Cholesterol: Know your numbers

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Cholesterol: Know your numbers Your cholesterol level has a lot to do with your chances of getting heart disease. In fact, the higher your cholesterol level, the greater your risk for developing heart disease or having a heart attack. Heart disease is the number one killer of women and men in the United States. Each year, more than a million Americans have heart attacks, and about 500,000 people die from heart disease. Recent studies in Andhra Pradesh, India show cardiovascular disease is also becoming the biggest killer in rural India, potentially replacing injury and infectious diseases as the top killers. According to an article in The Hindu, the incidence of heart disease in India has doubled in the last 20 years. Over time, a buildup of too much cholesterol in your blood causes “hardening of the arteries” so that arteries become narrowed and blood flow to the heart is slowed down or blocked. If enough blood and oxygen cannot reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack. High cholesterol itself does not cause symptoms; so many people are unaware that their cholesterol level is too high. It is important to find out what your cholesterol numbers are because lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack or dying of heart disease, even if you already have it. Lowering cholesterol is important for everyone, regardless of age, gender, or other health status. What the numbers mean Everyone age 20 and older should have

their cholesterol measured at least once every five years. It is best to have a blood test called a “lipoprotein profile” to find out your cholesterol numbers. This blood test is done after a 9- to 12-hour fast and gives information about your: · Total cholesterol · LDL (bad) cholesterol – the main source

of cholesterol buildup and blockage in the arteries · HDL (good) cholesterol – helps keep cholesterol from building up in the arteries · Triglycerides – another form of fat in your blood If it is not possible to get a lipoprotein profile done, knowing your total cholesterol and HDL cholesterol can give you a general idea about your cholesterol levels. If your total cholesterol is 200 mg/dL or more or if your HDL is less than 40 mg/dL, you will need to have a lipoprotein profile done. Desirable All of the following: • Total cholesterol less than

200 • LDL cholesterol less than 130 • HDL cholesterol 60 and above Borderline High One or more of the following: • Total cholesterol 200-239 • LDL cholesterol 130-159 High

Risk One or more of the following: • Total cholesterol 240 or higher • LDL cholesterol 160 or higher • HDL cholesterol less than 40 Note: Numbers = (mg/dL) milligrams per deciliter of blood. What about triglycerides? Like cholesterol, triglyceride blood fats are also produced by the liver, and elevated levels can also raise heart disease risk in some people. Both tend to rise when these factors are present: a diet high in saturated fat, obesity, uncontrolled diabetes, a kidney or liver disorder, and heavy alcohol use. At some point, your personal physician may want to check your triglyceride level as part of the lipoprotein profile. Triglyceride guidelines Normal Less than 150 Borderline High 150-199 High 200-499 Very High 500 and above Note: Numbers = (mg/dL) milligrams per deciliter of blood. Factors influencing cholesterol levels A variety of factors can affect cholesterol levels. The following are those within your control: Diet Saturated fat and cholesterol in the food you eat make your blood cholesterol level go up. Saturated fat is the main culprit, but cholesterol in foods also matters. Reducing the amount of saturated fat and cholesterol in your diet helps lower your blood cholesterol level. Weight Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol. Losing weight can help lower your LDL and total cholesterol levels, as well as raise your HDL and lower your triglyceride levels. Physical activity Not being physically active is a risk factor for heart

disease. Regular physical activity can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also helps you lose weight. You should try to be physically active for 30 minutes on most, if not all, days. Some factors affecting cholesterol levels are

outside your control. These include: Age and gender As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women’s LDL levels tend to rise. Heredity Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families. Take a self-quiz: Am I at risk? The following factors are associated with an increased risk for unhealthy blood cholesterol. Check those that apply to you. I am a male age 45 or older or female age 55 or older. I smoke cigarettes. I have immediate family members with a history of premature heart attach – before age 55 for men or 65 for women. I am a female, younger than age 55, having completed menopause (or had a total hysterectomy) and not taking supplemental estrogen. I have blood pressure higher than 140/90 mmHg measured at lest 2 separate occasions or am on blood pressure medication. I have low HDL (“good”) Cholesterol (less than 40 mg/dL). I have diabetes. I am overweight. If you checked two or more, you may be at risk for high cholesterol. Ask

your personal physician or other health care provider about cholesterol testing if you don’t know your HDL/LDL numbers. Based on your test results and personal risk factors, take steps to improve your score. Lowering cholesterol with TLC TLC (therapeutic lifestyle changes) is a set of things you can do to help lower your LDL cholesterol. The main parts of TLC are: The TLC diet This is a low saturated-fat, low-cholesterol eating plan that calls for less than 7% of calories from saturated fat and less than 200 mg of dietary cholesterol per day. The TLC diet recommends only enough calories to maintain a desirable weight and avoid weight gain. If your LDL is not lowered enough by reducing

saturated fat and cholesterol intakes, the amount of soluble fiber in your diet can be increased. Certain food products that contain plant stanols or plant sterols (for example, cholesterol-lowering margarines) can also be added to the TLC diet to boost its LDL-lowering power. Weight management If you are overweight, losing weight can help lower LDL and is especially important for those with a cluster of risk factors that includes high triglyceride and/or low HDL levels and being overweight with a large waist measurement (more than 40 inches/102 cm for

men and more than 35 inches/89 cm for women). Physical activity Regular physical activity (30 minutes on most, if not all, days) is recommended for everyone, even if you have a desirable cholesterol level. It can help raise HDL and lower LDL and is especially important for those with high triglyceride and/or low HDL levels who are overweight with a large waist measurement. Only if necessary: prescription medication Even if you begin a treatment regimen prescribed by your physician to lower your cholesterol, you will need to continue your treatment with lifestyle changes. This will keep the dose of medicine as low as possible, and lower your risk in other ways as well. Your doctor can help decide which type of drug is best for you. Once your LDL goal has been reached, your physician may prescribe treatment

for high triglycerides and/or a low HDL level, if present. The treatment includes losing weight if needed, increasing physical activity, quitting smoking, and possibly taking prescription medication.

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