Reader Hotline: Cholesterol Experts

Many people know that high cholesterol is dangerous for health. But few people know what different levels of lipids in the blood mean, when and how often they should be checked, and how elevated levels can be brought back down. On the occasion of this year’s Cholesterol Day, experts from the German Society for Combating Lipid Metabolism Disorders and Their Complications (DGFF/Lipid-Liga) provided information during a reader telephone campaign. Here are the most important questions and answers:

At what age and how often should blood lipids be checked?

Prof. Dr. Peter Grützmacher


As early as possible, as high blood lipids can be inherited. If they are detected in parents, it is necessary to measure the level of lipids in the blood of their children. The sooner you detect dyslipidemia and treat it with a healthy lifestyle or medication, the better it is for your blood vessels. Adults between the ages of 18 and 35 have the right to a one-time medical examination with determination of the blood lipid level, starting at the age of 35, every three years at Check-up 35. But it would be better to measure them earlier.

Why are high blood lipids especially dangerous for people with diabetes or high blood pressure?


Prof. Dr. Ulrich Julius: Diabetes and the associated high blood sugar levels lead to long-term physical changes that increase the risk of cardiovascular disease. These include atherosclerosis or hardening of the arteries with narrowing of blood vessels – the structure of the heart muscle changes and blood flow properties deteriorate. If blood pressure is consistently too high, the heart has to do excessive pumping work, and deposits – called plaques – can build up even more easily. They consist, among other things, of cholesterol. If LDL cholesterol also increases, the risk of plaque formation and therefore atherosclerosis increases. This can lead to clogging of blood vessels and as a result, for example, to a heart attack or stroke.

Specialists on the phone of the reader

Prof. Dr. Peter Grützmacher, specialist in internal medicine and nephrology

Doctor Fatima Gujil, specialist in internal medicine and cardiology

Prof. Dr. Ulrich Julius, specialist in internal medicine and diabetology

Prof. Dr. Reinhard Klingel, specialist in internal medicine and nephrology

Prof. Dr. Volker Schettler, specialist in internal medicine and nephrology

Dr. Brigitte Öhm, specialist in internal medicine and nephrology

Dr. Britta Otte, specialist in internal medicine and nephrology

information The DGFF (Lipid-Liga) offers information on the topic of dyslipidemia, which can be downloaded free of charge from www.lipid-liga.de or requested in printed form.


Question: What do different blood lipid levels say about my health?


Brigitte Um doctor: In a healthy person without risk factors for cardiovascular disease, the level of LDL cholesterol in the blood should be below 116 mg/dL (or 3 mmol/L). A triglyceride level of up to 150 mg/dL (or 1.7 mmol/L) is considered “normal.” For everyone else, this question cannot be answered in general. Doctors always determine a person’s overall risk profile. The recommendations of the European specialized societies provide guidance in evaluating the measured values ​​of blood lipids and deciding to what level they should be lowered, if necessary.


Question: Do LDL cholesterol limits change with age?


Prof. Dr. Reinhard Klingel: We are all born with very low levels of LDL cholesterol, but levels rise as we age. It is important to always look at LDL cholesterol levels in light of an individual’s cardiovascular risk profile.


Question: How to prevent high cholesterol?


Doctor Fatima Gujil: In principle, a healthy lifestyle is the basis of prevention and any therapy. Unfortunately, this is still underappreciated, but the success of some patients shows what can be done through lifestyle changes. This includes a Mediterranean diet with fruits, vegetables, olive oil, nuts, more fish, but less meat and fiber. Other building blocks of prevention are final smoking cessation and physical activity. You should aim for thirty minutes three times a week – even better, a total of 150 minutes. Choose an activity that you like – this way you will be better informed.


Question: How to lower high LDL cholesterol?


Prof. Dr. Volker Schettler: A healthy diet high in plant-based foods such as vegetables, salad, legumes, whole grains and fruit, and high in omega-3 fatty acids from oily marine fish and plant-based fats such as olive and flaxseed oil, but low in fat from meat, sausage and cheese, little sugar and white flour the most important action. Active exercise, such as endurance sports and losing weight if you are overweight, can also lower your LDL cholesterol.


Question: When is medication needed?


Prof. Dr. Volker Schettler: People with serious disorders of lipid metabolism, if there are already deposits in the blood vessels, a heart attack or stroke have already occurred, the drug is necessary in any case.

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