, and notify your physician of any adverse effect of the medicines. Remember, even if you are feeling well, you must still continue to monitor your cholesterol levels, as high cholesterol can lead to problems without warning.


For more information on stroke, stroke prevention, and stroke rehabilitation, including the latest treatment using Botox for post stroke spasticity, contact Neurology Office at or call: 239-231-1414 (Naples) or 239-231-1415 (Ft. Myers)

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Neurology Office, Joseph Kandel M.D. and Associates

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