Because both heart attacks and
strokes can be caused by atherosclerosis, and because atherosclerosis
is linked to high blood levels of cholesterol, doctors recommend
that patients keep their cholesterol less than 200 milligrams
per deciliter.
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20+ pages , explains to patients in
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Patients with proven CAD (coronary artery
disease) or a prior stroke should have an LDL cholesterol
of 100 milligrams per deciliter or less,
Symptoms
Most patients with high cholesterol have no symptoms until cholesterol-related
atherosclerosis
atherosclerosis
yellow placque like deposit
effectively lessens or blocks blood vessels
leads to significant narrowing of arteries to their heart
or brain. The result can be angina (heart-related chest pain) or other symptoms
of CAD, as well as symptoms of decreased blood supply to the brain
(either transient ischemic attacks or a
stroke).
In about one out of every 500 people, extremely high cholesterol
levels (above 300 milligrams per deciliter) are caused by an inherited,
genetically linked disorder called familial hypercholesterolemia.
In patients with this disorder, cholesterol-filled nodules called
xanthomas may be develop in various tendons, especially the Achilles
tendons of the lower leg. Cholesterol deposits may also occur
on the eyelids, where they are called xanthelasmas, or in the
cornea, where the condition is called arcus cornea. What Your Doctor Looks For
Your doctor will ask you about your family history of CAD, high
cholesterol and diabetes, as well as about your diet and your
history of cigarette smoking. He or she will check your blood
pressure and look carefully for xanthomas, xanthelasmas and arcus
corneae during your physical examination.
Diagnosis
Your doctor can make the diagnosis of high
cholesterol with a simple blood test.
Expected Duration
In almost all patients, battling high cholesterol is a long-term
problem. Switching to a diet that is low in saturated fat
may decrease blood cholesterol levels within four to six weeks.
Prevention
You may help prevent high cholesterol by eating a diet low in
saturated fat and cholesterol. This means switching from high-fat
foods (eggs, fatty red meats, palm or coconut oil, dairy products
made with whole milk) to fresh fruits and vegetables, whole-grain
breads and cereals and low-fat dairy products.
Treatment
High cholesterol can be treated with a low-fat, low-cholesterol
diet and with cholesterol-lowering medication.
Medications - Doctors can use four different classes of cholesterol-lowering
medications: bile acid-binding resins (cholestyramine, colestipol),
niacin, fibrates (gemfibrozil, fenofibrate, clofibrate) and the
HMG-CoA reductase inhibitors (lovastatin, simvastatin, pravastatin,
fluvastatin, atorvastatin, cerivastatin). The HMG-CoA reductase
inhibitors (referred to as statins) block an enzyme called HMG-CoA
reductase, which is an essential step in the production of cholesterol.
Heart doctors are amazed at the low
use of these medications in view of their overwhelming positive
effect in saving lives !
In addition to any treatment with
diet
or medication,
all patients with high cholesterol should try to modify their
other risk factors for CAD. This means keeping blood
pressure at normal levels, not smoking, controlling your blood sugar
if you have diabetes, losing weight if you are obese and following a regular exercise schedule!.
When To Call Your Doctor
Because it is possible to have high cholesterol for many years
without symptoms of atherosclerosis, it is important to check
your blood cholesterol level periodically. Adults older than 20
should have a blood test for total cholesterol (LDL cholesterol
and HDL cholesterol) at least once every
five years. If your levels are outside the desirable range,
your doctor may initiate a diet and/or check your cholesterol
more frequently.
Prognosis
The effectiveness of low-cholesterol diets and cholesterol-lowering
medications varies from person to person. In general, people who
have been eating the average American diet can lower their LDL
cholesterol by 8 percent to 10 percent with the Step 1 Diet and
13 percent to 17 percent with the Step 2 Diet. LDL cholesterol
can drop about 20 percent to 35 percent with the bile acid-binding
resins, 25 percent to 35 percent with niacin, and 25 percent to
50 percent with the HMG-CoA reductase inhibitors.
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