What
is High Cholesterol? Hypercholesterolemia is one of the most common cardiovascular
medical concerns. It is a silent killer, as many patients are unaware that they
have it. This is why regular blood cholesterol screening is essential to prevent
the complications of this disease. Cholesterol is subdivided into Total, Low Density
Lipoproteins (LDL), High Density Lipoproteins (HDL), and Triglycerides. For all
patients we would like to see the total cholesterol less than 200. High LDL levels
are most predictive of heart disease in men. Reducing fried and oily foods are
a good way to reduce the LDL levels. For most patients the goal LDL is less that
110. For patients who are at particularly high risk of heart disease the LDL goal
is closer to 70. HDL is the good cholesterol. High levels of HDL are desirable.
Levels in men for HDL should be greater than 40, and for women levels should be
greater than 50. Low levels of HDL are most predictive of heart disease in women.
Increasing daily exercise is the best way to increase HDL. Triglycerides are the
fats. Levels should be less than 150.
What
are the complications of cholesterol? Hypercholesterolemia takes its toll
on many important organs in the body. By causing damage to the inner lining of
the blood vessels, plaques and clots can form. In the brain this can lead to a
devastating stroke. In the heart, this damage can lead to a heart attack. In the
retinal artery, the damage to the blood vessel can cause blindness.
What
can I do to prevent or treat high blood cholesterol?
Exercise.
Regular exercise is key to well being. People who exercise regularly can also
reduce their total cholesterol and increase their HDL levels. Keep in mind high
HDL levels are protective against heart disease. Ideally we should exercise three
times a week for at least 30 minutes. Two thirds of the time should be aerobic
and get your heart rate up, one third should be anaerobic muscle strength workouts.
For those who can not fit large workouts into their routine, I ask for five minutes
of exercise before hitting the shower. Just do as many sit ups, push ups or jumping
jacks as you can. The results will speak for themselves.
Nutrition.
Eating properly to avoid sugar or caffeine highs or lows is important to keep
your appetite under control. Eating processed, carbohydrate heavy meals and snacks,
fast foods, and restaurant foods are likely to be high in cholesterol, and therefore
should be avoided. Eating multiple small unprocessed natural snacks and meals
will help to keep your cholesterol consumption to a minimum.
Weight
Loss. Reducing your weight 10-15% will have a substantial effect on your cholesterol.
For many of our patients eating properly and exercising work as well to reduce
cholesterol as standard medications that are prescribed. For more detailed weight
loss information, click here.
Do
I need medication for my high cholesterol?
There
are several classes of medications that are commonly used to treat high cholesterol.
Although in depth information is available through other websites (Rxlist.com
and others) some summary information is provided below.
"Statins"
are the mainstay of medication treatment for high cholesterol. Crestor, Lipitor
(atorvastatin), and Zocor (simvastatin) are the most commonly prescribed medications
in this class. They work to interfere with the way cholesterol is metabolized
in the body, and thus reduce levels. These medications in multiple studies have
shown a reduction in the endpoints of stroke, cardiac events, and sudden death
of 30-50%. These dramatic reductions are not thought to be achieved by simply
reducing the level of cholesterol. In fact another effect of these medications
is to stabilize and reduce unstable plaques in the vital arteries, and it is this
effect that is credited with the large reductions in the rate of heart attacks
and strokes.
Zetia
is another commonly used medication for the treatment of high cholesterol. It
blocks absorption of cholesterol in the intestines, and can be an alternative
for those who can not tolerate more common cholesterol medications
Niacin
is a naturally occuring vitamin that is very effective in reducing cholesterol.
However, it can cause very uncomfortable flushing in many patients. Taking aspirin
30 minutes before taking niacin can help reduce the flushing in some patients.
Copyright
Tareq Abedin, MD 2007
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