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September is National Cholesterol Awareness Month

Know Your Numbers: Are You at Risk?

Seventy-one million American adults have high cholesterol, but only one-third have the condition under control. September is National Cholesterol Education Month—a good time to get your cholesterol screened. High cholesterol is one of the main risk factors for coronary heart disease, heart attack, and stroke. So, as you take this time to think about your cholesterol and whether you’re at risk, ask yourself two questions: Do I know my numbers? Am I at risk?
Cholesterol is a waxy, fat-like substance your body needs to make hormones, vitamin D, and substances that help you digest foods. Your body makes all the cholesterol it needs. However, cholesterol can also be found in some of the foods you eat. Cholesterol travels through your bloodstream in small packages called lipoproteins. These packages are made of fat (lipid) on the inside and proteins on the outside.

When you have too much cholesterol in your blood, it can build up on the walls of your arteries and form blockages—leading to heart disease, heart attack, and stroke.
Two kinds of cholesterol can be found in the body: High-density lipoprotein (HDL) and low-density lipoprotein (LDL). HDL is also called “good” cholesterol while LDL is called “bad” cholesterol. When doctors talk about high cholesterol, they are speaking of “bad” LDL cholesterol.

The National Lipid Association (NLA) recommends that all adults age 20 or older have a fasting lipid profile (a blood draw taken after a fast without food, liquid, or pills) at least every five years to determine the numbers for their total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. In particular, adults who are gaining weight and those who have high blood pressure or diabetes should have their cholesterol levels checked.

High Blood Cholesterol
High blood cholesterol means you have too much cholesterol in your blood. By itself, the condition usually has no signs or symptoms so many don’t know their cholesterol levels are too high. Those with high blood cholesterol have a greater chance of getting coronary heart disease, also called coronary artery disease.
The higher the level of LDL cholesterol in your blood, the greater your chance is of getting heart disease. The higher the level of HDL cholesterol in your blood, the lower your chance is of developing heart disease.
Coronary heart disease is a condition in which plaque builds up inside the arteries of the heart. Over time, plaque hardens and narrows your coronary arteries. This limits the flow of oxygen-rich blood to the heart. Eventually, an area of plaque can rupture. This causes a blood clot to form on the surface of the plaque. If the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery. If the flow of oxygen-rich blood to your heart muscle is reduced or blocked, a heart attack may occur.

Plaque also can build up in other arteries in your body, such as those that bring blood to your brain and limbs. This can lead to problems such as carotid artery disease, stroke, and peripheral arterial disease (PAD).

What are the Risks?

LDL cholesterol is produced naturally by the body, but many people inherit genes from their mother, father, or even grandparents that cause them to make too much. Those with a previous history of heart attack, stroke, carotid artery disease, or artery blockage in the neck, PAD, or blockages in the extremities—such as the arms and legs—are considered at high risk for heart disease.

Eating foods with saturated fat or trans fats also increases the amount of LDL cholesterol in your blood. If this condition runs in your family, lifestyle modifications may not be enough to help lower your LDL blood cholesterol.

Diabetes also increases the risk for high cholesterol. Your body needs glucose (sugar) for energy. Insulin is a hormone made in the pancreas that helps move glucose from the food you eat to your body’s cells. If you have diabetes, your body doesn’t make enough insulin, can’t use its own insulin as well as it should, or both.
Diabetes causes sugars to build up in the blood. Talk to your doctor about ways to manage diabetes and control other risk factors.

Your Doctor Can Help

It’s important to have your cholesterol levels checked regularly by your doctor. It takes a team to develop and maintain a successful health program. You and your doctor each play an important role in maintaining and improving your heart health. Work with your doctor to determine your risk and the best way to minimize that risk. In all cases, lifestyle changes are important to reduce your risk for heart attack and stroke. In some cases, cholesterol-lowering statin medicines may also provide help.
Learn how to make diet and lifestyle changes easy and lasting. Also make sure you understand instructions for taking medication because it won’t work if you don’t take it as directed.

Bringing Your Numbers Down

As part of a complete prevention and treatment program for managing your cholesterol and lowering your risk of heart disease and stroke, your doctor may suggest a few lifestyle changes. Regardless of whether your plan includes drug therapy, you can do plenty to improve your cholesterol levels and your overall health:
Change your diet: To lower cholesterol, the American Heart Association recommends eating a dietary pattern that emphasizes fruits, vegetables, whole grains, low-fat dairy products, poultry, fish, and nuts. You should also limit red meat and sugary foods and beverages. Many diets fit that pattern, including the Dietary Approaches to Stop Hypertension (DASH) eating plan promoted by the National Heart, Lung, and Blood Institute and diets suggested by the U.S. Department of Agriculture and the American Heart Association.
Get up and move: Just 40 minutes of aerobic exercise of moderate to vigorous intensity (walking, swimming, bicycling, or a dance class), done three to four times a week, is enough to lower both cholesterol and high blood pressure.

Avoid tobacco smoke: If you smoke, your cholesterol level is another good reason to quit. Everyone should avoid exposure to secondhand smoke.

If you have high LDL cholesterol, your doctor may prescribe medicine in addition to the above lifestyle changes to control your levels, especially if:
> You previously had a heart attack or stroke.
> Your LDL cholesterol level is 190 mg/dL or higher.
> You are 40-75 years old with diabetes and LDL cholesterol of 70 mg/dL or higher.
> You are 40-75 years old with a high risk for developing heart disease or stroke and LDL cholesterol of 70 mg/dL or higher.
Discuss with your health care team about your overall cardiovascular health and how you may be able to reduce your cardiovascular disease risk.

The Path to Success

Once you’ve talked with your health care professional about your cholesterol levels, eating a healthy diet and including exercise in your routine can give you the edge in the fight against heart disease and stroke. Let your doctor be your coach in combating heart disease and stroke. It’s your health and your heart—take care of it!

For more information, visit To make an appointment for a cholesterol check call Coastal Carolina Health Care’s New Bern Family Practice at (252) 633-1678.

(Sources: Centers for Disease Control and Prevention, National Heart, Lung, and Blood Institute, American Heart Association, U.S. Department of Agriculture, National Lipid Association; National Cholesterol Education Program, Every Body Walk!, U.S. Department of Veterans Affairs.)