Wednesday, September 27, 2000
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Wednesday, September 27, 2000 |
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Time to check and control cholesterol By HOLLY VANCE, PHARM. D.
Want to live longer and healthier? Avoid America's number one killercoronary heart diseaseby keeping high cholesterol at bay. Everybody needs cholesterolbut not too much. When cholesterol levels in the blood are too high, fats, cholesterol, and other deposits cling to the inside surface of blood vessels. This thickening of the vessels is called atherosclerosis. It restricts blood flow and increases your risk for heart disease, heart attacks, and stroke. Your liver produces cholesterol to make hormones and maintain nerve cells. And many people will get additional cholesterol from animal products such as milk, eggs, and meat. People who makeor eattoo much cholesterol and fat may have high cholesterol. You won't notice the symptoms of high cholesterol until it's done damage: a heart attack, angina (chest pains), or a stroke. Fortunately, your doctor or health professional can measure your blood cholesterol levels with a simple blood test. That way, you'll know whether you need to take steps to lower your risk for heart disease. When should you start getting tested? Experts disagree. The American Heart Association recommends testing every five years starting at age 20. It also recommends that people at high risk of heart disease test more frequently. Risk factors for heart disease include age (men over 45 and women over 55), a family history of early heart disease, smoking, high blood pressure, and diabetes. Talk to your doctor about a schedule that's right for you.
How high is too high? Cholesterol levels are measured in milligrams per deciliter (mg/dL). Unless you have other risk factors, a total cholesterol level below 200 mg/dL means you're at relatively low risk for heart disease. If you're between 200 and 240, your risk may double. If you're above 240, your risk can rise even higher. If you test above 200, your doctor may check how much is "good" cholesterol (High Density Lipoprotein-HDL) and how much is "bad" cholesterol (Low Density Lipoprotein-LDL). HDL seems to help prevent heart disease and stroke, while LDL increases the risk. Most people should keep their LDL level below 131, but those who are at high risk of heart diseaseor already have heart diseaseshould keep the LDL level below 100. Also, if your HDL level falls below 35, you're at a higher risk.
Getting down to 200/131 If your cholesterol levels are too high, there are plenty of ways to get them down. First things firstexercise regularly and adopt a diet low in saturated fat and dietary cholesterol and high in fiber. Try to get at least thirty minutes of walking or other exercise three times a week to help lower LDL-cholesterol and raise HDL-cholesterol. Overweight people can drop LDL by dropping a few of the extra pounds. If your cholesterol level remains too high, your doctor may recommend niacin or prescription medication. Niacin, also called vitamin B3, can help the body lower total cholesterol and LDL-cholesterol, while increasing HDL-cholesterol. Niacin can cause stomach upset and skin flushing, and slow-release niacin can damage the liver. Please don't treat high cholesterol with niacin on your ownconsult your doctor. Prescription drugs used to treat high cholesterol include bile-acid resins and statins. Bile-acid resins include cholestryamine (brand name Questran), colestipol (Colestid), and a new medicine, colesevelam (Welchol). These drugs work by absorbing blood cholesterol so the body can get rid of it. Bile-acid resins can reduce levels of LDL-cholesterol by 10 to 20 percent. Statins work by lowering the amount of LDL-cholesterol that your body makes in your liver. Statins also fight against heart disease by increasing HDL-cholesterol levels. Prescription statin drugs include lovastatin (Mevacor), simvastatin (Zocor), pravastatin (Pravachol), fluvastatin (Lescol), atorvastatin (Lipitor), and cerivastatin (Baycol). These can lower LDL-cholesterol levels by 20 to 60 percent.
Alternative therapies Some people try alternative therapies, which include garlic and red yeast rice (Cholesterex and Naturade), chromium, lecithin, and quercetin. These approaches are controversial and should only be used under the guidance of your physician. Red yeast rice contains lovastatin, one of the statins found in prescription treatments for high cholesterol. Medical research has shown that red yeast rice is effective in reducing cholesterol, but it hasn't been compared to competing drugs.
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