High Cholesterol & Heart-Risk Care in Hilo & Across Hawaiʻi — Medicaid (QUEST) Accepted

High cholesterol means there is too much of certain fats in your blood, especially LDL, the “bad” cholesterol that builds up in artery walls and raises the risk of heart attack and stroke. It causes no symptoms on its own, so it is found through a simple blood test. The most important question is not a single cholesterol number but your overall cardiovascular risk, and that is what guides our care at Ohana Care Clinic in Hilo.

What high cholesterol is

Cholesterol is a waxy substance your body needs, carried through the blood in particles. LDL cholesterol can deposit in artery walls and form plaque, narrowing the vessels that feed your heart and brain, while HDL cholesterol helps clear it away. When LDL runs high over years, plaque builds silently until it causes a heart attack or stroke. A standard lipid panel measures these fats and gives us the starting point for prevention.

Why your overall risk matters more than one number

Modern care looks beyond the cholesterol value itself. Following the 2018 American College of Cardiology and American Heart Association cholesterol guideline, we estimate your ten-year risk of heart attack and stroke using factors such as age, blood pressure, diabetes, and smoking, and then decide on treatment together. The U.S. Preventive Services Task Force takes a similar risk-based approach to deciding who benefits from a statin. Two people with the same LDL can have very different risk, and very different best plans.

How we screen for and diagnose it

We check cholesterol with a routine blood test, sometimes fasting, and repeat it periodically based on your age and risk. We pair that result with your blood pressure, blood sugar, family history, and lifestyle to build a complete picture of your heart health rather than reacting to one lab value in isolation.

How we treat and manage it

For everyone, heart-healthy daily habits come first, and for many people that is enough. When risk is higher, statins are the best-studied, most effective medicines for lowering LDL and preventing heart attack and stroke, and additional options exist when statins are not enough or not tolerated. We make these decisions with you, weighing your risk and your preferences, and we monitor over time. Much of this care fits telehealth, with in-person visits for labs.

The mind-body connection

Heart health and mental health move together. Depression and chronic stress are linked to worse cardiovascular outcomes, and they make heart-healthy routines harder to sustain. Because we combine primary care and behavioral health, we can support mood, stress, and sleep as part of protecting your heart, not as a separate errand.

Culturally grounded care

We care for the whole person, in the spirit of lōkahi — balance and harmony among the connected parts of life: the body, the mind and emotions, the spirit, the ʻohana (family), and our relationship with the ʻāina (land) and community. In a Native Hawaiian understanding of health, these are not separate, and neither is our care. To mālama (care for and protect) your wellbeing and to live pono (in balance and rightness), we listen to your whole story, welcome your ʻohana into the process, and honor the values and traditions that ground you. Offering kōkua (help given freely, with aloha) in a way that respects who you are is at the heart of how we practice.

Insurance and how we see you

We accept Medicare and Medicaid, including the Hawaiʻi QUEST Integration plans (AlohaCare, the Hawaiʻi Medical Service Association (HMSA), ʻOhana Health Plan, and UnitedHealthcare Community Plan), along with most commercial insurance, and we are accepting new patients in Hilo. Primary care works best as a partnership. Your first visit is in person at our Hilo clinic. We see patients in person for physical exams, vitals, and lab work, and we use telehealth for follow-up visits, medication management, and chronic-disease check-ins whenever it is clinically appropriate.

Common questions about high cholesterol

What is a healthy cholesterol level?

There is no single target for everyone. In general, lower LDL (the ‘bad’ cholesterol) is better, but the right plan depends on your overall risk of heart attack and stroke, not the cholesterol number alone. We set goals with you based on your full risk picture.

Do I need a statin?

It depends on your estimated cardiovascular risk, not just your cholesterol. Following ACC/AHA and U.S. Preventive Services Task Force guidance, we weigh your age, blood pressure, diabetes, smoking, and history together and decide with you whether a statin is worthwhile.

Can cholesterol be managed by telehealth?

Yes. After a lipid panel, reviewing results, starting or adjusting medication, and follow-up can all be handled by video, with in-person visits for blood work.

What insurance do you accept?

We accept Medicare and Medicaid, including the Hawaii QUEST Integration plans (AlohaCare, HMSA, Ohana Health Plan, and UnitedHealthcare Community Plan), along with most commercial insurance. We are accepting new patients in Hilo.

References

Grundy, S. M., Stone, N. J., Bailey, A. L., Beam, C., Birtcher, K. K., Blumenthal, R. S., et al. (2019). 2018 AHA/ACC/multisociety guideline on the management of blood cholesterol. Circulation, 139(25), e1082–e1143. https://doi.org/10.1161/CIR.0000000000000625

American College of Cardiology. (2022, August 23). USPSTF releases updated statin guidelines for primary prevention of CVD. https://www.acc.org/Latest-in-Cardiology/Articles/2022/08/23/18/48/USPSTF-Releases-Updated-Statin-Guidelines-For-Primary-Prevention-of-CVD

Papa Ola Lōkahi. (n.d.). Native Hawaiian health. Retrieved June 29, 2026, from https://www.papaolalokahi.org/

This page is general health education from Ohana Care Clinic, written by George Mackel, MSN, APRN, NP-C, PMHNP-BC, CARN-AP. It is not a substitute for a personal evaluation by a qualified clinician who knows your situation, and reading it does not create a provider–patient relationship. If you think you may have a medical condition, reach out to us or another licensed provider. In an emergency, call 911.

George Mackel, MSN, APRN, NP-C, PMHNP-BC, CARN-AP — President & Owner