Cholesterol
Better Understood, But Some Not Addressing High Levels
September
is National Cholesterol Education Month
While many people in the US
know about the dangers of high cholesterol, much still needs to be done
to help those individuals with high cholesterol levels reduce their
risk for heart disease.
"Our survey data shows
that awareness over the last 20 years has grown enormously," says
Dr. James Cleeman, coordinator of the National Cholesterol Education
Program of the National Heart, Lung, and Blood Institute (NHLBI).
"People can identify that high cholesterol is a risk factor for
heart disease and that they ought to do something about it.
"But sometimes," Dr. Cleeman adds, "the
problem is what they know and what they do are not necessarily lined
up."
US
Statistics Reveal High Numbers
According to the National Center
for Health Statistics, about 102 million US adults have total
blood cholesterol levels of 200 milligrams per deciliter (mg/dL)and
higher - which is above what is deemed desirable.
Of those individuals, 41.3 million have levels of 240
and higher, which is considered high risk.
All of these people should take action, says Dr. Cleeman,
who notes that dietary and lifestyle changes can lower their risk of
heart disease or, if they already have heart disease, lower their risk
of death or possible bypass surgery.
In light of this challenge, September has
been designated National Cholesterol Education Month
by the National Institutes of Health (NIH).
"We want people to know their numbers
and know their risk," says Dr. Cleeman, who adds that the NIH
released new practice guidelines in 2001 calling for more aggressive
treatment of high cholesterol.
People should be aware of not only their total cholesterol,
but also their levels of so-called "good" HDL cholesterol,
"bad" LDL cholesterol, and triglycerides, which are fatty
compounds in the blood.
HDL levels should be 40 mg/dL or higher,
LDL levels should be less than 130 mg/dL for individuals with no previous
risk factors for heart disease, triglycerides should be less than 150
mg/dL.
Under the new guidelines, adults are advised to have
their cholesterol levels checked at least every five years.
Several years ago, a research study suggested that once
you are past a certain age, cholesterol levels might not have to be
watched so closely. But Dr. Cleeman and another expert, Dr. Daniel Lee,
say more recent research refutes that notion.
It is wise for patients over the age of 70 to keep an
eye on cholesterol, says Dr. Lee, of the Santa Monica-UCLA Medical Center.
Reducing
"Bad" Cholesterol Lowers Risk
Dr. Cleeman points to a study, published
in the medical journal The Lancet in 2002, showing
that taking cholesterol-lowering drugs reduced deaths from heart disease
by 24 percent in the group that took the drugs instead of a placebo
(inactive substance).
Some people can manage their high cholesterol
with an improved diet and exercise, according to a recent study published
in the Journal of the American Medical Association.
Researchers also found recently that eating a low-fat
diet high in fiber, nuts, and vegetable proteins was sometimes as successful
as drugs in lowering cholesterol.
For some patients, Dr. Lee and other experts first recommend
lifestyle changes, such as a healthful diet with less than 30 percent
of total calories from fat (both fat and cholesterol in the diet drive
up blood cholesterol, but experts say fat is the main problem).
Dr. Lee also advises exercising three to five times
a week for at least 30 minutes.
Dr. Lee finds that if the lifestyle change is going
to work, "you will usually see the full effect in about a month
or two."
Then, he reevaluates the person to see if cholesterol-lowering
drugs, such as statins, should be added to the regimen.
Both Dr. Cleeman and Dr. Lee agree that if lifestyle
changes do not work, no one should feel like a failure for having to
go on medication. For some, the combination approach works best.
And certain patients, including those with risk factors
such as diabetes, might be prescribed medications along with lifestyle
improvements from the start.
Always consult your physician for more
information.
Online
Resources
American
Heart Association
Centers
for Disease Control and Prevention (CDC)
HealthierUS.Gov
National
Cancer Institute (NCI) Eat 5 to 9 A Day
National
Heart, Lung, and Blood Institute (NHLBI) |
September 2003
Cholesterol
Better Understood, But Some Not Addressing High Levels
US
Statistics Reveal High Numbers
Reducing
"Bad" Cholesterol Lowers Risk
Facts
About Cholesterol
Online
Resources
Find
a St. John's Mercy Physician
In
Other News About Your Heart Health:
Facts
About Cholesterol
Cholesterol is a waxy
substance that can be found in all parts of your body. It aids in
the production of cell membranes, some hormones, and vitamin D.
The cholesterol in your
blood comes from two sources: the foods you eat and your liver.
However, your liver makes all of the cholesterol your body needs.
Cholesterol and other
fats are transported in your blood stream in the form of spherical
particles called lipoproteins. The two most commonly known lipoproteins
are low-density lipoproteins (LDL) and high-density lipoproteins
(HDL).
What is LDL (low-density
lipoprotein) cholesterol?
This type of cholesterol
is commonly called the "bad" cholesterol, and is a type
of fat in the blood that contains the most cholesterol. It can contribute
to the formation of plaque buildup in the arteries, known as atherosclerosis.
You want your LDL to be
low. To help lower it:
What is HDL (high-density lipoprotein)
cholesterol?
This type of cholesterol
is known as the "good" cholesterol, and is a type of fat
in the blood that helps to remove cholesterol from the blood, preventing
the fatty buildup and formation of plaque.
You want your HDL to be
as high as possible. Some people can raise HDL by:
For others, medicine may
be needed. Because raising HDL is complicated, you should work with
your physician on a therapeutic plan.
What are triglycerides?
Triglycerides are another
class of fat found in the bloodstream. The bulk of your body's fat
tissue is in the form of triglycerides.
The link between triglycerides
and heart disease is under clinical investigation. However, many
people with high triglycerides also have other risk factors such
as high LDL levels or low HDL levels.
Elevated triglyceride
levels may be caused by medical conditions such as diabetes, hypothyroidism,
kidney disease, or liver disease.
Dietary causes of elevated
triglyceride levels may include obesity and high intakes of fat,
alcohol, and concentrated sweets.
A healthy triglyceride
level is less than 150 mg/dL.
Always consult your physician
for more information.
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