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Protecting Your Heart
Rethinking CholesterolAccording to the latest research, it’s all about lowering your LDLSo what is a healthy cholesterol level? With each new research study, the experts seem to have a different recommendation. The topic has been all over the news lately, yet in spite of that, 60 million Americans either don’t know their cholesterol is high or aren’t being treated for it. Are you one of them?Cholesterol is a waxy, fat-like substance produced by your liver that helps build cell walls and certain hormones. Unfortunately, about 100 million of us have too much of this good thing circulating in our blood—and raising our risk for heart disease and stroke. Some of the causes of high cholesterol are lifestyle-related, including excess weight, a high-fat diet and inactivity. These you can do something about. Risk factors beyond your control are your age (cholesterol tends to rise with age), gender (women have lower LDLs than men up until menopause) and genes (high cholesterol tends to run in families). Getting the full pictureIf you know your total cholesterol level, it’s a good start but far from the whole story. You need to know the three components that make up your total cholesterol in the blood test known as a lipid profile, says nurse practitioner Lori Neri of Lehigh Valley Hospital and Health Network. They are:LDL (low density lipoprotein) is the “bad” cholesterol that can build up on artery walls and cause blockages.According to current National Cholesterol Education Program (NCEP) guidelines, everyone should aim for an LDL level below 130 mg/dL*. The more heart disease risk factors you have (including family history, high blood pressure, smoking, obesity) the more critical that becomes. If you have heart disease, diabetes, blockages in your neck or leg arteries, or have had a stroke, Neri says, your LDL level should be below 100 mg/dL. Regular exercise and a low-fat, high-fiber diet can help reduce LDL cholesterol, but many people need medication as well. HDL (high density lipoprotein) is the “good” cholesterol that carries excess fats away from the arteries and back to the liver for disposal. Guidelines recommend an HDL level above 40 mg/dL for men and above 50 for women. Several studies show that high HDL helps protect you against heart disease, Neri says. To raise your HDL, eat a low-fat, high-fiber diet, stop smoking, exercise regularly and keep your weight under control. Triglycerides are another form of fat in the bloodstream that can increase your heart disease risk, especially in combination with low HDL. According to current guidelines, triglyceride levels below 150 mg/dL are normal and above 200 are too high. Triglyceride levels rise after a meal, which is why you need to fast for several hours before your lipid profile. The same diet, exercise and weight control measures that control LDL and HDL help reduce triglycerides. Neri also recommends cutting alcohol consumption and taking omega-3 fish oil capsules. Zeroing in on LDLThe buzz in cholesterol research lately is about LDL—and how low you need to go. “The current excitement revolves around the group of drugs known as statins,” says cardiologist Robert Biggs, D.O., of Lehigh Valley Hospital and Health Network. “Studies have shown that statins in higher doses significantly lower LDL, and subsequent heart attack risk, in people with a history of heart attacks. They also reduce arterial plaque buildup in some patients, with relatively minor side effects.“What we don’t yet know is how low an LDL level the average person should aim for to prevent heart disease,” he says. “I expect the NCEP will revise its recommendations downward soon.” Meanwhile, have your cholesterol measured at least every five years after age 20, more often if you have risk factors—and discuss the results carefully with your doctor.
Want to Know More about assessing your risk for heart disease?
For a self-assessment test, call 610-402-CARE. This page last updated 2/12/08 04:08 PM
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