When's the last time you had your cholesterol checked? Do you know your "numbers"? Seventy-one million American adults have high LDL cholesterol (the bad kind), but only one-third of them have their condition under control, according to the Centers for Disease Control (CDC).

September is National Cholesterol Education Montha good time to learn your numbers by getting your cholesterol level checked. Why is this something you should know?

According to the World Health Organization (WHO), Cardiovascular disease (CVD - heart disease, stroke) is the leading cause of death worldwide, affecting more than 23 percent of the world's population. By 2030, it is projected that around 40 percent of the US population will have some form of CVD. LDL cholesterol is strongly associated with CVD riskand its reduction.

Cholesterol is a waxy, fatty substance produced in the liver that your body actually needs. But, when you produce too much in your blood, it can begin building up on the walls of your arteries and form blockages. This often leads to heart disease, heart attacks and stroke. For those who already have CVD issues, cholesterol can raise risks exponentially.

There are two kinds of cholesterol: high-density lipoprotein (HDL) and low-density lipoprotein (LDL). HDL is often referred to as the "good" cholesterol, while, as previously mentioned, LDL is known as the "bad" cholesterol. In terms of talking about high cholesterol, we're interested in keeping the "low"-density lipoprotein - low. And the lower, the better.

What number should you be trying to achieve?

Your doctor can determine the LDL cholesterol level that is right for you, based on your risk of developing heart disease. In general:

LDL Cholesterol Level (mg/dL)

Less than 100 - Optimal

100-129 - Near optimal

130-159 - Borderline high

160-189 - High

190 and above - Very high

How do I achieve those numbers?

While some factors, such as gender, race and family history come into play, pursuing a healthy lifestyle is the best method.

Eat a healthy diet. Avoid saturated fats and trans fats, which tend to raise cholesterol levels. Other types of fats, such as polyunsaturated fats, can actually help lower cholesterol levels, as can consuming more fiber in your diet.

Maintain a healthy weight. Being overweight (a body mass index over 25) or obese (BMI over 30) can raise your cholesterol levels. Losing weight can help lower your cholesterol.

Exercise regularly. Physical activity can help lower cholesterol. The Surgeon General recommends that adults engage in moderate-intensity exercise for 2 hours and 30 minutes every week.

If you smoke, quit as soon as possible.

If cholesterol control medication is prescribed by your doctor, stick with it.

At what LDL number should I begin taking medication?

If you have made an honest effort at diet and exercise for three months and despite your efforts, your LDL is still above 130, you may be a candidate for statin treatment. They work by blocking a substance your body needs to make cholesterol. Statins may also help your body reabsorb cholesterol that has built up in plaques on your artery walls, preventing further blockage in your blood vessels and heart attacks.

The National Cholesterol Education Program recommends that adults aged 20 years or older have their cholesterol checked every five years and more often if any of the following apply to you:

n Your total cholesterol is 200 mg/dL or higher.

n You are male and older than age 45 or a female older than age 50.

n Your HDL "good" cholesterol is lower than 40 mg/dL.

n You have other risk factors for heart disease and stroke.

If it's been awhile, or you're not sure where your cholesterol levels are, it's time to get them checkedand keep them in check.

Dr. Daniel H. Dunker, MD, FACC, is with the Carondelet Heart Institute at St. Marys Medical Center and can be reached at 816-220-1117.