Health Topic 2

Cholesterol

High blood cholesterol is a major women's health issue. More than half of women over age 55 need to lower their blood cholesterol, and a quarter of all American women have blood cholesterol levels high enough to pose a serious risk for coronary heart disease.
Overall, an estimated 105 million American adults have total blood cholesterol levels of 200 milligrams per deciliter (mg/dL) and higher, which is above desirable levels. Of these, 42 million have levels of 240 mg/dL or higher, which is considered high risk for heart disease. This is important because cholesterol levels are a contributing factor to heart disease, which develops over years.
But don't fool yourself into thinking that high blood cholesterol is a problem only for middle-aged or elderly men and women. In fact, up to one-third of American children from age two through the teenage years have high cholesterol, which can lead to heart disease in adulthood.
Guidelines released by the National Cholesterol Education Program (NCEP), a division of the National Heart, Lung and Blood Institute (NHLBI), in May 2001 and in July 2004, substantially expanded the number of American women and men who need treatment for high cholesterol.
Based on mounting evidence that deaths from heart disease could be cut with aggressive treatment of high cholesterol, the NCEP guidelines spotlight elevated low-density lipoprotein (LDL) or "bad" cholesterol. Elevated LDL cholesterol injures blood vessel walls and has been identified as a major cause of CHD.
Updated NCEP recommendations include:
More aggressive cholesterol lowering treatment and better identification for those at risk for a heart attack
Use of a complete lipoprotein profile as the first test for high cholesterol
A revised level at which low HDL cholesterol becomes a major heart disease risk factor
A revised optimal level for LDL cholesterol for the population
More aggressive treatment of high cholesterol for those with diabetes
More intensive LDL cholesterol goals and treatment options for people at very high, high and moderately high risk for heart attack
Intensified use of nutrition, physical activity and weight control to treat elevated cholesterol levels. Medication may also be recommended for individuals at moderate to high or very high risk of developing heart disease, based on their cholesterol ranges.
This integrated approach, called the Therapeutic Lifestyle Changes (TLC) treatment plan, was introduced in the 2001 NCEP report and remains a primary recommendation.
A sharper focus on a cluster of heart disease risk factors linked to insulin resistance, known as "the metabolic syndrome," which often occur together and dramatically increase the risk for coronary complications.
Increased attention to the treatment of high triglycerides
Advisory against using menopausal hormone therapy (HT) to treat high cholesterol.
For more information on the updated NHLBI cholesterol guidelines, visit: www.nhlbi.nih.gov.
Your Cholesterol Glossary-Terms to Know
While high levels of cholesterol—a waxy, fat-like substance—are dangerous, our bodies do need some cholesterol. Cholesterol belongs to a family of chemicals called lipids, which also includes fat and triglycerides. Cholesterol is found in cells or membranes throughout the body, and is used to produce hormones, vitamin D and the bile acids that help digest fat. The body is able to meet all these needs by producing cholesterol in the liver.
Whole-milk dairy products, eggs, animal fats and meat add cholesterol to the blood. The added cholesterol, together with saturated fats from these dietary sources and trans fats from foods like coconut oil, cocoa butter, palm kernel oil, palm oil and partially hydrogenated oils—often found in processed foods—raise blood levels of cholesterol. Over the years, cholesterol and fat in the blood are deposited in the inner walls of the arteries that supply blood to the heart, called the coronary arteries. These deposits make the arteries narrower, a condition known as atherosclerosis. It is a major cause of coronary heart disease (CHD).
If the coronary arteries become narrowed or blocked, then oxygen- and nutrient-supplying blood can't reach the heart. The result is coronary heart disease (CHD) or a heart attack. The part of the heart deprived of oxygen dies.
Types of blood cholesterol. Cholesterol travels in the blood in packages called lipoproteins, which consist of lipids (fats) and protein. Cholesterol packaged in low-density lipoprotein (LDL) is often called "bad" cholesterol because too much LDL in the blood can lead to cholesterol buildup and blockage in the arteries. LDL carries most of the cholesterol in the blood.
Another type of cholesterol package is high-density lipoprotein (HDL), often called "good" cholesterol. HDL helps transport cholesterol from other parts of the body to the liver, which helps remove it from the body, preventing it from piling up in the arteries.
A third type of lipoprotein is very low density (vLDL). This package transports triglycerides in the blood; high levels of vLDL and triglycerides have also been linked to an increased risk of heart disease.

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