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National Cholesterol Education Month

15 September 2009

High cholesterol is a serious condition that increases a person's risks of heart disease, hardening of the arteries, peripheral vascular disease, and stroke. According to the Centers for Disease Control and Prevention (CDC), more than 98 million Americans have total cholesterol levels that are unhealthy. Of those, over 34 million Americans have cholesterol levels which put them at a high risk of developing heart disease. Lowering cholesterol levels that are too high lessens the risk of developing heart disease and reduces the chances of having a heart attack or dying of heart disease. September is National Cholesterol Education Month, a good time to have your blood cholesterol checked and to take steps to lower high cholesterol. It is also a good time to learn about lipid profiles and food and lifestyle choices that can help you reach personal cholesterol goals.
What is cholesterol?
Cholesterol is a waxy, fat–like substance that is found in all cells of the body. Cholesterol is important because it plays a role in normal body functions such as the formation of cell walls, the production of hormones, and the production of the bile acids that are needed for digestion. Too much cholesterol, however, leads to a build–up of fatty materials and plaque on the walls of the arteries that supply blood to the heart and other organs. The liver has the ability to produce all of the cholesterol that our bodies need and, therefore, there is no need for extra cholesterol in our diets.

Cholesterol moves through the bloodstream in particles called lipoproteins. There are two types of lipoproteins:
  • Low–density lipoproteins (LDL): LDL is known as the "bad cholesterol" because it carries a large amount of cholesterol in the blood and is responsible for depositing cholesterol in the walls of the blood vessels, which can lead to heart disease. The lower your LDL number, the better.
  • High–density lipoproteins (HDL): HDL is known as the "good cholesterol" because it helps to carry cholesterol away from the walls of the arteries and transport it to the liver for excretion. The higher your HDL number, the better.
What do Blood Cholesterol Numbers Mean?
There are no symptoms associated with high cholesterol and, therefore, many people do not know that their cholesterol levels are too high. The only way to know is to have the level of cholesterol in your blood tested. Your physician can check your cholesterol with a simple blood test called a lipid profile. The lipid profile measures total cholesterol, triglycerides (another form of fat in the blood), LDL and HDL.

The National Cholesterol Education Program (NCEP) of the National Heart Lung and Blood Institute (NHLBI) recommends that adults older than age 20 have their cholesterol tested at least once every five years. Some adults need to be tested more often. Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. The following guidelines summarize cholesterol numbers and their meanings:
  • Total cholesterol: Desirable (less than 200 mg/dL); Borderline (200–239 mg/dL); High (greater than 240 mg/dL)
  • Triglycerides: Desirable (less than 150 mg/dL); Borderline (150–199 mg/dL); High (200–400 mg/dL)
  • HDL: Desirable (greater than 60 mg/dL); Borderline (40–59 mg/dL); High (less than 40 mg/dL)
  • LDL: Desirable (less than 100 mg/dL); Borderline (130–159 mg/dL); High (160–189 mg/dL)
It is important to keep your cholesterol levels within healthy limits and to review your cholesterol levels with your physician. If you discover that you have high cholesterol, work with your physician to develop a treatment plan that is right for you.

According to the NCEP, the main goal of cholesterol–lowering treatment is to lower LDL levels. Studies have shown that lowering LDL levels can prevent heart attacks and reduce deaths from heart disease in both men and women. It can slow, stop, or even reverse the buildup of plaque within the arteries. It can also lower the cholesterol content within unstable plaques, thereby making such plaques less likely to cause a heart attack. In general, the higher your LDL level and number of risk factors, the greater your chances are of developing heart disease or having a heart attack. Risk factors that affect your LDL level include:
  • Cigarette smoking
  • High blood pressure (140/90 mm Hg and above or use of blood pressure medication)
  • Low HDL cholesterol (less than 40 mg/dL)
  • Family history of early heart disease
  • Age (for men, age 45 and older; for women, age 55 and older)
Lowering Cholesterol
Making lifestyle changes is an important step in lowering LDL levels and preventing heart disease. The NCEP recommends:
  • Reducing saturated fat and cholesterol intake: Reducing the amount of saturated fat in your diet can help lower high LDL cholesterol levels. Eating less total fat can help reduce your saturated fat intake and as well as your overall calorie intake.
  • Increasing intake of soluble fiber: Soluble fiber can help reduce your risk of heart disease by helping to lower LDL cholesterol. Soluble fiber dissolves into a gel–like substance in the intestines. This helps to block cholesterol and fats from being absorbed through the walls of the intestines into the blood stream.
  • Maintaining a healthy weight: Being overweight or obese increases your chances for having high triglycerides, high LDL and low HDL. It also increases your chances of developing high blood pressure, diabetes, heart disease, some cancers, and other serious health problems. Losing extra weight reduces these risks and improves both your cholesterol and triglyceride levels.
  • Increasing physical activity: Regular physical activity can help you to manage your weight and, as a result, lower your LDL level. Physical activity can also help raise your HDL level and lower triglycerides, improve the fitness of your heart and lungs, and lower blood pressure.
Many people are able to lower their LDL levels sufficiently through lifestyle changes alone. When lifestyle changes are not enough, however, medications may be prescribed to help lower cholesterol levels. There are several types of medicines that are used to lower LDL cholesterol including statins, bile acid sequestrants, nicotinic acid, fibric acids, and cholesterol inhibitors. Your physician will help decide which type of medication is right for you.

It is important to remember that cholesterol–lowering medications are not a replacement for lifestyle changes. Changing your lifestyle is still the most effective way to lower your cholesterol and prevent heart disease. Eating well and being active will go a long way toward getting your cholesterol levels where you need them to be. To attain the maximum benefit from these healthier habits, it is important to make them a permanent part of your daily routine.

MEDICAL DISCLAIMER: The information is not intended to constitute medical advice and is not a substitute for consultation with a physician or other health care provider. Individuals with specific complaints should seek immediate consultation from their personal physicians.

National Cholesterol Education Month an EHE International publication and is reprinted and distributed with its expressed written permission. For more information, contact EHE International, 10 Rockefeller Plaza, 4th Floor, New York, New York 10020; 212.332.3738 or

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