Take Steps To Keep the "Bad" Cholesterol Low
You get your blood test results back and breathe a sigh of relief.
Your cholesterol levels are well within the "safe" zone, much lower than the 200 milligrams per deciliter (mg/dl) mark at which your chances of a heart attack or stroke increase.
That means you can keep living as you have been, same old habits and diet and activities.
Or does it?
Some physicians now say that even people with "normal" cholesterol can lower their risk of heart attack if they start eating right, exercising, or even taking cholesterol-lowering statin medications.
"We've been studying how low you can take 'bad' cholesterol and still see a benefit," says Dr. John C. LaRosa, president of the State University of New York Downstate Medical Center in Brooklyn. "The answer is you can take it much lower than naturally occurs in a Western population."
September is National Cholesterol Education Month, and physicians are urging everyone to check their cholesterol levels with their family physician at least once every five years.
Cholesterol is a soft, waxy substance found in the bloodstream and in all your body's cells, according to the American Heart Association (AHA). It is essential to have some cholesterol, as it is used to produce cell membranes and some hormones, and serves other needed bodily functions.
But if there is too much cholesterol in your blood, it can begin sticking to the walls of arteries and veins. These plaque deposits can block blood flow to the heart or brain, leading to heart disease, heart attack, or stroke.
The goal is to lower your low-density lipoprotein (LDL) cholesterol, which is the bad kind that clogs blood vessels.
"We call it the bad cholesterol because it's being delivered to the cells from your liver," Dr. LaRosa says. "If you're delivering more cholesterol than your tissues can use, some of it tends to find itself in places where it shouldn't be, including the blood vessel walls."
On the other hand, "good" cholesterol - high-density lipoprotein (HDL) cholesterol - tends to carry cholesterol away from the arteries and back to the liver, where it is passed from the body. High HDL levels are considered a good thing.
An estimated 106.9 million American adults have total blood cholesterol values in the "borderline high risk" range of 200 milligrams per deciliter and higher, according to the AHA. Of these, about 37.7 million people have levels of 240 or above - a level at which physicians recommend immediate lifestyle changes and a prescription for statins.
Persons with total cholesterol over 240 have double the risk of heart disease, compared to those who keep their cholesterol under 200, the AHA says.
Studies have shown that statins are extremely effective, reducing LDL levels by 25 percent to 35 percent. The medications also have proven themselves to be relatively risk-free, Dr. LaRosa says. "These are very safe drugs, these statins, and very effective. They're safer than aspirin, for example."
However, due to some risk for developing liver problems, persons should have their liver function tested by their physician before starting to take a statin medication, and their liver function should be checked periodically while taking statins. There is also a risk, though rare, for developing muscle damage when taking statins.
Accordingly, physicians now are prescribing them to a wider range of people.
Individuals with "high-risk" profiles - smokers, those with cardiovascular disease, persons with poorly controlled high blood pressure - might find themselves on statins even though their LDL levels are around 100 milligrams per deciliter.
And some physicians believe statins should be made available to anyone who cannot make the diet and lifestyle changes necessary to keep their LDL levels down, even if they currently are in the safe zone.
"Cholesterol should be kept under control quite rigorously, rather than leaving it to chance," says Dr. David J.A. Jenkins, a professor in the department of nutritional sciences at the University of Toronto. "It may be easier to take a pill in the evening, rather than go for a run in the morning."
That does not mean that Dr. Jenkins and others are advocating the use of medications over a healthy lifestyle.
The physician notes that eating well and exercising can provide other benefits, including a reduction in the risk of diabetes and cancer.
The lifestyle changes that can make a big difference in your cholesterol levels include reducing the amount of saturated fat and cholesterol in your diet; losing weight if you are overweight, which can reduce your LDL cholesterol and boost your HDL cholesterol; and devoting at least 30 minutes a day to exercise.
"No one who is promoting medications would do so responsibly unless they were equally vigorous in promoting diet and lifestyle change," Dr. Jenkins says. "If they do make major changes in their diet and lifestyle, they can have achievement in a range of health issues. We shouldn't give up on this."
Always consult your physician for more information.
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Healthy aging does not have to be an oxymoron. But for older Americans it means exercising and eating right - plus a whole lot more, health expert say.
And with September designated as Healthy Aging Month, experts are taking the opportunity to remind seniors that their later years can be much more enjoyable if they are fit, active, and self-assured.
The Healthy Aging Campaign, a national health promotion designed to broaden awareness of the positive aspects of aging, breaks down four keys to growing old with style: physical fitness, social wellness, mental wellness, and financial fitness.
Of those four, physical fitness is the key upon which the others turn, says Dr. Carmel Dyer, associate professor of medicine at Baylor College of Medicine in Houston, and director of the Harris County Hospital District Geriatrics Program.
"The fountain of youth truly is exercise," Dr. Dyer says.
Exercise increases your muscle mass and flexibility, making it less likely you will fall and suffer a fracture, Dr. Dyer notes.
It also helps you break down and use blood sugar better, decreasing your risk of diabetes. And it keeps your blood vessels open and dilated, which reduces your blood pressure, she says.
Dr. Dyer recommends exercising for at least 30 minutes three times a week, and adding days as your fitness increases.
Good nutrition, including a diet low in saturated fats and containing five or more servings of fruits and vegetables each day, also is crucial to good health.
And if you are a smoker, quit - it is never too late.
Another part of good health is making sure you get regular checkups, says Dr. Michael Fleming, a Shreveport, La., physician and board chairman of the American Academy of Family Physicians.
"It's important for everyone to have a personal physician you can have a relationship with, that knows you and your family and your risk factors," Dr. Fleming explains, adding that everyone should have a "coordinator of your care."
Dr. Dyer agrees, adding that persons should proactively plan for health screenings for conditions such as heart disease, diabetes, and osteoporosis - to name a few - that could both prolong life and make it more enjoyable.
"Why not see your doctor once a year and get the proper preventative treatment?" Dr. Dyer asks. "It puts you more in control of your health."
Older people also should try to avoid unnecessary medications, Dr. Dyer says, noting that people taking as much as eight medications - including vitamins - have a 100 percent chance of suffering from some sort of medication interaction.
"I would have everyone ask their doctor for the reason for each medication, and what they could do in place of the drugs," she says, noting that physical activity or a healthy diet could supplant the need for some prescription medications.
Having good health and being physically fit also can help keep your mind clear and healthy, both Drs. Dyer and Fleming say.
Just being active can go a long way to improving one's attitude as you grow older, Dr. Fleming says. "If you don't believe you can age actively, I'm pretty sure you can't."
Seniors also should exercise their minds by traveling, learning new skills, reading, researching new interests, or developing a hobby.
A healthy social life also can help seniors stay mentally sharp, Dr. Dyer says.
"Any type of activity is important because it keeps you more alert," she says. "When your social network starts to shrink, it becomes easy to get depressed. It's easier for people to take advantage of you. You may not eat well because you don't like eating alone."
Many seniors stay socially active by contributing time to their communities through local volunteer groups, religious organizations, or civic groups. They also can attend classes at local senior centers or community colleges.
Experts also recommend staying in close contact with friends and family, writing or calling someone every day to be in touch.
Finally, people should take care to make sure they are financially secure as they enter their senior years, Dr. Dyer says.
Long before you near retirement, you should save at least 10 percent of your income and invest in savings plans that compound interest. And people on the verge of retirement should establish financial goals and prepare a budget for their post-employment years.
"People need to prepare for a stable financial future," Dr. Dyer says. "And make sure your money is in a safe place with responsible people. You want to be sure your funds are in trustworthy hands."
Always consult your physician for more information.
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