High Cholesterol

The Big Heart Disease Lie

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Cholesterol contributes to atherosclerosis, which narrows and blocks blood vessels and can result in heart attack and strokes. Many doctors believe that the ideal cholesterol level for American adults should be less than

Rheumatic Fever:

Associated with streptococcus infections, although not actually an infection itself. It usually appears weeks after the infection and may be an allergic reaction to the infection. It can affect the heart, the heart valves, the joints, and the nervous system.

Atherosclerosis:

Lipids, cholesterol, and other fatty deposits located on the inner surface and wall of the artery. It can cause coronary blockages and heart attacks.

Cholesterol:

A fat-like substance, both produced in the body and present in certain types of foods that are made from animals.

Low-density Lipoprotein (LDL):

Although it is necessary for the body to function, it is considered the bad type of cholesterol. An excess amount makes a person more prone to developing coronary artery disease and other types of atherosclerotic diseases.

Cholesterol levels are affected by diet. Diets rich in vegetables and fruits — and even including moderate amounts of alcohol — have been shown to help prevent heart disease.

200 milligrams per deciliter (mg/dl) of blood. Studies of large groups of people have shown that when a person's cholesterol level is more than 240 mg/dl, the risk of heart attack is double that of those people with a cholesterol level less than 200 mg/dl. What is an acceptable cholesterol level may actually vary from one person to another. For example, when a person has no risk factors for cardiovascular disease — is not obese, is not diabetic, is a nonsmoker, and has no family history of heart disease — the doctor may be comfortable in regularly reevaluating such a patient with a cholesterol level in the 240 mg/dl range without prescribing cholesterol-lowering medication. On the other hand, when a patient has numerous risk factors or known atherosclerotic heart disease, a doctor will work with the patient to decrease the total cholesterol level to less than 200 mg/dl.

One subtype of cholesterol, low-density lipoprotein (LDL), can be dangerous if its level in the blood is excessively elevated. It is desirable to keep the LDL level less than 130 mg/dl. Patients with a level of more than 160 mg/dl are at significantly greater risk of developing heart attacks and other problems related to atherosclerosis. From a practical standpoint, LDL serves as the most important cholesterol-related guide to the risk of heart disease and other atherosclerosis-related diseases.

In patients with known heart disease, such as post-coronary bypass patients, this level should be kept to less than 100 mg/dl. In patients who are not actually known to have coronary heart disease but are at high risk of developing heart disease, such as patients with high blood pressure and diabetes, a positive family history of coronary disease, a history of smoking, and obesity, this level should be less than 130 mg/dl.

Lowering of the cholesterol level should first be attempted by diet and exercise. If these interventions alone are not successful in obtaining satisfactory levels, a number of very effective medicines can be used. Most of them belong to a class of drugs called the statins. These drugs can usually be used safely but require monitoring by a physician with periodic blood tests because certain side effects and complications sometimes occur when these drugs are taken.

It is important to know that not all cholesterol subtypes are harmful. High-density lipoprotein, or HDL, is considered the good or protective type of cholesterol. It is desirable to have an HDL level of thirty-five mg/dl or higher, and ideally of more than forty-five. If the HDL level is less than thirty-five, one is at higher risk for heart attacks and strokes.

After your physician checks your serum cholesterol level and cholesterol subtypes (LDL, HDL), he or she will recommend which foods to avoid and medicines to take, if necessary.

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Your Heart and Nutrition

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