Rolanda Perkins’ heart disease story started with a really bad headache.
She took over-the-counter medication and waited for the pain to pass as she was getting ready for her sister’s 40th birthday party. She didn’t want the headache and accompanying fatigue to slow her down. The party went off without a hitch, but the next day things got worse.
“I was cleaning my kitchen floor and I felt a pain in my chest,” says Perkins, 50, who lives in Smyrna, Tennessee. “I didn’t go to the hospital at that time because I brushed it off as being indigestion, and if it continued I would go to the doctor the next morning.”
More chest pain woke Perkins up in the middle of the night. She was driven to the hospital and when doctors evaluated her, she was startled by the diagnosis: She was having a heart attack.
“Thank God I had no blocked arteries,” she says. But afterward she found out one of the likely causes of her heart attack was something she’d never given much thought to — high cholesterol.
How High Cholesterol Causes Heart Attacks
After her heart attack, Perkins’ cardiologist showed her a diagram of how too much cholesterol — along with other fats, your cells’ waste products, calcium, and fibrin — forms plaques that can block the arteries.
Cholesterol is a fat-like substance produced in your liver, and there are two kinds of it in your blood: “good” cholesterol (HDL) and “bad” cholesterol (LDL). HDL cholesterol is considered protective because it helps to remove excess fat from the bloodstream. Too much LDL cholesterol is a risk because it causes plaque to build up on the walls of your arteries. This can eventually cause deadly blockages that reduce blood flow to the heart.
“The higher the bad cholesterol levels, the higher the risk of heart attack and heart disease,” says Richard Milani, MD, vice-chairman of the department of cardiology at Ochsner Health System in New Orleans.
A diagnosis of high cholesterol after a heart attack — like Perkins was given — is common, even though high cholesterol is a treatable heart disease risk factor. The Centers for Disease Control and Prevention (CDC) estimates 73.5 million American adults have high LDL cholesterol levels, yet fewer than 1 in 3 of those people have their high cholesterol under control.
“It can be controlled through lifestyle changes and medication if necessary,” says Dr. Milani.
Control High Cholesterol to Prevent Heart Attacks
Perkins says she was initially prescribed at least eight drugs when she was discharged from the hospital after her heart attack. Currently, she only takes one cholesterol medication, a statin.
Medication is an important way to control cholesterol levels, and the most commonly prescribed drugs for doing this are statins. These not only lower your LDL cholesterol levels, but also increase HDL cholesterol levels and lower triglycerides (another fat found in the bloodstream and linked to heart disease).
“Statins are prescribed if someone has high cholesterol right after a heart attack, to prevent a second one from occurring, but also as a preventive measure if they have many of the other risk factors for heart attack, like smoking, diabetes, and obesity,” says Milani.
Perkins continued to educate herself about her condition, but wasn't satisfied with her initial cardiologist’s plan to treat her solely with medication.
She switched doctors and asked her current cardiologist what more she could do to prevent high cholesterol from causing another heart attack. “She [my cardiologist] suggested that I cut back on the foods that were high in saturated fats,” says Perkins, and to cut sodium consumption.
Lifestyle changes are crucial to controlling high cholesterol, particularly when it comes to dietary fats. Consistently eating foods high in saturated fats (like meat and full-fat dairy items) can cause cholesterol levels to rise quickly. Choosing plant-based proteins, like beans, nuts, and seeds, and getting plenty of foods high in fiber can lower LDL cholesterol. Sodium doesn't directly affect cholesterol levels, but it does cause high blood pressure, another heart attack risk factor.
Perkins started paying close attention to the nutrition labels on the foods she was buying. “Prior to the diagnosis, I used to purchase whatever I wanted with no regard to its nutritional content or the effects on my body,” she says.
“I was also instructed to incorporate consistent exercise in my daily routine,” says Perkins.
Another thing she thanks for her recovery? Her dog. “He was a lifesaver. He helped make exercises like running and walking a lot more enjoyable.”
Make Healthy Changes Into Habits to Prevent Heart Attack
Milani says, “It’s very important that these lifestyle changes become habits, otherwise high cholesterol or other risk factors will eventually return.” He suggests including the whole family in those changes, instead of just cooking special meals for the person with heart disease, or leaving them to self-motivate to exercise.
“You never want to have a repeat heart incident,” says Dr. Milani. “If there’s a way to get everyone involved and turn these into permanent habits, then it’s harder for people to slip back into old behaviors.”
Perkins’ unexpected heart attack was a wake-up call. Before her heart attack, she never gave thought to what food she was eating or what her cholesterol levels were. Now she’s eating healthier, enjoying exercise with her dog, and helping to save other lives through her volunteer work with the American Heart Association.
She hopes her story can serve as an example of how someone can turn a previously unhealthy — and almost deadly — lifestyle into a heart-healthy one.
If you’ve just been diagnosed with high cholesterol after a heart attack, Perkins says it helps to do a few simple things. “Follow the doctor’s orders,” she says. “And if you need help adjusting to the new lifestyle, then seek out the help. Don’t be ashamed to do so.”