Why Your Heart Health Depends on More Than Cholesterol

For decades, heart health has been reduced to a single question: What’s your cholesterol?

If your numbers fall inside a reference range, you’re reassured. If they don’t, you’re prescribed a statin—end of discussion. But cardiovascular health is far more complex—far more personal—than a lipid panel alone.

At Halcyon, we see this every day in patients who are doing “everything right” and still don’t feel well. Their labs are labeled normal, yet their energy is low, their sleep is poor, and their stress is high. Something feels off. Something is missing.

Cholesterol plays a role in heart health, but it’s only one data point. It doesn’t explain why plaque forms, why inflammation persists, or why two people with identical lipid panels can have wildly different outcomes. 

Heart disease develops at the intersection of:

• Hormones

• Metabolic health

• Inflammation

• Lifestyle stressors

Hormones directly influence how your cardiovascular system functions.

• Estrogen supports healthy blood vessels, cholesterol transport, and controls inflammation. Declining estrogen—common in perimenopause and menopause—can increase cardiovascular risk even when cholesterol appears “normal.”

• Testosterone affects muscle mass, insulin sensitivity, fat distribution, and vascular tone. Low testosterone in men and women is associated with higher rates of metabolic syndrome and heart disease.

• Cortisol, the stress hormone, is healthy in acute doses. But when it’s chronically elevated, blood pressure, blood sugar, and inflammation levels skyrocket.

When hormone imbalances are ignored, heart disease is underestimated. This is one reason we see hormone imbalance heart risk missed in traditional screenings.

Metabolic Health Matters More Than Most Realize

Cardiovascular disease is closely tied to metabolic dysfunction.

Key drivers include:

• Insulin resistance

• Elevated fasting glucose or A1C (even within “normal” ranges)

• Abdominal fat and altered body composition

• Chronic inflammation

Someone can have acceptable cholesterol but still be on a fast track toward cardiovascular disease if their metabolic health is compromised.

Lifestyle Is a Driver

Sleep deprivation, chronic stress, poor recovery, and inconsistent movement all strain the cardiovascular system.

What we often see:

• High performers running on stimulants

• Patients under-eating protein and over-eating quick snacks

• Sleep apnea or disrupted sleep going undiagnosed

• Exercise that doesn’t match hormonal or recovery capacity

These patterns directly affect blood pressure, inflammation, insulin sensitivity, and hormone regulation—yet they rarely show up in a standard screening. What’s measured is managed, and what’s missed is multiplied.

“Normal” Labs Do Not Equal Optimal Health

One of the most misleading mantras in medicine is “Everything looks normal.”

Reference ranges are built to identify disease, not define optimal function. You can fall within range and still experience:

• Fatigue

• Weight gain

• Brain fog

• Anxiety

• Poor exercise tolerance

And yes—ongoing cardiovascular risk.

Practitioners should ask: Does this make sense for you? For your symptoms? For your goals?

A Better Way to Think About Heart Health

True heart health is proactive, personalized, and preventative. 

That means:

• Evaluating hormones alongside lipids

• Looking at metabolic markers early

• Understanding lifestyle stressors

• Adjusting care as your body changes

For individuals experiencing heart health concerns, this integrated approach identifies root causes and enables earlier, more effective intervention.