Cholesterol Care

Cholesterol care is the screening, diagnosis, and ongoing treatment of high cholesterol (hyperlipidemia) and the cardiovascular risk that comes with it. The goal isn't just to chase a number on a lab report — it's to lower your long-term risk of heart attack and stroke.

At Good Health NC in Knightdale, cholesterol care is built around a standard lipid panel, your other risk factors (age, family history, blood pressure, diabetes status, smoking, body weight), and a 10-year cardiovascular risk estimate. From there, the plan is matched to the person. Some patients need lifestyle adjustments and a follow-up in six months. Others need a statin, a more aggressive workup, or both. The American Heart Association and the U.S. Preventive Services Task Force both recommend cholesterol screening starting in the early 40s — sooner if you have a family history of premature heart disease.

Cholesterol problems rarely show up alone. Our team treats the full lipid picture:

• High LDL cholesterol — the "bad" cholesterol that drives plaque buildup in arteries
• Low HDL cholesterol — the protective form, often low alongside metabolic syndrome
• High triglycerides — usually tied to diet, alcohol use, and insulin resistance
• Mixed hyperlipidemia — when multiple lipid numbers are out of range
• Familial hypercholesterolemia — genetic high cholesterol that often presents early and needs aggressive treatment
• Statin intolerance — patients who've had muscle aches or other side effects on prior therapy

Because lipid problems cluster with other cardiovascular risk factors, your visit will usually touch on hypertension, diabetes, thyroid function, and weight, all in one coordinated plan.

A first cholesterol visit at Good Health NC takes about 30 to 45 minutes:

1. History and risk assessment — family history of heart disease, prior labs, current medications, lifestyle factors
2. On-site labs — full lipid panel (total cholesterol, LDL, HDL, triglycerides), fasting glucose or A1C, thyroid panel, and liver function
3. Physical exam — blood pressure, weight, BMI, and a focused cardiovascular exam
4. 10-year cardiovascular risk calculation — using the standard ASCVD risk score
5. Shared decision on treatment — lifestyle-only versus medication, which medication, and why
6. Follow-up scheduling — typically a recheck in 6 to 12 weeks after starting therapy, then every 6 to 12 months once stable

Fasting before the visit is helpful but not always required — modern lipid panels can be interpreted non-fasting in most cases.

Treatment is matched to your cardiovascular risk, your specific lipid pattern, and how you've tolerated past therapies. The full toolkit includes:

• Lifestyle therapy — practical nutrition counseling (Mediterranean-style eating patterns have the strongest evidence), activity coaching, and weight management when relevant
• Statins — the first-line medication class for most patients, with multiple options at different intensities. We start low and adjust based on labs and tolerance
• Non-statin medications — ezetimibe, bempedoic acid, and PCSK9 inhibitors for patients who can't tolerate statins or need additional LDL lowering
• Triglyceride-focused therapy — for very high triglycerides, including icosapent ethyl when indicated
• Medication management — coordinating cholesterol meds with the rest of your prescription list to avoid interactions
• Preventive care integration — combining cholesterol care with cardiac screening, diabetes prevention, and weight management

We follow the American College of Cardiology's cholesterol management guidelines, which emphasize matching treatment intensity to overall cardiovascular risk — not just to a single lab number.

Schedule a visit if any of these apply:

• You're 40 or older and haven't had a lipid panel in the last five years
• Your last lipid panel showed LDL above 130, triglycerides above 150, or HDL below 40 (men) or 50 (women)
• You have a parent or sibling who had a heart attack or stroke before age 55 (men) or 65 (women)
• You were started on a statin but stopped it because of side effects, and nobody has revisited that conversation
• You've been diagnosed with diabetes, hypertension, or metabolic syndrome — all of which raise cardiovascular risk independent of your cholesterol number
• You're a current or former smoker and want a full risk assessment

Chest pain, shortness of breath at rest, or symptoms of a possible stroke are not cholesterol-clinic problems. Call 911 or go to the nearest emergency department.

Cholesterol management is a long game. Here's how we approach it:

• Risk-based, not number-based — we treat the patient, not the lab slip. Two patients with the same LDL can need very different plans depending on their other risk factors
• On-site labs and same-day results when available — no waiting a week to find out where you stand
• Honest conversations about statins — including the muscle-ache concerns patients hear about online, and what the actual evidence shows
• Coordinated chronic care — cholesterol rarely shows up alone, and we treat the whole picture in one plan
• A 22-year primary care provider as your point of contact — our experienced PA-C clinical lead, leading every visit
• Walk-in support — for medication side effects or new symptoms that come up between scheduled visits

If your last cholesterol conversation was a five-minute drive-by — or hasn't happened at all — we'd be glad to give it the time it deserves.