Harvard Heart Letter

In brief

Take care of triglycerides. One in three Americans has higher-than-healthy levels of triglycerides, the main fat-carrying particle in the bloodstream (Archives of Internal Medicine, March 23, 2009). High triglycerides often take a back seat to a high level of harmful LDL cholesterol and a low level of protective HDL, but they are worth paying attention to on their own. Fatty foods, rapidly digested carbohydrates, excess weight, and some medications can boost triglycerides. You can keep them in check by cutting back on easily digested carbohydrates like white bread and mashed potatoes and eating more whole grains. Saturated and trans fats boost triglycerides, while unsaturated fats can lower them. Eating fatty fish twice a week can help, as can exercise and losing weight if you are overweight.

Unraveling drug therapy's benefits. Although more people than ever are taking medications to lower blood pressure and cholesterol, habits such as overeating, underexercising, and continued smoking are undermining the intended effects of this therapy (The Lancet, March 14, 2009). It's a little like dumping water into a sinking canoe while you are trying to bail it out. If you are taking medications to keep your cholesterol, blood pressure, or blood sugar in check, help the drugs along — don't subvert them — with diet, exercise, and other healthful lifestyle choices.

Another chore for statins? The family of drugs known as statins was designed to lower the amount of harmful LDL cholesterol in the bloodstream. They do other things, too. Statins ease inflammation, stabilize cholesterol-filled plaques, and act as antioxidants. A study suggests another possible benefit — preventing the formation of blood clots that lead to deep-vein thrombosis or pulmonary embolism. In the JUPITER trial, volunteers taking rosuvastatin (Crestor) were half as likely to develop one of these potentially dangerous problems as those taking a placebo. Statins won't be prescribed for this, but it's nice to know they are doing double duty.

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