CHOLESTEROL

Is cholesterol really such a big deal? Approximately 1 in 6 Americans have high cholesterol, otherwise known as hyperlipidemia or hypercholesterolemia. Cholesterol is a waxy, fat-like substance which is needed for multiple functions in the body, but is a major risk factor for heart disease and stroke when abnormally elevated.

So what does all this talk about cholesterol mean? Cholesterol is typically divided into three categories, LDL, HDL and triglycerides. LDL, low-density lipoprotein, is generally considered “bad cholesterol.” When too much LDL circulates in the blood it slowly builds up in artery walls that supply the heart and brain. This leads to plaque formation in arteries, which is referred to as atherosclerosis. If a clot forms nears these plaques blood flow to the heart muscles can be blocked and cause a heart attack, or MI. Similarly, a clot can block blood flow to the brain and cause a stroke. HDL, high-density lipoprotein, is concerned “good cholesterol.” HDL appears to carry cholesterol away from the arteries and back to the liver. A higher HDL level actually protects the heart.

So how do we get all this cholesterol? While our bodies produce cholesterol, we also take in cholesterol through our diet. Food from animals, such as egg yolks, meat, milk and dairy products add cholesterol to our diet. Saturated fatty acids from processed foods also contribute to raising cholesterol. Fruits, vegetables, grains and seeds do not contribute to bad cholesterol levels. While diet makes up the greatest controllable risk factor, obesity, inactivity and smoking also negatively affect cholesterol. Some risk factors for increased cholesterol can not be helped, such as age, sex and heredity. Men typically have higher cholesterol levels but both sexes have increased risks for elevated levels as we age.

Will I know if I have high cholesterol? No, elevated cholesterol levels do not have symptoms, which is why it is very important to see you PCP yearly for cholesterol screening. A simple blood test taken in the office and then sent to a lab for further analysis. To get a true reading you need to come in fasting (meaning you can’t eat or drink anything other than water for 8 hours). Typically this works best to come in the am.

So what are my goals for my cholesterol? This can get confusing because goals are based on personal risk factors. Persons with existing cardiac disease and diabetes have the most stringent goals. People with tobacco use, hypertension and certain family history have higher goal to reach then those without risk factors. Cholesterol goals can best be understood by meeting with your pcp to discuss your health and lifestyles, which will determine which category you should be in.

Generally speaking in low risk factor groups your cholesterol should be as follows:

Total cholesterol Less than 200 mg/dL

LDL “bad” Less than 100mg/dL

HDL “good” 40 mg/dL or higher

Triglycerides Less than 150 mg/dL

These numbers to do not apply to high risk groups.

Now that I know I have high cholesterol, how do I treat it? First are therapeutic lifestyle changes. Regular exercise will lower the bad LDL and actually raise the good HDL. Increasing your omega3 intake through fish or supplements will also help raise your HDL.

For more information on what you can do yourself, turn to the CDC website which has sites on nutrition, physical activity and obesity

http://www.cdc.gov/nutrition/everyone/basics/fat/saturatedfat.html

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Maintain a healthy weigh

http://www.cdc.gov/healthyweight/index.html

Exercise regularily

http://www.cdc.gov/physicalactivity/index.htnl

Don’t smoke

http://www.cdc.gov/tobacco

Sometimes, even with the best efforts, medication is needed to lower cholesterol to goal. There are several different classes of medications used to lower cholesterol and sometimes different medications have to be tried before the goal is reached. Our clinic also has Walk-in Weight loss program which can help get cholesterol to goal.