HDLP61 Cholesterol LM BCBSNE 101806
User Manual: HDLP61
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MANAGING
CHOLESTEROL
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UNDERSTANDING
CHOLESTEROL
Getting Started
Too much cholesterol (ko-LES-ter-ol) in
the blood, or high blood cholesterol, can be
serious. People with high blood cholesterol
have a greater chance of getting heart disease.
Unfortunately, many people are unaware that
they have high blood cholesterol because the
condition does not cause any symptoms.
What is Cholesterol?
Here are some key facts about cholesterol:
»Cholesterol is a waxy, fat-like substance
that is found in all cells of the body.
Your body needs some cholesterol to
properly function.
»Cholesterol is also found in some of the
foods you eat.
»Your body uses cholesterol to make
hormones, Vitamin D, and substances
that help you digest foods.
Blood is watery and cholesterol is fatty. Just
like oil and water, the two do not mix. So, in
order to travel in the bloodstream, cholesterol
is carried in small packages called lipoproteins
(lip-o-PRO-teens). The small packages are
made of fat (lipid) on the inside and proteins
on the outside. Two kinds of lipoproteins
carry cholesterol throughout your body. It is
important to have healthy levels of both:
»LDL (low density lipoprotein)
cholesterol is sometimes called “bad”
cholesterol.
• High LDL cholesterol leads to a buildup
of cholesterol in the arteries. The higher
the LDL level in your blood, the greater
chance you have for getting heart
disease.
»HDL (high density lipoprotein)
cholesterol is sometimes called “good”
cholesterol.
• HDL carries cholesterol from other
parts of your body back to your liver.
The liver removes the cholesterol from
your body. The higher your HDL
cholesterol level, the lower your chance
of getting heart disease.
2MANAGING CHOLESTEROL
BLOCKED
ARTERY
NARROWED
ARTERY
HEALTHY
ARTERY
What is High Blood
Cholesterol?
»Too much cholesterol in your blood can
build up in the walls of your arteries (blood
vessels that carry blood from the heart to
other parts of the body). is buildup of
cholesterol is called plaque. Over time, plaque
can cause narrowing of the arteries. is is
called atherosclerosis (ath-er-o-skler-O-sis) or
“hardening of the arteries.”
»Special arteries, called coronary arteries,
bring blood to the heart. Narrowing of your
coronary arteries due to plaque can stop or
slow down the flow of blood to your heart.
When the arteries narrow, the amount of
oxygen-carrying blood is decreased. is is
called coronary artery disease (CAD). Large
plaque areas can lead to chest pain called
angina. Angina happens when the heart does
not receive enough blood and the oxygen it
carries with it. Angina is a common sign of
CAD.
»Some plaque has a thin covering and can burst
(rupture), releasing fat and cholesterol into the
bloodstream. e release of fat and cholesterol
may cause your blood to clot. A clot can block
the flow of blood. is blockage can cause
angina or a heart attack.
»Lowering your cholesterol level decreases your
chance for having plaque burst and the chance
of a heart attack. Lowering cholesterol may
also slow down, reduce, or even stop plaque
from building up.
»Plaque and resulting health problems can also
occur in arteries elsewhere in the body.
OTHER NAMES FOR
HIGH BLOOD CHOLESTEROL
9Hypercholesterolemia
9Hyperlipidemia
DID YOU KNOW?
According to the Centers
for Disease Control and
Prevention (CDC), high
cholesterol affects about
33% of adults over the age
of 20 in the United States.
Unfortunately, less than
half of adults with high LDL
cholesterol get treatment.
People with high
total cholesterol have
approximately twice the
risk of heart disease as
people with optimal levels. A
desirable level is lower than
200 mg/dL.
The average total
cholesterol level for adult
Americans is about 200
mg/dL, which is borderline
high risk.
33%
3MANAGING CHOLESTEROL
What Causes High
Blood Cholesterol?
A variety of things can aect the cholesterol
levels in your blood. Some of these things you
can control and others you cannot.
You CAN control:
9What you eat. Certain foods have
types of fat that raise your cholesterol
level.
»Saturated fat raises your LDL
cholesterol level more than anything
else in your diet.
»Trans fatty acids (trans fats) are made
when vegetable oil is “hydrogenated”
to harden it. Trans fatty acids also
raise cholesterol levels.
»Cholesterol is found in foods that
come from animal sources, for
example, egg yolks, meat, and cheese.
9Your weight. Being overweight
tends to increase your LDL level, low-
er your HDL level, and increase your
total cholesterol level.
9Your activity. Lack of regular exer-
cise can lead to weight gain and raise
your LDL cholesterol level. Regular
exercise can help you lose weight and
lower your LDL level. It can
also help you raise your HDL
level.
You CANNOT control:
9Heredity. High blood cholesterol
can run in families. An inherited
genetic condition (familial hyper-
cholesterolemia) results in very high
LDL cholesterol levels. It begins at
birth, and results in a heart attack
at an early age.
9Age and sex. Starting at puberty,
men have lower levels of HDL than
women. As women and men get
older, their LDL cholesterol levels
rise. Younger women usually have
lower LDL cholesterol levels than
men, but after age 55 they usually
have higher levels than men.
CHOLESTEROL IS FOUND
IN FOODS THAT COME
FROM ANIMAL SOURCES
LIKE EGG YOLKS, MEAT,
AND CHEESE.
4MANAGING CHOLESTEROL
HOW DO I KNOW
IF I HAVE HIGH CHOLESTEROL?
5MANAGING CHOLESTEROL
What are the Signs
and Symptoms of High
Blood Cholesterol?
There are usually no signs or symptoms of high
blood cholesterol. In fact, many people don’t
know that their cholesterol level is too high.
Everyone age 20 and older should have their
cholesterol levels checked at least once every
ve years. You and your doctor can discuss
how often you should be tested.
How is High Blood
Cholesterol Diagnosed?
High blood cholesterol is diagnosed by
checking levels of cholesterol in your blood. It
is best to have a blood test called a lipoprotein
prole to measure your cholesterol levels.
Most people will need to “fast” (not eat or
drink anything) for 9 to 12 hours before
taking the test.
The lipoprotein prole will give information
about your:
9Total cholesterol
9LDL (bad) cholesterol: the main
source of cholesterol buildup and
blockage in the arteries
9HDL (good) cholesterol: the good
cholesterol that helps keep choles-
terol from building up in arteries
9Triglycerides: another form of fat in
your blood
If it is not possible to get a lipoprotein prole
done, knowing your total cholesterol and HDL
cholesterol can give you a general idea about
your cholesterol levels. Testing for total and
HDL cholesterol does not require fasting. If
your total cholesterol is 200 mg/dL or more,
or if your HDL is less than 40 mg/dL, you will
need to have a lipoprotein prole done.
Cholesterol levels are measured in milligrams
(mg) of cholesterol per deciliter (dL) of blood.
See how your cholesterol numbers compare to
the tables on the following page.
THERE ARE USUALLY NO
SIGNS OR SYMPTOMS OF
HIGH BLOOD CHOLESTEROL.
IN FACT, MANY PEOPLE
DON’T KNOW THAT THEIR
CHOLESTEROL LEVEL IS
TOO HIGH.
Triglycerides can also raise your risk for heart
disease. Levels that are borderline high (150-
199 mg/dL) or high (200 mg/dL or more)
may need treatment. Things that can increase
triglycerides include:
»Overweight
»Physical inactivity
»Cigarette smoking
»Excessive alcohol use
»Physical inactivity
»Very high carbohydrate diet
»Certain diseases and drugs
»Genetic disorders
6MANAGING CHOLESTEROL
Total Cholesterol Levels Category
Less than 200 mg/dL Desirable level that
puts you at lower risk
for coronary heart
disease. A cholesterol
level of 200 mg/dL or
higher raises your risk.
200 to 239 mg/dL Borderline high
240 mg/dL and above High blood
cholesterol. A person
with this level has
more than twice the
risk of coronary heart
disease as someone
whose cholesterol is
below 200 mg/dL.
HDL Cholesterol Levels Category
Less than 40 mg/dL
(men)
Less than 50 mg/dL
(women)
Low HDL cholesterol.
A major risk factor for
heart disease.
60 mg/dL and above High HDL cholesterol.
An HDL of 60 mg/
dL and above is
considered protective
against heart disease.
If your total cholesterol is 200 mg/dL or more, or
your HDL cholesterol is less than 40 mg/dL (for
men) and less than 50 mg/dL (for women), you
need to have a lipoprotein profile done to determine
your LDL cholesterol and triglyceride levels. If your
cholesterol is high or you have other risk factors,
your healthcare provider will likely want to
monitor your cholesterol more closely. Follow
your provider’s advice about how often to have your
cholesterol tested. He or she will set appropriate
management goals based on your LDL cholesterol
level and other risk factors.
LDL Cholesterol Levels Category
Less than 100 mg/dL Optimal
100 to 129 mg/dL Near or above optimal
130 to 159 mg/dL Borderline high
160 to 189 mg/dL High
190 mg/dL or above Very high
Triglyceride Levels Category
Less than 150 mg/dL Normal
150 to 199 mg/dL Borderline high
200 to 499 mg/dL High
500 mg/dL or above Very high
MEASURING CHOLESTEROL
Source: American Heart Association Recommended
Cholesterol Levels
TREATMENT
AND RISK FACTORS
How is High Blood
Cholesterol Treated?
The main goal of a cholesterol-lowering
treatment is to lower your LDL level enough
to reduce your risk of having a heart attack
or other diseases caused by hardening of the
arteries. In general, the higher your LDL
level and the more risk factors you have, the
greater your chances of developing heart
disease or having a heart attack. Some people
are at high risk for heart attack because they
already have heart disease. Other people
are at high risk for developing heart disease
because they have diabetes or a combination
of risk factors for heart disease.
The Risk Factors
Your blood cholesterol level is aected
not only by what you eat but also by how
quickly your body makes LDL (“bad”)
cholesterol and disposes of it. In fact, your
body makes all the cholesterol it needs, and
it is not necessary to take in any additional
cholesterol from the foods you eat.
Many factors help determine whether your
LDL-cholesterol level is high or low. The
following factors are the most important:
9Heredity. Your genes inuence how
high your LDL (“bad”) cholesterol is
by aecting how fast LDL is made and
removed from the blood. One specic
form of inherited high cholesterol that
aects one in 500 people is familial
hypercholesterolemia, which often leads
to early heart disease. But even if you
do not have a specic genetic form of
high cholesterol, genes play a role in
inuencing your LDL cholesterol level.
9What you eat. Two main nutrients
in the foods you eat make your LDL
(“bad”) cholesterol level go up: saturated
fat, a type of fat found mostly in
foods that come from animals; and
cholesterol, which comes only from
animal products. Saturated fat raises
your LDL cholesterol level more than
anything else in the diet. Eating too
much saturated fat and cholesterol is the
main reason for high levels of cholesterol
and a high rate of heart attacks in the
United States. Reducing the amount of
saturated fat and cholesterol you eat is
7MANAGING CHOLESTEROL
GET SCREENED! Make a point of getting
screened for high cholesterol regularly. If you’re
over the age of 20, you need to have your
cholesterol checked every five years. High
cholesterol can be managed—either with lifestyle
modification, medication, or both—but you must
know your cholesterol is high in order to address it
effectively.
8MANAGING CHOLESTEROL
a very important step in reducing your
blood cholesterol levels.
9Weight. Excess weight tends to increase
your LDL (“bad”) cholesterol level. If
you are overweight and have a high
LDL cholesterol level, losing weight may
help you lower it. Weight loss also helps
to lower triglycerides and raise HDL
(“good”) cholesterol levels.
9Physical activity/exercise. Regular
physical activity may lower LDL (“bad”)
cholesterol and raise HDL (“good”)
cholesterol levels.
9Age and sex. Before the age of
menopause, women usually have total
cholesterol levels that are lower than those
of men the same age. As women and men
get older, their blood cholesterol levels rise
until about 60 to 65 years of age. After the
age of about 50, women often have higher
total cholesterol levels than men of the
same age.
9Alcohol. Moderate alcohol intake
increases HDL (“good”) cholesterol but
does not lower LDL (“bad”) cholesterol.
Doctors don’t know for certain whether
alcohol also reduces the risk of heart
disease. Drinking too much alcohol can
damage the liver and heart muscle, lead to
high blood pressure and raise triglycerides.
Because of the risks, alcoholic beverages
should not be used as a way to prevent
heart disease.
9Stress. Stress over the long term has
been shown in several studies to raise
blood cholesterol levels. One way that
stress may do this is by aecting your
habits. For example, when some people
are under stress, they cope by eating
fatty foods. The saturated fat and
cholesterol in these foods contribute to
higher levels of blood cholesterol.
MANAGING
YOUR CHOLESTEROL
Lowering Cholesterol
with TLC
Therapeutic lifestyle changes (TLC) is a set of
changes you can make to help lower your LDL
cholesterol. The components of TLC are diet,
weight management, and physical activity.
9Diet Recommendations
»Limiting the amount of saturated fat
and cholesterol you eat.
»Eating only enough calories to achieve
or maintain a healthy weight.
»Increasing the soluble ber in your
diet. For example, oatmeal, kidney
beans, and apples are good sources of
soluble ber.
9Weight Management
Losing weight if you are overweight can
help lower LDL. Weight management
is especially important for those with a
group of risk factors that includes high
triglyceride and/or low HDL levels and
being overweight with a large waist
measurement (more than 40 inches
for men and more than 35 inches for
women). We’ll cover how you can
determine your ideal weight in the next
section.
9Physical Activity
Regular physical activity is recommended
for everyone. It can help raise HDL and
lower LDL and is especially important
for those with high triglyceride and/
or low HDL levels who are overweight
with a large waist measurement. Tips
and helpful hints on how to start a basic
exercise program are covered later in this
handbook.
Determine Your Ideal
Weight with the Body
Mass Index
Body Mass Index (BMI) is one of the
best measures of our true weight status.
Put simply, BMI is a common measure
expressing the relationship of weight-to-
height, and is an easy calculation using
inches and pounds.
9MANAGING CHOLESTEROL
When calculated, your BMI will help you
determine your true weight status as either
underweight, normal, overweight, or obese.
Generally, as a person’s BMI increases,
so does their risk for a number of health
conditions and diseases. These include the
risk of premature death, heart disease, high
blood pressure, osteoarthritis, cancer, and
diabetes.
Calculating Your BMI
The BMI Chart found on page 10 (Chart 2)
makes determining your BMI easy. Simply
nd your height and weight and circle the
number where the two lines intersect. This is
your BMI. Once you have determined your
BMI, you can use this number to determine
weight status (using Chart 1—underweight,
normal, overweight, or obese). BMI values for
adults are interpreted using a xed number,
regardless of age or gender.
CHART 1
BMI Weight Status
Below 18.5 Underweight
18.5 - 24.9 Normal
25.0 - 29.9 Overweight
30.0 and above Obese
Using Chart 1, we can tell that a BMI of 25.0
is dened as being overweight.
10MANAGING CHOLESTEROL
HEIGHT
(INCHES)58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76
BMI BODY WEIGHT (POUNDS)
NORMAL
19 91 94 97 100 104 107 110 114 118 121 125 128 132 136 140 144 148 152 156
20 96 99 102 106 109 113 116 120 124 127 131 135 139 143 147 151 155 160 164
21 100 104 107 111 115 118 122 126 130 134 138 142 146 150 154 159 163 168 172
22 105 109 112 116 120 124 128 132 136 140 144 149 153 157 162 166 171 176 180
23 110 114 118 122 126 130 134 138 142 146 151 155 160 165 169 174 179 184 189
24 115 119 123 127 131 135 140 144 148 153 158 162 167 172 177 182 186 192 197
OVERWEIGHT
25 119 124 128 132 136 141 145 150 155 159 164 169 174 179 184 189 194 200 205
26 124 128 133 137 142 146 151 156 161 166 171 176 181 186 191 197 202 208 213
27 129 133 138 143 147 152 157 162 167 172 177 182 188 193 199 204 210 216 221
28 134 138 143 148 153 158 163 168 173 178 184 189 195 200 206 212 218 224 230
29 138 143 148 153 158 163 169 174 179 185 190 196 202 208 213 219 225 232 238
OBESE
30 143 148 153 158 164 169 174 180 186 191 197 203 209 215 221 227 233 240 246
31 148 153 158 164 169 175 180 186 192 198 203 209 216 222 228 235 241 248 254
32 153 158 163 169 175 180 186 192 198 204 210 216 222 229 235 242 249 256 263
33 158 163 168 174 180 186 192 198 204 211 216 223 229 236 242 250 256 264 271
34 162 168 174 180 186 191 197 204 210 217 223 230 236 243 250 257 264 272 279
35 167 173 179 185 191 197 204 210 216 223 230 236 243 250 258 265 272 279 287
36 172 178 184 190 196 203 209 216 223 230 236 243 250 257 265 272 280 287 295
37 177 183 189 195 202 208 215 222 229 236 243 250 257 265 272 280 287 295 304
38 181 188 194 201 207 214 221 228 235 242 249 257 264 272 279 288 295 303 312
39 186 193 199 206 213 220 227 234 241 249 256 263 271 279 287 295 303 311 320
SEVERE OBESITY
40 191 198 204 211 218 225 232 240 247 255 262 270 278 286 294 302 311 319 328
41 196 203 209 217 224 231 238 246 253 261 269 277 285 293 302 310 319 327 336
42 201 208 215 222 229 237 244 252 260 268 276 284 292 301 309 318 326 335 344
43 205 212 220 227 235 242 250 258 266 274 282 291 299 308 316 325 334 343 353
44 210 217 225 232 240 248 256 264 272 280 289 297 306 315 324 333 342 351 361
45 215 222 230 238 246 254 262 270 278 287 295 304 313 322 331 340 350 359 369
46 220 227 235 243 251 259 267 276 284 293 302 311 320 329 338 348 358 367 377
47 224 232 240 248 256 265 273 282 291 299 308 318 327 338 346 355 365 375 385
48 229 237 245 254 262 270 279 288 297 306 315 324 334 343 353 363 373 383 394
49 234 242 250 259 267 278 285 294 303 312 322 331 341 351 361 371 381 391 402
50 239 247 255 264 273 282 291 300 309 319 328 338 348 358 368 378 389 399 410
51 244 252 261 269 278 287 296 306 315 325 335 345 355 365 375 386 396 407 418
52 248 257 266 275 284 293 302 312 322 331 341 351 362 372 383 393 404 415 426
53 253 262 271 280 289 299 308 318 328 338 348 358 369 379 390 401 412 423 435
54 258 267 276 285 295 304 314 324 334 344 354 365 376 386 397 408 420 431 443
CHART 2
11 MANAGING CHOLESTEROL
Lowering
Cholesterol with TLC:
START A WALKING PROGRAM
Walking does wonders in helping to reduce
the harmful eects of high cholesterol. But
you have to leave time in your busy schedule
to follow a walking program that will work
for you. In planning your walking program:
9Choose a safe place to walk. Find
a partner or group of people to walk
with you. Your walking partner(s) should
be able to walk with you on the same
schedule and at the same speed.
9Wear shoes with thick exible
soles that will cushion your feet and
absorb shock.
9Wear clothes that will keep you
dry and comfortable. Look for
synthetic fabrics that absorb sweat and
remove it from your skin.
9For extra warmth in winter, wear
a knit cap. To stay cool in summer,
wear a baseball cap or visor.
9Do light stretching before and after
you walk.
9Think of your walk in three parts.
Walk slowly for ve minutes. Increase
your speed for the next ve to 20 minutes.
Finally, to cool down, walk slowly again
for ve minutes.
9Try to walk at least three times
per week. Add two to three minutes per
week to the fast walk. If you walk less than
three times per week, increase the fast
walk more slowly.
9To avoid sti or sore muscles or
joints, start gradually. Over several
weeks, begin walking faster, going further,
and walking for longer periods of time.
The more you walk, the better you will feel.
12MANAGING CHOLESTEROL
IS IT OK FOR ME TO WALK?
Answer the following questions before you begin a walking program.
Has your health care provider
ever told you that you have heart
trouble?
YES NO
When you are physically active,
do you have pains in your chest or
on your left side (neck, shoulder,
or arm)?
YES NO
Do you often feel faint or have
dizzy spells?
YES NO
Do you feel extremely breathless
after you have been physically
active?
YES NO
Has your health care provider
told you that you have high blood
pressure?
YES NO
Has your health care provider
told you that you have bone or
joint problems, like arthritis,
that could get worse if you are
physically active?
YES NO
Are you over 50 years old and not
used to a lot of physical activity?
YES NO
Do you have a health problem or
physical reason not mentioned
here that might keep you from
starting a walking program?
YES NO
If you answered yes to any of these questions, please check with
your health care provider before starting a walking program
or other form of physical activity.
Source: http://win.niddk.nih.gov/publications/walking.htm
13 MANAGING CHOLESTEROL
Cholesterol-Lowering
Medicines
Along with changing the way you eat
and exercising regularly, your doctor
may prescribe medicines to help lower
your cholesterol. Even if you begin drug
treatment, you will need to continue TLC.
Drug treatment can control but does not
“cure” high blood cholesterol. Therefore,
you must continue taking your medicine and
make changes to your lifestyle to keep your
cholesterol level in the recommended range.
There are ve major types of cholesterol-
lowering medicines:
9Statins
»Very effective in lowering LDL
(“bad”) cholesterol levels
»Safe for most people
»Rare side effects to watch for are
liver and muscle problems
9Bile Acid Sequestrants
(seh-KWES-trants)
»Help lower LDL cholesterol levels
»Sometimes prescribed with statins
»Not usually prescribed as the only
medicine to lower cholesterol
9Nicotinic (Nick-o-tin-ick) Acid
»Lowers LDL cholesterol and
triglycerides, and raises HDL (“good”)
cholesterol
»Should only be used under a doctor’s
supervision
9Fibrates
»Lower triglycerides
»May increase HDL (good) cholesterol
levels
»When used with a statin, may increase
the chance of muscle problems
9Ezetimibe
»Lowers LDL cholesterol
»May be used with statins or alone
»Acts within the intestine to block
cholesterol absorption
When you are under treatment, you will be
checked regularly to:
9Make sure your cholesterol level
is in control
9Check for other health problems
You may take medicines for other health
problems. It is important that you take ALL
medicines as prescribed by your doctor. The
combination of medications may lower your
risk for heart disease or heart attack.
When trying to lower your cholesterol or keep
it low, it is important to remember to follow
your treatments for other conditions you may
have such as high blood pressure. Get help
with quitting smoking and losing weight if they
are risk factors for you.
14MANAGING CHOLESTEROL
FREQUENTLY
ASKED QUESTIONS
Q Do I need to worry
about lowering my blood
cholesterol now that I’m
over 65?
Yes. Older Americans have the nation’s highest
rate of coronary heart disease (CHD) and
can benet greatly from lowering elevated
cholesterol. Cholesterol lowering also has
been shown to reduce the risk of strokes.
For seniors who do not have heart disease,
cholesterol lowering will reduce their high risk
of developing CHD. Older Americans should
have their total cholesterol and, if possible, their
high density lipoprotein (HDL, the “good”
cholesterol) tested once every ve years. Older
Americans should keep their cholesterol low by
following an eating pattern lower in saturated
fat, total fat, and cholesterol, being physically
active, and maintaining a healthy weight.
Q Should I be concerned
about my child’s blood
cholesterol?
Yes. Everyone older than age 2 should
care about cholesterol to reduce the risk of
developing heart disease as an adult. Children
as well as adults can improve the health of
their hearts by following a low-saturated fat
and low-cholesterol diet, avoiding obesity, and
being physically active. Only children from
families in which the father or grandfather has
had heart disease at the age of 55 or younger,
or the mother or grandmother has had heart
disease at the age of 65 or younger, or in which
a parent has high blood cholesterol (240 mg/dL
or higher), should have their cholesterol levels
tested. If a child from such a “high-risk” family
has a high cholesterol level, it should be lowered
under medical supervision, primarily through
dietary changes and increased physical activity.
Q How useful is it to know
my cholesterol ratio?
Although the cholesterol ratio can be a useful
predictor of heart disease risk, especially in
the elderly, it is more important for treatment
purposes to know the value for each level
separately because both LDL and HDL
cholesterol separately aect your risk of heart
disease and the levels of both may need to be
improved by treatment. The ratio is useful if
it helps you and your doctor keep the entire
picture of your LDL and HDL levels in mind,
but it should not take the place of knowing
your separate LDL and HDL levels.
Q What is a heart-healthy
diet?
A heart-healthy diet emphasizes foods low
in saturated fat, total fat, and cholesterol
to help lower blood cholesterol. This is the
recommended eating pattern for Americans
older than 2:
»Less than 10 percent of calories from
saturated fat;
»An average of 30 percent of calories or
less from total fat; and
»Less than 300 mg a day of dietary
cholesterol.
15 MANAGING CHOLESTEROL
Saturated fat increases blood cholesterol more
than anything else you eat, so choose foods low
in saturated fat to reduce blood cholesterol. If
you are overweight, losing weight is important
for lowering blood cholesterol. Being physically
active also helps improve blood cholesterol
levels because it can raise HDL (“good”)
cholesterol and lower LDL (“bad”) cholesterol,
as well as help you lose weight, lower your
blood pressure and improve the tness of your
heart and blood vessels.
Q My last cholesterol level
was within my goal.
Does that mean I do not
have to worry about my
cholesterol any more?
High cholesterol and heart disease are not
cured but are only controlled by diet and drug
therapy. Stopping your treatment quickly
returns your cholesterol to the level that existed
before therapy was started.
Q In a cholesterol-lowering
eating pattern, is it
healthier to eat butter or
margarine?
Use butter sparingly—opt for buttery-tasting
spreads or better yet, extra virgin olive oil.
In lieu of stick margarine, which is packed
with trans fats, you can choose from a
delicious array of “tubbed” spreads like
Smart Balance. Whatever alternative you
16MANAGING CHOLESTEROL
choose, be sure to check the label to ensure
that it lists “0” grams of trans fat and is free
of “partially hydrogenated oil.”
Source: Dr. Ann’s Eat Right For Life
Q How does smoking affect
my cholesterol?
Smoking has several harmful eects on
cholesterol. Smoking reduces HDL (“good”)
cholesterol and in all likelihood changes LDL
(“bad”) cholesterol to a form that promotes the
buildup of deposits in the walls of the coronary
arteries. In addition, smoking has harmful
eects on the heart and blood vessels. In these
ways, smoking substantially raises the risk
for coronary heart disease if you are healthy
and multiplies that risk many more times if
you have other risk factors such as high blood
cholesterol. All in all, smoking is the leading
preventable cause of death.
Q I’m young and healthy.
Do I need to have my
cholesterol checked?
Yes. Young adults 20 years of age and older
should have their cholesterol measured.
Studies have shown that the buildup of plaque
in the arteries that supply the heart begins in
late adolescence and early adulthood, and a
cholesterol level measured at age 22 predicts
the risk of a heart attack over the following 30
to 40 years. Waiting until midlife to measure
and lower cholesterol reduces the benet that
can be obtained. Checking your cholesterol
and discussing it with your doctor can help you
make lifestyle changes—eating right, being
physically active, and controlling weight—to
maintain good health now and prevent heart
disease later in life.
17 MANAGING CHOLESTEROL
Questions About Cholesterol Testing
NO MATTER WHICH TESTING SYSTEM IS USED, YOU MAY WANT TO ASK:
The accuracy and reliability of cholesterol tests vary from lab to lab. Labs
participating in the U.S. Centers for Disease Control and Prevention (CDC)
standardization testing should be used.
9What is being measured—total
cholesterol, HDL cholesterol,
LDL cholesterol, and/or
triglycerides?
9Do I need to fast before the test?
9How long will it take to get the
test results?
9Will someone be available to
explain the results and whether I
need further testing?
9Will I receive educational
materials with my test results?
9How reliable are the results? Is
the lab certied?
MANAGING CHOLESTEROL
The information contained in this guide is based on the best health
information available and has been reviewed for accuracy. This
information is not intended to replace the advice of your healthcare
provider. If you have any questions about managing your own health
and/or seeking medical care, please contact a medical professional.
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