High Cholesterol

What is cholesterol?

Definition

An atherosclerotic aorta caused by high cholesterol that may be prevented with the new combination treatment.High cholesterol (hypercholesterolemia or hyperlipidemia) refers to the presence of higher than ordinary amounts of total cholesterol circulating in the bloodstream. Cholesterol is a fatty substance (lipid) that is essential to the body as protection for the walls of the vasculature (veins and arteries) and linings of body organs, a component in the manufacture of hormones, and a factor in the digestion of consumed fats in foods. It is manufactured in the liver and carried throughout the body in the bloodstream. Cholesterol is also a component of animal tissue and can be consumed in products such as meat, eggs, fish, milk, and milk products such as butter and cheese. Elevated cholesterol levels can result in the accumulation of fatty deposits on blood vessel walls, narrowing veins and arteries and impeding blood flow to the heart, brain, and other organs.

Description

Cholesterol has both a good form and a bad form that add up to total cholesterol when measured together. The body needs cholesterol to produce bile acids that help digest fats ingested in food, make hormones, protect cell walls, and participate in other processes that help maintain health. Ironically, cholesterol can also be a problem, if too much is manufactured by the liver or consumed through the diet and not metabolized or used. The utilization of fat in the body, or fat metabolism, is a complex process, complicated even more by abnormally high levels of cholesterol found circulating in the blood. Although high cholesterol is not often found in young children, it may begin to develop in adolescents or young adults either as an inherited condition or through unhealthy eating habits and can continue into adulthood, creating potentially serious health problems. High cholesterol levels and fatty deposits in veins and arteries (atherosclerosis) have been found during autopsies of children who have died of accidents and other causes.

The liver metabolizes cholesterol, including the cholesterol obtained from foods in the diet. The components of cholesterol are then carried into the bloodstream bound to the surface of certain lipoproteins. Low-density lipoproteins or LDLs carry about 75 percent of the cholesterol into the blood and high-density lipoproteins carry the other 25 percent. LDL is the lipoprotein known as bad cholesterol because it consists primarily of cholesterol and is most associated with the development of vascular disease. Cholesterol is not the major part of HDL, the so-called good cholesterol, and the presence of higher amounts of HDL in the blood actually helps reduce the more harmful LDL levels. Another lipoprotein, very low-density lipoprotein (VLDL), carries harmful fats known as triglycerides but does not carry a significant amount of cholesterol. Triglycerides are also measured as part of a lipid profile and high levels are associated with vascular disease and heart disease. Cholesterol levels in blood serum vary considerably from day to day and even from one time of a day to another related to the consumption of fats in the diet.

High LDL (low-density lipoprotein) is a major precursor of vascular disease and heart disease. This form of cholesterol combines with triglycerides, cellular waste, calcium, and scar tissue to form a waxy deposit (plaque) on the inner walls of large and medium-sized arteries, causing a condition called hardening of the arteries (atherosclerosis or arteriosclerosis). Plaque typically builds up as people get older, more in some people than others depending on lifestyle (diet, exercise, alcohol consumption, and smoking) and heredity. The result may be a narrowing (stenosis) or blockage of blood vessels, interrupting the essential flow of blood and oxygen to the heart, brain, abdominal organs, and peripheral circulation to the arms and legs. Eventually this can lead to heart attack or stroke, permanent damage to the heart or brain, and life-threatening complications

What are LDL and HDL cholesterol?

Definition

LDL cholesterol is called "bad" cholesterol, because elevated levels of LDL cholesterol are associated with an increased risk of coronary heart disease. LDL lipoprotein deposits cholesterol on the artery walls, causing the formation of a hard, thick substance called cholesterol plaque. Over time, cholesterol plaque causes thickening of the artery walls and narrowing of the arteries, a process called atherosclerosisHigh cholesterol can lead to atherosclerosis - hardening of the arteries

Cholesterol

Description

Comments about “good” and “bad” cholesterol refer to the type of carrier molecule that transports the cholesterol. These carrier molecules are made of protein and are called apoproteins. They are necessary because cholesterol and other fats (lipids) cannot dissolve in water, which also means they can’t dissolve in blood. When these apoproteins are joined with cholesterol, they form a compound called lipoproteins. The density of these lipoproteins is determined by the amount of protein in the molecule. “Bad” cholesterol is the low-density lipoprotein (LDL), the major cholesterol carrier in the blood. High levels of these LDLs are associated with atherosclerosis. “Good” cholesterol is the high-density lipoprotein (HDL); a greater level of HDL–think of this as drain cleaner you pour in the sink–is thought to provide some protection against artery blockage.

A high level of LDL in the blood may mean that cell membranes in the liver have reduced the number of LDL receptors due to increased amounts of cholesterol inside the cell. After a cell has used the cholesterol for its chemical needs and doesn’t need any more, it reduces its number of LDL receptors. This enables LDL levels to accumulate in the blood. When this happens, the LDLs begin to deposit cholesterol on artery walls, forming thick plaques. In contrast, the HDLs–the “good” guys–act to remove this excess cholesterol and transport it to the liver for disposal.

A third group of carrier molecules, the very low-density lipoproteins (VLDL) are converted to LDL after delivering triglycerides to the muscles and adipose (fat) tissue.

The levels of HDL, LDL and total cholesterol are all indicators for atherosclerosis and heart attack risk. People who have a cholesterol level of 275 or greater (200 or less is desirable) are at significant risk for a heart attack, despite a favorable HDL level. In addition, people who have normal cholesterol levels but low HDL levels are also at increased risk for a heart attack.

What you should know about High Cholesterol

High cholesterol is the best known of all the many threats to a healthy heart. When excess amounts of this waxy, fat-like substance build up along the walls of the arteries, you face a dramatically higher risk of a complete blockage, leading to a heart attack or stroke.

At normal levels, cholesterol is not a bad thing. On the contrary, it's an essential raw material used by the body to build cell walls and produce hormones such as estrogen and testosterone. The body produces its own supply of cholesterol in the liver, and it's found naturally in all animal products (such as meats, eggs, milk, and cheese). It poses a problem only when the body is unable to use or eliminate excessive supplies.

As one of a variety of fatty substances in the body, cholesterol is classified as a lipid. It is carried through the bloodstream attached to proteins, forming complexes called lipoproteins. There are two major types of lipoproteins: the low-density lipoproteins (LDL) commonly known as "bad" cholesterol, and the high-density lipoproteins (HDL) usually dubbed "good" cholesterol. The “bad” LDL cholesterol tends to form deposits on the artery walls. HDLs, on the other hand, help to clear excess cholesterol from the bloodstream. The ideal situation to aim for, then, is a low level of LDL cholesterol, a high level of HDL cholesterol, and a moderate total of both.

Cholesterol is measured in milligrams per deciliter of blood. According to the National Cholesterol Education Program, a desirable target profile consists of:

·        A total blood cholesterol level of less than 200.

·        An LDL level of:

Less than 100 if you have heart disease

                                    Less than 130 if you are at risk of heart disease.

                                    Less than 160 if your risk of heart disease is low

·        An HDL level greater than 40.

You are generally considered at risk of heart disease if two or more of the following factors apply to you:

Heart Attack City - Are you heading there?           

·        Cigarette smoking

·        High blood pressure

·        Low HDL cholesterol (below 40)

·        A family history of early heart disease (before 55 in a man, or 65 in a woman)

·        Your own age (over 45 if you're man, over 55 if you're a woman)

What happens if the cholesterol level is high?

If there is too much cholesterol in the blood and the body can’t get rid of it, the unused cholesterol can builds up in the artery walls, leading to the hardening and narrowing of the arteries. This narrowing of the arteries slows down the flow of blood to your heart; this condition is known as arteriosclerosis. In severe cases the blood supply can be cut off completely, it is at this point a heart attack occurs. If an artery in the brain becomes blocked this can trigger a stroke to occur.

How do you know if you have high cholesterol?

You do not normally know if you have high cholesterol, as there are no symptoms of it. If anyone in your immediate family has suffered a heart attack before the age of 50, you have diabetes, are overweight or smoke or you believe you have an increased risk of heart disease or stroke then you should go to your doctor and ask to have your cholesterol levels checked. Cholesterol is diagnosed from a blood test.

What can you do to reduce your cholesterol?

There are several steps you can take to reduce your cholesterol levels. The first is to eat a low-fat, low-cholesterol diet. That means keeping your total fat consumption–saturated, polyunsaturated and monounsaturated–to fewer than 30 percent of your daily intake of calories. (See How Fat Works for details.) Remember to keep your cholesterol intake to fewer than 300 milligrams per day. Saturated fats contained in butter, whole milk, hydrogenated oils, chocolate shortening, etc. should comprise no more than one third of your total fat consumption. To reduce your total fat and cholesterol intake, limit your consumption of meats such as beef, pork, liver and tongue (always trim away excess fat). In addition, avoid cheese, fried foods, nuts and cream, and try to curb your intake of eggs to no more than four per week. Try to eat meatless meals several times a week, use skim milk and include fish in your diet. Eat a wide variety of vegetables, pasta, grains and fruit. Another good tip is to look at the package label of the foods you buy, and restrict your choices to foods containing 3 grams of fat or less per serving.

There is evidence that water-soluble fibers can aid in lowering cholesterol; these foods include the fiber in oat or corn bran, beans and legumes, pectin found in apples and other fruits, and guar that is used as a thickener. Although highly touted by the media and health food stores, the phospholipid Lecithin has not been confirmed as a reducer of blood cholesterol levels.

If you are overweight, trying to lose weight and including aerobic exercise in your routine can help raise those desirable HDL levels. Diet and exercise alone can decrease cholesterol levels by up to 15 percent. It probably comes as no surprise to you that, if you smoke, you should quit to avoid a wide range of health problems, including lower HDL levels and increased risk of heart attack.

Who has high cholesterol?

Throughout the world, cholesterol levels (measured in the blood) vary widely. Generally, people who live in countries where blood cholesterol levels are lower, such as Japan, have lower rates of heart disease. Countries with very high cholesterol levels, such as Finland, have very high rates of coronary heart disease. However, some populations with similar total cholesterol levels have very different heart disease rates, suggesting that other factors also influence risk for coronary heart disease.

What causes cholesterol to be high?

In the UK, too much saturated fat in the diet is the most common cause of high cholesterol. Saturated fat encourages the body to make more cholesterol than it needs or can get rid of. In the UK, we tend to eat a lot of saturated fat and this is probably why we have the highest rates of coronary heart disease in the world.

If you are a cigarette smoker, you have about twice the risk of having a heart attack than a non-smoker. If you also suffer with high blood pressure and high cholesterol, the 3 factors together multiply the chances of you suffering a heart attack by more than 8 times.

However, high cholesterol levels can occasionally run in families, and in this situation, it is usually because the body does not cope well with normal amounts of cholesterol being eaten.

High Cholesterol Causes

Definition

Several drugs and diseases can bring about high cholesterol, but, for most people, a high-fat diet and inherited risk factors may be the main causes. Your doctor will rule out the possibility that you have an under active thyroid or kidney or liver disease.

Causes

High cholesterol, low cholesterol diet, and low cholesterol resources and information centerHeredity

Your genes influence how high your LDL (bad) cholesterol is by affecting how fast LDL is made and removed from the blood. One specific form of inherited high cholesterol that affects 1 in 500 people is called familial hypercholesterolemia, which often leads to early heart disease. But even if you do not have a specific genetic form of high cholesterol, genes play a role in influencing your LDL cholesterol level.

Weight

 Excess weight may modestly 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 especially helps to lower triglycerides and raise HDL (good) cholesterol levels.

 

Physical activity/exercise

Regular physical activity may lower triglycerides and raise HDL cholesterol levels.

Age and sex

 Before menopause, women usually have lower total cholesterol levels than men of the same age. As women and men age, their blood cholesterol levels rise until about 60-65 years of age. After about age 50 years, women often have higher total cholesterol levels than men of the same age.

Alcohol use

 Moderate (1-2 drinks daily) 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 triglyceride levels. Because of the risks, alcoholic beverages should not be used as a way to prevent heart disease.

Mental stress:

 Several studies have shown that stress raises blood cholesterol levels over the long term. One way that stress may do this is by affecting your habits. For example, when some people are under stress, they console themselves by eating fatty foods. The saturated fat and cholesterol in these foods contribute to higher levels of blood cholesterol.

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Risk factors of High Cholesterol

Definition

You are more likely to have high cholesterol if you are inactive, obese or eat unhealthy foods. Although high cholesterol can lead to heart disease on its own.

 

 

Factors Compound the Risk of High Cholesterol

·        Smoking Cigarette smoking damages the walls of your blood vessels, making them likely to accumulate fatty deposits. Smoking may also lower your level of HDL cholesterol.

·        High blood pressure Increased pressure on your artery walls damages your arteries, which can speed the accumulation of fatty deposits.

·        Diabetes High blood sugar contributes to high LDL cholesterol and low HDL cholesterol. High blood sugar also damages the lining of your arteries.

·        Family history of heart disease If a parent or sibling developed heart disease before age 55, high cholesterol levels place you at a greater than average risk of developing heart disease.

Diseases related with the High Cholesterol

What is coronary heart disease and a heart attack?

Definition

Coronary heart disease comes in two main forms: heart attack and angina. The heart is one of the strongest muscles in the body. It has to be to keep blood pumping every second of your life. It is essential that your heart, veins and arteries remain in good condition.

Arteries have different names, depending on what part of the body they supply. The arteries supplying the heart are known as coronary arteries. When these arteries are affected, the result is coronary heart disease.

Coronary heart disease results from the coronary arteries becoming narrowed with fatty deposits on the inside wall. This narrowing of these arteries reduces the flow of blood to the heart and increases the chances of a blood clot blocking the artery. The formation of a blood clot is also known as thrombosis. When one of the blood vessels becomes completely blocked, the blood supply to part of the heart stops and is damaged. The results of this are a heart attack or myocardial infarction to call it by its medical name. If the blood supply to a large part of the heart is stopped it may cause death.

 

 

 

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What causes heart disease to develop?

Definition

Heart disease as mentioned earlier is caused by the build up of fatty deposits on the walls of the arteries. The fatty deposits that build up on the artery walls takes years to build up and this process is medically known as, atherosclerosis. The fatty deposits known as 'plaques' are made up of many substances including a fatty substance called cholesterol (for more information on cholesterol click here). If you have high levels of cholesterol in your blood the fatty deposits will increase, so you should try to cut down on saturated fats. Butter, margarine, meat, milk and cakes are all major sources of saturated fats. See below for further risk factors, which can increase the chances of you developing heart disease.

What are the risk factors for heart disease?

Definition

There are a number of things you can do to help reduce your risk of heart disease, though some factors like age cannot be changed. These risk factors include:

  • High cholesterol - the average diet in the U.K. is very unhealthy, the consumption of fatty foods is far too high and the intake of fruit and vegetables is far too low
  • Smoking - this is one of the main factors, which causes heart disease, causing 1 in 5 of all heart disease deaths. Smoking harms your heart because the chemicals in the cigarette smoke damage arterial linings, leading to heart disease. It may also encourage thrombosis.
  • High blood pressure.
  • Previous heart disease.
  • Diabetes
  • Physical inactivity (lack of exercise) - an average person should aim for at least 30 minutes of moderate exercise on most days of the week. Physical activity should be introduced gradually and at appropriate levels for the age and health of the individual. Regular exercise makes your heart grow stronger, so that it can pump more blood with each beat.
  • Alcohol heavy drinkers are twice more likely to die of heart disease than non-drinkers.
  • Overweight (more than 20%) - being overweight is associated with raised blood pressure, high cholesterol and inactivity, therefore you have an increased risk of heart disease.
  • Age - over 45 in men and 55 in women.
  • A family history of early heart disease.
  • A raised homocysteine level - raised homocysteine levels are thought to damage the lining of the arteries and may be a factor in increasing blood clots. High homocysteine levels may be caused by kidney disease, insufficient folic acid in your diet, age, lupus and certain medications.

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What are the symptoms of heart disease?

Definition

As the coronary arteries narrow, patients will often experience chest pain or tightness, known as angina. This pain may spread to the left shoulder or arm or to the neck and jaw. The pain can occur after exercise, a strain, in stressful situations and especially in the cold weather. Palpitations, when you are aware that you heart is not beating normally or shortness of breath, when doing light activity, may also be early symptoms of heart disease. However, some people can have heart disease without having any noticeable symptoms. If you have any concerns about heart disease you should consult your doctor for advice.

What is angina?

Definition

Angina is a Latin word meaning chest pain and is the main symptom of heart disease. People with angina experience frequent chest pain, which is usually worse after or during exercise as the heart struggles to get the oxygen it needs. The pain lasts a few minutes and usually goes away after rest. Angina is the hearts way of saying that it is not getting enough oxygen. This can be either because the coronary arteries that supply blood to the heart are blocked or because the heart is being over worked and needs more oxygen than normal. The pain can be mistaken for indigestion because the tight, burning sensations are similar.

What are the symptoms of a heart attack?

Definition

A heart attack is more likely to occur between 5am and 10am and the body is likely to send one or more warning signs of a heart attack, these include:

  • An uncomfortable pressure or pain in the centre of the chest lasting for more than a few minutes.
  • Pain spreading to the shoulders, neck or arms. The pain may be mild or intense.
  • Chest discomfort with dizziness, fainting, sweating, nausea or shortness of breath.
  • Anxiety, nervousness and/or cold sweaty skin.
  • An increased or irregular heart rate.

If you believe you are having a heart attack or have any of the symptoms mentioned you should call 999 immediately.

What can you do to reduce the risks of heart disease?

Definition

Heart disease and attacks are common but they’re not inevitable, there is action you can take to reduce your risk of developing heart disease. There are many risk factors of heart disease that are mentioned above and those that can be avoided should be avoided, try giving up smoking, take up some form of regular exercise, even walking can be beneficial and eat a healthy balanced diet. There is also some evidence that women who take H.R.T. (Hormone Replacement Therapy) are less likely to suffer a heart attack.

An aspirin a day can be beneficial in preventing a heart attack. However, before taking aspirin you should speak to your doctor to make sure you are okay to take it daily.

How is heart disease diagnosed?

Definition

Heart disease is only usually diagnosed when a person develops symptoms of the disease and unfortunately, a heart attack can be the first sign. If you have, symptoms that suggest you mat be suffering from heart disease your doctor will probably carry out a physical examination and may arrange for you to have a number of tests. Tests that you may have include a chest x-ray, electrocardiogram (ECG) or a coronary angiography.

A ECG monitors the heart's electrical activity and records any problems with the heart's rhythm. An ECG can also tell the doctor if you have had a previous heart attack or if your heart is enlarged. You may also have an ECG carried out before, during and after exercise (usually on a treadmill) as some heart problems only show up when the heart is working hard, this is known as a stress test.

A coronary angiography is a fine tube that explores the coronary arteries, it detects if any of the arteries are blocked or seriously narrowed.

What treatment is available for heart disease?

A diagnosis of heart disease can be quite worrying, however, there are many treatments and steps you can take to reduce the risk of you suffering a heart attack. If the heart is not too badly damaged a change in lifestyle and medication is usually the recommended treatment. Medication that you may be given include, Beta-blockers, which reduce the hearts demand for oxygen, nitrates, to lower your blood pressure or diuretics to increase the flow of urine and help lower blood pressure.

If damage is severe and/or medications fail to help, surgery may be necessary. There are two main types of surgery available angioplasty and a coronary bypass.

A bypass is highly effective in people with heart disease and angina that’s not widespread. It can improve your ability to exercise, reduce symptoms and decrease the amount of drugs you need to take. An angioplasty operation involves a balloon being positioned into the coronary artery and inflated and deflated to improve the passage for the flow of blood. It is removed after the operation and the patient will usually remain awake throughout. If this operation does not work, a bypass may then be needed.

In a bypass operation, a blood vessel, usually taken from the leg or chest, is grafted onto the blocked artery, bypassing the blocked area.

It is important to remember that though the medication and surgery may alleviate your symptoms, they cannot cure it.

On rare occasions you may be offered a heart transplant, this is where the heart is removed and replaced with a healthy heart from a donor. A lung transplant may be carried out at the same time. Unfortunately, there is a shortage of donors, which is why heart transplants are only carried out when heart disease is at an advanced stage.

Is it important to get treatment straight away after a heart attack?

Most people who suffer a heart attack wait 2 hours before seeking medical help, they put their chest pain down to indigestion or expect the pain to go away. Those people who survive a heart attack are usually left with permanent damage to their heart, this damage occurs during the first hour of a heart attack.

A heart attack is not a one-time event that just happens, it usually evolves over 4-6 hours and with each passing minute, more tissue is deprived of oxygen and deteriorates or dies. This is why if you believe you may be suffering a heart attack or notice any of the symptoms mentioned above, you should call 999 immediately.

If you think you are having a heart attack it is also advised that you take an aspirin (unless you are allergic). An aspirin makes your blood less likely to clot. If possible chew the aspirin as this will get it into your system faster.

 

What happens after a heart attack?

If the blood supply to the heart is cut off severely or for a long time, the muscle cells suffer irreversible injury and die. Disability or death can be a result of this, depending on how much muscle is damaged. If a heart attack affects the bottom of the heart and affects less than 10% this would be considered a mild attack. If more than 40% of the heart is damaged death can occur. A heart attack is a signal for you to make some changes in your lifestyle. Begin to eat a healthy diet, exercise and if you smoke quit. Talk to your doctor about how you can live a normal life as soon as possible.

Some people may need to have surgery after a heart attack, a bypass or angioplasty, whereas others may just need to take medication, it all depends on how damaged the heart and arteries are.

Facts about heart disease:

  • In the U.K. some 275,000 people every year will have a heart attack and around 120,000 will die, making coronary heart disease the U.K.’s number one health problem.
  • Death rates from coronary heart disease in the U.K. are among the highest in the world.
  • Someone in the U.K. has a heart attack every 2 minutes.
  • 1 in 4 men and 1 in 6 women now die from heart disease

What is blood pressure?

Definition

As the blood circulates around the body, it is under pressure. The blood pressure is a result of the pumping action of the heart and the resistance of the vessels, through which the blood flows.  When blood pressure is high, it puts an unnecessary strain on the heart and blood vessels.

Blood pressure may rise temporarily due to exercise, excitement, anger or anxiety making your heart beat faster.

What is normal blood pressure?

Your blood pressure levels will vary during the day and will normally be highest around lunchtime or after exercise and lowest when you are resting or sleeping. Blood pressure is quoted as 2 numbers, the first number known as systolic pressure, is the blood pressure during each heartbeat. The second, known as diastolic, is the blood pressure between beats.

The latest guideline from the British Hypertension Society (2004) defines blood pressure of 130/85 or below as normal but say that 120/80 is the optimal. 140/90 is the level used to diagnose high blood pressure. If your blood pressure reading is consistently 140/90 or above this is considered high blood pressure and treatment may be required. The high blood pressure reading can be either a systolic reading of 140 or above, a diastolic reading of 90 or above, or both.

 

What causes blood pressure to be high?

Anyone can develop high blood pressure and it does not always have an obvious cause. If you have persistent high blood pressure, the condition is called hypertension.

High blood pressure tends to run in families. Blood pressure will also increase, as you get older. This may be why heart attacks are more common in older people. In a few cases high blood pressure can be related to another medical condition.

There are many other elements that contribute to high blood pressure that can be avoided, such as being overweight, drinking too much alcohol, smoking, lack of exercise and a poor diet.

How can I tell if I have high blood pressure?

You may feel perfectly well, as high blood pressure usually causes no symptoms and generally will go undiscovered until a doctor happens to take your blood pressure. If you have very high blood pressure you may experience dizziness, headaches, blurred vision and possible breathlessness. The only way you can tell for sure if you have high blood pressure is to have it measured by your doctor, or purchase one of the many blood pressure monitors that are available from most pharmacies.

What are the dangers of having high blood pressure?

High blood pressure in itself is not a disease, but it can cause serious health problems such as, heart disease and strokes. You are also more likely to suffer from kidney damage or failure.

How can I reduce the risk of high blood pressure?

A healthy lifestyle can help prevent high blood pressure. For a healthy lifestyle you should cut down on salt intake and watch your weight, find a weight that is right for you and try to stick to it. You should also give up smoking, drink less alcohol, eat a balanced healthy diet and get regular exercise.

If these measures are not successful in lowering blood pressure, then there is a wide range of drugs available to treat high blood pressure. Your doctor will help you decide what treatment is right for you. Some women experience high blood pressure because of the contraceptive pill, your doctor will monitor your blood pressure if you are on the pill. High blood pressure can also occur during pregnancy and usually returns to normal after the birth, always consult your doctor if you are worried.

·        High cholesterol is more common in men younger than 55 years and in women older than 55 years.

·        The risk for high cholesterol increases with age.

Causes & Symptoms High Cholesterol

Definition

There are no readily apparent symptoms that indicate high LDL or triglycerides, or low HDL. The only way to diagnose a problem is through a simple blood test. However, one general indication of high cholesterol is obesity. Another is a high-fat diet. In 2001, new research involving twins demonstrated that both genetic factors and diet contribute to cholesterol levels.

Diagnosis of High Cholesterol

Definition

High cholesterol often is diagnosed and treated by general practitioners or family practice physicians. In some cases, the condition is treated by an endocrinologist or cardiologist. Total cholesterol, LDL, HDL, and triglyceride levels as well as the cholesterol to HDL ratio are measured by a blood test called a lipid panel. The cost of a lipid panel is generally $40-100 and is covered by most health insurance and HMO plans, including Medicare, providing there is an appropriate reason for the test. Home cholesterol testing kits are available over the counter but test only for total cholesterol. The results should only be used as a guide and if the total cholesterol level is high or low, a lipid panel should be performed by a physician. In most adults the recommended levels, measured by milligrams per deciliter (mg/dL) of blood, are: total cholesterol, less than 200; LDL, less than 130; HDL, more than 35; triglycerides, 30-200; and cholesterol to HDL ratio, four to one. However, the recommended cholesterol levels may vary, depending on other risk factors such as hypertension, a family history of heart disease, diabetes, age, alcoholism, and smoking.

Doctors have always been puzzled by why some people develop heart disease while others with identical HDL and LDL levels do not. New studies indicate it may be due to the size of the cholesterol particles in the bloodstream. A test called a nuclear magnetic resonance (NMR) LipoProfile exposes a blood sample to a magnetic field to determine the size of the cholesterol particles. Particle size also can be determined by a centrifugation test, where blood samples are spun very quickly to allow particles to separate and move at different distances. The smaller the particles, the greater the chance of developing heart disease. It allows physicians to treat patients who have normal or close to normal results from a lipid panel but abnormal particle size.

Treatment of High Cholesterol

Medical Treatment

Definition

If following a low-saturated fat, low-cholesterol diet, increasing your physical activity, and losing weight have not lowered your risk for developing coronary heart disease after about 3 months, your doctor may consider prescribing a cholesterol-lowering medication. If your doctor prescribes medicine, you must still (1) follow your cholesterol-lowering diet, (2) be more physically active, (3) lose weight if you are overweight, and (4) control or stop all of your other coronary heart disease risk factors (including high blood pressure, diabetes, and smoking).

Taking all these steps together may lessen the amount of medicine you need or make the medicine work better, which reduces your risk for developing coronary heart disease. Your doctor may prescribe medication for you from the following categories:

Statins: controls the rate of cholesterol production in the body. These drugs lower cholesterol by slowing down the production of cholesterol and by increasing the liver's ability to remove the LDL cholesterol already in the blood.

Studies using statins have reported 20-60% lower LDL cholesterol levels in people taking them. Statins also reduce high triglyceride levels modestly and produce a mild increase in HDL cholesterol.

The statins are most often given in a single dose at the evening meal or at bedtime. It is important that these medications be given in the evening to take advantage of the fact that the body makes more cholesterol at night than during the day. Newer, long-acting statins, such as atorvastatin (Lipitor), may be administered in the morning.

Statin drugs include the following:

Atorvastatin (Lipitor): Atorvastatin is a highly effective drug in lowering LDL cholesterol when used in large doses (though high doses are not commonly used). Atorvastatin has been shown to reduce coronary heart disease events in people with hypertension.

Fluvastatin (Lescol):  Fluvastatin is the least potent statin drug. Fluvastatin has been shown to reduce coronary heart disease events in people after percutaneous coronary intervention or balloon angioplasty.

Lovastatin (Mevacor, Altocor): Lovastatin is the first statin to be approved by the FDA. Lovastatin is proven to reduce coronary heart disease events.

Pravastatin (Pravachol): Pravastatin is the most studied statin in clinical trials and is also proven to reduce coronary heart disease events and deaths.

Simvastatin (Zocor): Simvastatin is the first drug shown to reduce the total death rate by reducing LDL concentrations in people with coronary heart disease. Simvastatin is proven to reduce coronary heart disease events and deaths.

Rosuvastatin (Crestor): Rosuvastatin is the newest statin (cholesterol-lowering drug) approved in the United States and the most potent of the statin drugs. It is particularly effective in lowering very high cholesterol levels or when a cholesterol level has not been decreased with other drugs.

Bile Acid Sequestrants: These drugs bind with cholesterol-containing bile acids in the intestines and are then eliminated in the stool. The usual effect of bile acid sequestrants is to lower LDL cholesterol by about 10-20%. Small doses of sequestrants can produce useful reductions in LDL cholesterol.

Cholesterol absorption inhibitors: This new class of drugs was approved in late 2002. The drug inhibits cholesterol absorption in the gut and has few, if any, side effects. Cholesterol absorption inhibitors may rarely be associated with tongue swelling (angioedema). Ezetimibe (Zetia) is the first drug in this class. Ezetimibe reduces LDL cholesterol by 18-20%. It is probably most useful in people who cannot take statins or as an additional drug for people who take statins but who notice side effects when the statin dose is increased. Adding Ezetimibe to a statin is equivalent to doubling or tripling the statin dose.

Nicotinic acid or niacin: This water-soluble B vitamin improves all lipoproteins when given in doses well above the vitamin requirement. Nicotinic acid lowers total cholesterol, LDL cholesterol, and triglyceride levels, while raising HDL cholesterol levels.

 

 

 

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Home Remedy Treatments for High Cholesterol

Definition

It is never too early -- or too late -- to act on lowering your cholesterol. Although people with a total blood cholesterol level over 240 are considered to have the greatest risk of heart disease, the numbers can be a bit misleading, because most heart attacks occur in people whose cholesterol is below 250. So if your total cholesterol puts you in a low- or borderline-risk group, don't assume it's safe for you to ignore your lifestyle habits. Likewise, if you've already had a heart attack or been diagnosed with heart disease, there's no need to throw in the towel. There's still plenty you can do to prevent another attack, and home remedies are available to keep your disease from worsening.

Make some permanent changes. Making a commitment to lowering blood cholesterol and improving heart health requires a change of mind-set and daily habits for the long haul, not a temporary fad diet. Adopting a healthier lifestyle also means avoiding "yo-yo" dieting -- losing weight and gaining it back repeatedly. Yo-yo dieting has been shown to cause cholesterol levels to rise.

Ignore the magic bullets. This week it's rice bran, last week it was garlic, the week before it was oat bran and fish oil. All were touted as the solution to your cholesterol problem. While it's the American way to search for shortcuts, such an approach just doesn't cut it when you're dealing with your health.

Stay away from saturated fats. It might seem counterintuitive, but while the amount of cholesterol in your diet has some effect on the level of cholesterol in your blood, it's actually the amount of saturated fat you consume that has the greatest dietary influence on your blood cholesterol levels. The more saturated fat -- the kind found in dairy products made from whole milk, the marbling in red meat, the skin of poultry, and certain oils commonly used in commercially prepared baked goods -- in your diet, the more cholesterol in your blood. Be sure to check food labels to compare the saturated-fat content and choose the one with the lowest.

Avoid trans fats. Another culprit is partially hydrogenated vegetable oil, which contains Tran’s fatty acids, substances that increase the cholesterol-raising properties of a fat. Tran’s fats are found in processed baked goods, margarines, and many other foods. Check margarine labels and buy trans-fat-free margarine. (You might also ask your doctor if it is worthwhile for you to try one of the new margarines spiked with substances called plant sterols and stanols. They tend to be more expensive than regular margarines, but consuming one of these special margarines may lower LDL cholesterol by up to 14 percent when it replaces other sources of fat in your diet.) Choose snack foods without partially hydrogenated fats; again, be sure to check labels.

Let TLC guide you. The TLC -- Therapeutic Lifestyle Changes -- Diet is a dietary plan from the National Heart, Lung and Blood Institute designed to help people with heart disease or those at high risk for developing it (such as those with high blood cholesterol levels). It is a diet low in saturated fat and cholesterol that will help reduce your blood cholesterol level to decrease your chance of developing heart disease or experiencing future heart attacks and other heart disease complications.

Learn to count grams of fat. The TLC Diet outlines the percentages of daily calories that should come from saturated fat and total fat. And it's true that most package labels these days indicate what percentage of a 2,000-calorie-a-day diet the specific food would contribute in calories, fat, and saturated fat. But what do you do if your recommended daily calorie intake is well above or below 2,000? You can do some minor calculations to determine the maximum number of grams of total fat and saturated fat you should consume in a day; then compare the grams of fat listed on the food label to your personal limits to decide if a food will fit in your daily diet.

How many grams of fat, and how many grams of saturated fat, can you have each day? First multiply your total number of calories per day by .25 (depending on your activity level, age, gender, and weight, you may be allowed 30 or even 35 percent of calories from fat -- in which case you would multiply by .30 or .35, respectively; ask your doctor or a registered dietitian what level you should aim for). Next, divide that result by 9, which will give you the maximum grams of total fat recommended for you. (You divide by 9 because each gram of fat provides 9 calories.) Because you should get less than 7 percent of your day's total calories from saturated fat, you can multiply your total number of calories per day by .07 and then divide by 9 to determine that limit as well.

Eat as much like a vegetarian as possible. Dietary cholesterol is found only in animal products; animal products also tend to be higher in fat (skim milk products are exceptions), especially saturated fat. Foods derived from plant sources, on the other hand, contain no cholesterol and tend to be lower in fat. The fats they do contain are generally polyunsaturated and monounsaturated, which are healthier than the saturated kind. (The exceptions are coconut oil, palm oil, palm kernel oil, and partially hydrogenated oils, which contain higher amounts of saturated fatty acids.) You'll be doing your arteries a favor if you increase your intake of vegetable proteins, such as beans, whole grains, and tofu, and keep servings of high-fat animal products to a minimum.

Increase your complex carbohydrate intake. Eating plenty of complex carbohydrates will fill you up and make you feel more satisfied, leaving less room for fatty meats and desserts. Complex carbohydrates include fruits, vegetables, dried beans, whole-grain pastas and breads, brown rice, and other grains.

Read your meat. The small orange labels stuck to packages of meat at the grocery store aren't advertisements or promotions; they're actually grades of meat. "Prime," "Choice" and "Select" are official U.S. Department of Agriculture shorthand for "fatty," "less fatty" and "lean." Prime is 40 percent to 45 percent fat by weight; choice is 30 percent to 40 percent fat, and select or "diet lean" is 15 percent to 20 percent fat. So when you do add meat to your meal, opt for "select" cuts.

Change the way you cook. Broiling and steaming are heart-smart ways to cook food. Unlike frying, these methods require no added fat.

Skin your poultry. The skin of chicken (and turkey, too, for that matter), is an absolute no-no for people who are watching their fat intake. It contains high amounts of saturated fat.

Skip the pastry. One hidden source of saturated fat is pastry -- donuts, Danishes, piecrust, éclairs, and so on. These confections are often made with shortening, butter, and/or hydrogenated fats -- just the kinds of ingredients that should be limited by people striving to eat less saturated fat. Stick with whole-grain bread and rolls, and read labels to be sure you know what is in the package.

Eat fish. Although fish oil does not lower cholesterol, it has a dual benefit for the heart. In the simplest sense, if you choose halibut instead of prime rib, you're avoiding a huge amount of saturated fat and cholesterol, since fish is low in both. But your heart gets a bonus, since fish is a rich source of omega-3 fatty acids, unsaturated fats that have been shown to protect the heart. The American Heart Association recommends eating fish twice a week. Fatty fish have more of those healthful omega-3 fatty acids, so the best varieties to add to your menu are mackerel, lake trout, herring, sardines, albacore tuna, and salmon. 

Don not fears eggs. But, do not think you can raid the henhouse anytime you like, either. Eggs were long considered no-no's if you were concerned about heart disease, since eating just one provides a bit more than the recommended daily limit of cholesterol (200 milligrams). But in recent years, cardiologists have relaxed the rules a bit. Eggs can fit into a healthy diet if you omit other sources of cholesterol on days when you indulge.

Eat smaller meat portions. One way to trim your saturated fat intake without giving up the steaks you love is to keep your portions to about three ounces, the size of a deck of cards. Also, make whole grains the center of your meals, and use meat as more of a garnish or side.

Give up organ meats. Although rich in iron and protein, these meats are also tremendously high in fat and cholesterol. That goes for pate, too.

Increase your fiber intake. Fiber, especially the soluble kind found in fruits and brans, has been shown to lower cholesterol levels. If you follow the recommendation to eat more complex carbohydrates, you'll naturally boost your fiber intake. You might also consider punching up your fiber consumption with a daily one-teaspoon dose of a psyllium-husk powder, such as Metamucil. Women should aim for 25 grams of fiber each day, and men should try to get 38 grams. You don't want to go much above that, but that's unlikely, since we average only about half the recommended intake as it is. Be sure to increase your fiber intake gradually to give your system time to adjust, and drink plenty of fluids, so that fiber doesn't end up plugging your internal plumbing.

Quit smoking. Although most of us are aware that smoking can cause lung cancer and can raise the risk of experiencing a heart attack, few people know that smoking can actually affect cholesterol levels. When you quit the habit, your HDL, or "good," cholesterol goes up.

Add exercise to your daily routine. Studies have shown regular aerobic exercise (the type that gets your large muscles moving and your heart pumping faster for sustained periods) can boost levels of HDL in the blood. Exercise also helps reduce weight and lower triglyceride (another type of fatty molecule in the blood that, when present in high levels, can increase the risk of heart disease) and LDL levels. Aim for at least 30 to 45 minutes of moderate exercise, such as walking, most days.

Move, move, move. In addition to scheduling regular heart-pumping exercise, you need to graduate from a sedentary lifestyle to a more active one. That means fitting in extra physical movement whenever you can, such as taking stairs instead of elevators, running errands on foot or by bicycle rather than by car, and parking at the far end of parking lots. Consider getting a pedometer as a mini-motivator, and aim to accumulate 10,000 steps a day.

 

 

Natural Home Remedies for High Cholesterol

These common kitchen staples can play a role in lowering your cholesterol. Give these home remedies a try as part of the cholesterol plan you've discussed with your doctor.

Home Remedies from the Counter

Garlic. Studies show that garlic may not only reduce LDL but raise HDL and decrease the amount of fat in your blood. Add some fresh garlic regularly to your cooking to keep your heart healthy.

Home Remedies from the Cupboard

Almonds. Studies indicate that snacking on almonds regularly for as little as three weeks may decrease LDL by up to ten percent.

Honey. Add 1 teaspoon honey to 1 cup hot water in the morning, and you may rid your system of excess fat and cholesterol, according to Ayurvedic medicine. Add 1-teaspoon limejuice or 10 drops cider vinegar to give that drink a more powerful cholesterol-fighting punch.

Oats. In any pure form, oats are a traditional cholesterol buster. Eating only 1/2 cup oatmeal a day, along with a low fat diet, may reduce cholesterol levels by nine percent.

Rice. The oil that comes from the bran of rice is known to lower cholesterol. And brown rice is particularly high in fiber, which is essential in a cholesterol-lowering diet. One cup provides 11 percent of the daily fiber requirement.

Soybeans. These beauties may reduce LDL by as much as 20 percent when 25 to 50 grams of soy protein are eaten daily for as short a time as a month. Besides that obvious benefit, soy may fend off a rise in LDL in people with normal levels and also improve the ability of arteries to dilate. This means they expand better to allow the unimpeded passage of fats and other substances that otherwise might cause a blockage.

Walnuts. A cholesterol-lowering diet that includes walnuts eaten at least four times a week may lower LDL by as much as 16 percent. And studies indicate that those who munch on these nuts regularly cut their risk of death by heart attack in half when compared to non-walnut munchers.

Home Remedies from the Drawer

Calculator. Add up those cholesterol milligrams daily to see how you're doing.

Notebook. Chart your daily diet.

Nutrition & food guide. Use it to gauge the cholesterol content of the foods you eat. Record the results.

Home Remedies from the Refrigerator

Alfalfa sprouts. These may improve or normalize cholesterol levels.

Warning! Sprouts are not clean or washed when you buy them in the store, and they may be a source of E.coli bacteria. Wash thoroughly before you consume or use a veggie-cleaning product available in most grocery stores.

Apples. Apples are high in pectin, which can lower cholesterol levels.

Artichokes. This veggie can actually lower cholesterol levels. Early studies pointed to their beneficial cholesterol-busting properties, but recent studies have shown that artichokes may be even more effective than they were first thought to be.

Beets. Full of carotenoids and flavonoids, beets help lower -- and may even prevent -- the formation of LDL, the bad cholesterol.

Carrots. Full of pectin, they're as good as apples in lowering cholesterol levels.

Olive oil. It protects your heart by lowering LDL, raising HDL, and preventing your blood from forming clots.

Pears. These are high in soluble fiber, which helps regulate cholesterol levels.

Rhubarb. Yep, this is a cholesterol-buster. Consume it after a meal that's heavy in fats. You can cook it in a double boiler, with a little honey or maple syrup for added sweetness, until done. Add cardamom or vanilla if you like.

Yogurt. Eating 1 cup plain yogurt with active cultures a day may reduce LDL by four percent or more and total cholesterol by at least three percent. Some scientists believe that eating yogurt regularly may even reduce the overall risk of heart disease by as much as ten percent.

Home Remedies from the Spice Rack

Turmeric. This may lower blood cholesterol. Added to eggplant, you may reap twice the cholesterol-fighting benefit. Mix 3/4 teaspoon turmeric with 2 tablespoons cooked, mashed eggplant and 1 1/2 tablespoons boiling water. Spread it on whole wheat bread and eat after a meal heavy in fats.

It is important to watch your diet, exercise, talk to your doctor, and keep our heart-healthy home remedies in mind when you want to lower your high blood cholesterol.

Mediterranean diet for High Cholesterol

Definition

The Mediterranean diet is a heart-healthy eating plan combining elements of Mediterranean style cooking.

If you are looking for a heart-healthy eating plan, the Mediterranean diet might be right for you. The Mediterranean diet incorporates the basics of healthy eating, plus a splash of flavorful olive oil and perhaps a glass of good red wine, among other components characterizing the traditional cooking style of countries bordering the Mediterranean Sea.

Most healthy diets include fruits and vegetables, fish and whole grains, and limit unhealthy fats. While these fundamental parts of a healthy diet remain tried and true, subtle variations or differences in proportions of certain foods may make a difference in your risk of heart disease.

Benefits of the Mediterranean diet

The Mediterranean eating style significantly reduces the risk of further heart disease in individuals who had already had a heart attack. Remarkably, this benefit was not related to any significant difference in cholesterol levels — rather other components of the diet seem to work in concert to protect the body.

Key components of the Mediterranean diet include:

  • Eating a generous amount of fruits and vegetables
  • Consuming healthy fats such as olive oil and canola oil
  • Eating small portions of nuts
  • Drinking red wine, in moderation, for some
  • Consuming very little red meat
  • Eating fish on a regular basis
  • Fruits, vegetables and grains
  • The traditional diet among some Mediterranean countries includes fruits, vegetables, pasta and rice. For example, residents of Greece eat very little red meat and average nine servings a day of antioxidant-rich fruits and vegetables. This eating pattern has been associated with a lower level of low-density lipoprotein (LDL) oxidation — a change in LDL cholesterol (the "bad" cholesterol) that makes it more likely to build up deposits in your arteries.
  • Grains in the Mediterranean region typically contain very few unhealthy trans fats, and bread is an important part of the diet there. However, throughout the Mediterranean region, bread is eaten without butter or margarines, which contain saturated fat or trans fats.

Healthy fats

The Mediterranean diet doesn't view all fat as bad. The focus of the diet isn't to limit total fat consumption, but to make wise choices about the types of fat you eat.

The Mediterranean diet is similar to the American Heart Association's Step I diet, but it contains less cholesterol and has more fats that contain the beneficial linolenic acid (a type of omega-3 fatty acid). These fat sources include olive oil, canola oil and nuts, particularly walnuts. Fish — another source of omega-3 fatty acids — is eaten on a regular basis in the Mediterranean diet. Studies have shown that omega-3 fatty acids lower triglycerides and may provide an anti-inflammatory effect helping to stabilize the blood vessel lining. The Mediterranean diet discourages saturated fats and hydrogenated oils (trans-fatty acids), both of which contribute to heart disease.

Choosing oils and fats

Olive oil. All types of olive oil provide monounsaturated fat, but "extra-virgin" or "virgin" oil are the least processed forms, and so contain the highest levels of the protective plant compounds that provide antioxidant effects.

Nuts. Nuts are high in fat — up to 80 percent of their calories — but tree nuts, including walnuts, pecans, almonds and hazel nuts, are low in saturated fat. Walnuts also contain omega-3 fatty acids. Nuts are high in calories, so they should not be eaten in large amounts — generally no more than a handful a day. For the best nutrition, avoid honey-roasted or heavily salted nuts.

Wine

The health effects of alcohol have been debated for many years, and some doctors are reluctant to encourage alcohol consumption because of the health consequences of excessive drinking. However, light intake of alcohol is associated with a reduced risk of heart disease.

Red wine has an aspirin-like effect, reducing the blood's ability to clot, and also contains antioxidants. The Mediterranean diet typically includes some red wine, but this should be consumed only in moderation. This means no more than one 5-ounce glass of wine daily for women (or men over age 65), and no more than two 5-ounce glasses of wine daily for men under age 65. Any more than this increases the risk of health problems, including increased risk of certain types of cancer.

If you are unable to limit your alcohol intake to the amounts defined above, you have a personal or family history of alcohol abuse, or you have liver disease, refrain from drinking wine or any other alcohol. Keep in mind that red wine may also trigger migraines in some people.

Putting it all together

You can successfully incorporate the Mediterranean diet into your life by being an informed consumer and a smart shopper. Choose plenty of fresh fruits and vegetables, limit intake of red meat, eat fish — not fried or laden with butter or heavy sauces — at least once a week, don't be afraid of healthy fats such as olive oil, nuts and canola oil (but use these in moderation because of their high calorie content), and reduce or eliminate saturated fat and trans fats (also known as hydrogenated or partially hydrogenated oils) from your diet. Read food labels to see what you're really buying. Here are some specific steps you can take:

Eat natural peanut butter, rather than the kind with hydrogenated fat added.

Use butter sparingly, and don't think that "low fat" or "cholesterol-free" on the label means a product is necessarily good for you. Many of these items are made with trans fats.

Eat a variety of whole fruits and vegetables every day. Ultimately, strive for seven to 10 servings a day. Keep baby carrots, apples and bananas on hand for quick, satisfying snacks. Fruit salads are a wonderful way to eat a variety of healthy — and tasty — fruit.

Use canola or olive oil in cooking. Try olive oil for salad dressing and as a healthy replacement for butter or margarine. After cooking pasta, add a touch of olive oil, some garlic and green onions for flavoring. Dip bread in flavored olive oil or lightly spread it on whole-grain bread for a tasty alternative to butter.

Substitute fish and poultry for red meat. Avoid sausage, bacon and other high-fat meats. Limit higher fat dairy products such as whole or 2% milk, cheese and ice cream. Switch to skim milk, fat-free yogurt and low-fat cheese.

Eat fish once or twice a week. Water-packed tuna, salmon, trout, mackerel and herring are healthy choices. Grilled fish tastes good and requires little cleanup. Avoid fried fish, unless it is sauteed in a small amount of olive oil.

Keep walnuts, almonds, pecans and Brazil nuts on hand for a quick snack.

If it's OK with your doctor, go ahead and have a glass of red wine at dinner with your pasta or fish. If you do not drink alcohol, you don't need to start.

Once you experience the delicious and healthy choices, the Mediterranean diet has to offer, it just might become your favorite diet.

Prevention of High Cholesterol

Definition

Adoption of a healthier lifestyle, including aerobic exercise and a low-fat diet, should reduce the prevalence of obesity, high cholesterol, and, ultimately, the risk of coronary heart disease.

First, see your doctor. A simple blood test checks for high cholesterol. You may be asked to fast overnight before the test. Just knowing your total cholesterol level isn’t enough. A complete lipid profile measures your LDL, total cholesterol, HDL (the good cholesterol), and triglycerides. The guidelines say healthy adults should have this analysis every 5 years.

Next, set dietary goals based on the guidelines from the National Cholesterol Education Program.

·        Strive for daily intake of less than 7% of your calories from saturated fat and less than 200 mg of cholesterol from the food you eat.

·        You may eat up to 30% of your calories from total fat, but most should be from unsaturated fat, which doesn’t raise cholesterol levels.

·        Add more soluble fiber (found in cereal grains, beans, peas, and many fruits and vegetables) and foods that contain plant stanols and sterols (included in certain margarines and salad dressings) to boost your LDL-lowering power. The best way to know what’s in the foods you eat is to read the nutrition label.

·        Lower cholesterol levels start at the grocery store. Read food labels, and buy foods low in saturated fat and low in cholesterol.

To help you know what to look for when grocery shopping, the National Heart, Lung, and Blood Institute has a partial shopping list for you.

·        Breads - Whole wheat, rye, pumpernickel, or white

·        Soft tortillas - Corn or whole wheat

·        Hot and cold cereals - Except granola or muesli

·        Rice - White, brown, wild, basmati, or jasmine

·        Grains - Bulgur, couscous, quinoa, barley, hominy, or millet

·        Fruits - Any fresh, canned, dried, or frozen without added sugar

·        Vegetables - Any fresh, frozen, or (low-salt) canned without cream or cheese sauce

·        Fresh or frozen juices without added sugar

·        Fat-free or 1% milk

·        Cheese with 3 grams of fat or less per serving

·        Low-fat or nonfat yogurt

·        Lean cuts of meat - Eye of round beef, top round, sirloin, or pork tenderloin

·        Lean or extra lean ground beef

·        Chicken or turkey - White or light meat, skin removed

·        Fish - Most white meat fish is very low in fat, saturated fat, and cholesterol.

·        Tuna - Light meat canned in water

·        Peanut butter, reduced fat

·        Eggs, egg whites, egg substitutes

·        Low-fat cookies or angel food cake

·        Low-fat frozen yogurt, sorbet, sherbet

·        Popcorn without butter or oil, pretzels, baked tortilla chips

·        Margarine - Soft, diet, tub, or liquid

·        Vegetable oil - Canola, olive, corn, peanut, or sunflower

·        Nonstick cooking spray

·        Sparkling water, tea, lemonade