The ‘Low-Down’ On Lipids

High cholesterol and lipid levels significantly increase a person’s risk of developing chest pain, heart attack and stroke. The World Health Organization estimates that 20% of all strokes and over 50% of all heart attacks can be linked to high cholesterol. Unfortunately, this is a problem that many people do not take very seriously. After all, high cholesterol does not cause any symptoms until it is too late.

Debra Geier, MD, Sanford Health

WHAT IS HIGH CHOLESTEROL

Fats in the blood come in several different varieties. The details are sometimes difficult to keep straight. Let’s review:

Cholesterol is a fat-like substance circulating in the blood. Some cholesterol comes from the foods you eat, however much of it is produced in the liver. Cholesterol comes in several different forms. Usually, the focus is primarily on LDL and HDL.

LDL is also referred to as “bad cholesterol”. An easy way to remember this is to think of “L” as standing for lousy. LDL is generally the main treatment target.

HDL is “good cholesterol”. “H” stands for healthy. HDL helps bind bad cholesterol so it can be filtered out of the body. Higher is better!

Triglycerides are another type of fat in the blood. Although high levels do increase cardiovascular risk, triglycerides are generally considered a secondary target after LDL.

WHO NEEDS TREATMENT FOR HIGH CHOLESTEROL
Ask your doctor…
Although this may seem simplistic, it is the true answer. When speaking of cholesterol, and more specifically of LDL, there is no normal range. What your value should be depends on your individual risk factors for heart disease. Major risk factors include cigarette smoking, hypertension, family history, age and low HDL. However, what if you are diabetic, or have peripheral vascular disease, HDL>60, or prior heart attack? One size does not fit all.

WHAT ARE THE TREATMENT OPTIONS
This also depends on each individual’s risk profile, however most agree that everyone with high cholesterol should start with a little “TLC”. I’m not talking about tender loving care. Actually, there is nothing tender or loving about it. It takes hard work and dedicated changes. TLC refers to therapeutic lifestyle change. These changes include diet, exercise, weight loss, reducing stress and quitting smoking to name a few. Even if your cholesterol numbers don’t budge these are healthy steps to take. Get motivated and get moving!

There are several prescription medication options for treatment of high cholesterol if therapeutic lifestyle change is not enough. Statins are the most powerful drugs for lowering LDL cholesterol and are the most effective drug for prevention of coronary heart disease, heart attack, stroke and death. Not everyone can tolerate statins however. Other options include Zetia, bile acid sequestrants, niacin and fibrates. Your doctor can decide if these medications are right for you.

A wide array of nutritional supplements are available and marketed for their cholesterol-lowering effect. Although most are probably not harmful, the benefit of these supplements has not been demonstrated or proven.

NEXT STEPS
The treatment of high cholesterol is a lifelong process which starts with knowing your numbers. Don’t put off testing or treatment for another year. Make 2012 a New Year for a New You!!

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