What to do about High Cholesterol
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High cholesterol affects about 17% of Americans
ages 20 and older, contributing to atherosclerotic
heart disease, which is the single leading cause
of death and disability in the developed world.
The good news is that for most people, heart
disease is preventable if you live a heart-healthy
lifestyle to lower your LDL cholesterol.
Just what level of cholesterol is healthy for
you, and how can you achieve it? The National
Cholesterol Education Project has created guidelines
that give you an easy, step-by-step method to
evaluate your risk of heart disease, set your
cholesterol goal, and take the steps you need
to reach it. Exercising and eating a diet low
in saturated and trans fats can help you go a
long way toward that goal. If you need more help,
effective medications can take you the rest of
the way. And this report should provide the further
encouragement you need to get your cholesterol
under control and keep it there.
Prepared by the editors of Harvard Health Publications
in consultation with Mason Freeman, M.D., associate
professor of medicine, Harvard Medical School
and Chief of the Lipids Metabolism Unit at Massachusetts
General Hospital. (updated: 2006)
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Table of Contents:
- Cholesterol in the
body
- HDLs, LDLs, and
other fat particles
- The cholesterol connection
- The role of diet
- From cholesterol
to heart disease
- What causes heart
disease?
- Some risk factors
- Some protective
factors
- Weighing the
risks
- Why treat cholesterol?
- Benefits of lowering
your cholesterol
- What are the
risks of treatment?
- Is treatment
worth the trouble or the cost?
- Your cholesterol
test
- The blood test
- Physical examination
and further tests
- Do you need treatment?
- Step 1: What
are your cholesterol levels?
- Step 2: Do you
have heart disease, diabetes, or
chronic kidney disease?
- Step 3: How many
risk factors do you have?
- Step 4: What’s
your heart attack risk?
- Step 5: Finding
your treatment category
- A new, lower
cholesterol goal?
- First steps in treatment
- Finding the cause
- Starting the
program
- Your cholesterol-lowering
diet
- Guidelines for
heart-healthy eating
- Low-carb diets
and cholesterol
- Your exercise
program
- Monitoring your
progress
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- Drug treatments for
high cholesterol
- Reductase inhibitors
(statins)
- Ezetimibe
- Fibric acid derivatives
(fibrates)
- Niacin
- Bile acid binders
- Drug combinations
- Selective estrogen
receptor modulators
- Substances that
may lower cholesterol
- Treating other lipid
problems
- What to do about
low HDL
- How to treat
high triglycerides
- Taking an individual
approach
- Cholesterol in
people who have heart disease
- Cholesterol in
people who have diabetes
- Cholesterol in
people who have chronic kidney disease
- Cholesterol in
women
- Cholesterol in
the elderly
- Glossary
- Resources
- Organizations
- Books and pamphlets
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Here's an
Excerpt from this High Cholesterol Special Health
Report
In the early days of the cholesterol era, researchers
naturally assumed that dietary cholesterol (the
cholesterol in such foods as eggs, red meat,
and dairy products) was the main villain in elevated
blood cholesterol, and so they recommended that
people stay away from cholesterol-rich foods.
Eggs fell from grace as a good, healthful food.
As it turns out, dietary cholesterol isn’t
the only food component responsible for raising
the level of cholesterol in your blood, or even
the most important. Another key culprit is dietary
fat—particularly saturated and trans fats.
Saturated fats are found in foods such as meats,
whole-fat dairy products, and eggs. Trans fats
occur naturally in meat, but today people usually
get this type of fat in an artificial form contained
in hydrogenated oils, used in margarine and many
commercial baked goods and processed foods.
It appears that high cholesterol levels are
an unfortunate result of the luxuries of modern
life. Our bodies seem to be geared to the low-fat
diets of our early ancestors, and we are poorly
adapted, at least physiologically, to a life
of inactivity and easy access to fatty foods.
Diet isn’t the only cause of high cholesterol.
Your cholesterol levels reflect a combination
of factors, including your genetic makeup. For
some who are genetically predisposed, the amount
of cholesterol they eat has relatively little
impact on the amount that circulates in their
blood. For most people, though, levels of blood
cholesterol are closely tied to the amounts of
fat and cholesterol in their food.
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