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 100 mg/dL, and 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

(Our Organization is not responsible for the content of Internet sites.)  

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) 

National Institutes of Health (NIH)        

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

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.