CD-ROM Today (UK) (Spanish) 15/CDRT.iso/dp/0175/01754.txt

Text File | 1994-01-17 | 16KB | 268 lines

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$Title{Cholesterol Control:  A Lifetime Plan, part I}
$Subject{Cholesterol high blood pressure pressures heart disease diseases
Cigarette smoking diet dietary dieting dieter dieters diets animals fats fat
blocked arteries artery LIPOPROTEINS LIPOPROTEIN low-density high-density very
LDL HDL VLDL SATURATED UNSATURATED MONOUNSATURATED POLYUNSATURATED OMEGA-3
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How Cholesterol Levels Affect the Arteries*0002701.scf
HDL Transports Cholesterol Back to the Liver*0002702.scf
Exercise Increses HDL*0002703.scf
Exercise Lowers Triglycerides and Raises HDL*0003203.scf
The Effects of Smoking*0007301.scf
Glossary*0174201.tid}

Copyright (c) 1991-92,1993   Tribune Media Services, Inc.


Health Update

by Dr. Allan Bruckheim

Cholesterol Control:  A Lifetime Plan, part I


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CHOLESTEROL AWARENESS IN AMERICA

     High blood cholesterol is one of the three major risk factors for heart
disease.  Cigarette smoking and high blood pressure are the other two.
Fortunately, all three risk factors can be modified--that is, you can change
them, and lower your risk of developing heart disease.
     Most Americans are acutely aware of cholesterol.  Newspapers and
magazines run frequent articles on it, best-selling books tell how to control
it, and grocery store shelves are lined with products boasting that they don't
contain it.  Cholesterol is such an important public health concern that more
than 20 health groups, including the American Heart Association and the
National Heart, Lung and Blood Institute have joined a campaign, called the
National Cholesterol Education Program, to promote lower cholesterol levels.
     Unfortunately, the more we see and hear about cholesterol, the more
complicated and confusing the message gets.  What exactly is cholesterol?  Why
is some cholesterol "good" and some "bad"?  What is the difference between
"dietary" cholesterol and "blood" cholesterol?  Does diet really affect
cholesterol levels?  Can exercise lower cholesterol levels?  Can reducing
cholesterol protect you from heart disease or premature death?
     This booklet is designed to end your confusion over cholesterol.  It
includes the latest, most reliable scientific information on this complex and
important topic.  You can do something to lower your cholesterol level--and
lower your risk for heart disease.
     Here is the information you need to begin a lifetime plan to control
cholesterol and keep your heart healthy.  The cornerstone of cholesterol
control is dietary modification.  Other measures, and sometimes
cholesterol-lowering medications, may also be appropriate.  After reviewing
your medical history and measuring the amount of cholesterol in your blood,
your physician can recommend the approach that is best for you

WHAT IS CHOLESTEROL?

     Cholesterol is a waxy, fat-like substance that is an important part of
the normal system of blood fats found in humans and animals.  Cholesterol is
not bad by itself; in fact, it is essential to several vital body processes.
It helps produce hormones, it contributes to development of the brain, and it
aids the functioning of the nervous system.
     It is not necessary to consume cholesterol in your diet.  The liver
manufactures all that your body needs:  it also processes the additional
cholesterol that comes from the foods you eat.  Cholesterol becomes a problem
only when the body makes too much of it.  The bloodstream carries cholesterol
from the liver to other body cells.  Excess cholesterol that the cells don't
need can collect on the lining of the blood vessels.  This can cause a
condition called coronary atherosclerosis--that is, the buildup of fatty
deposits, or plaque, in the arteries.
     These fatty deposits narrow the blood vessels, making the heart work
harder to pump blood through.  Blood clots (thrombosis) can also form around
these fatty deposits.  Atherosclerosis can cut off the supply of blood
carrying oxygen and other vital nutrients to the heart and other organs.  Poor
circulation of blood to the legs can cause crampy pains that doctors call
intermittent claudication.  In an artery supplying the heart, clogging can
disrupt the normal beating of the heart and Lead to a heart attack or chest
pain (angina).  If a blood vessel nourishing the brain becomes clogged, the
decreased supply of oxygen and nutrients could lead to a stroke.

LESS CHOLESTEROL MEANS LOWER RISK

     The bad news is that the higher your total blood cholesterol level, the
greater your risk of heart disease.  The good news is that you can reduce your
risk of heart disease by lowering the amount of cholesterol in your blood.
According to the American Heart Association, for every I percent that you
lower blood cholesterol levels, you reduce your risk of heart attack by 2
percent--in other words, you are two times less likely to have a heart attack
than if your levels remained high.
     But does lowering cholesterol actually reduce the risk of death from
heart disease?  This has been an area of considerable scientific controversy.
For many years, there was no evidence that people who reduced their
cholesterol levels lived any longer than those who didn't--even though they
were less likely to have heart attacks.  Because there was no clear scientific
evidence that reducing cholesterol saved lives, some scientists and physicians
were skeptical about whether people should make drastic changes in lifestyle
and diet to control cholesterol.
     Now the evidence is in.  A 10-year scientific study of more than 800
people proved that those with normal hearts whose blood cholesterol is brought
down from abnormally high levels live longer than those whose cholesterol
levels remain high.  Furthermore, people who lowered their cholesterol levels
were less likely to need surgery to unclog blocked arteries.  Lowering
cholesterol to reduce the buildup of atherosclerotic plaque in blood vessels
also protected against heart attacks.
     The knowledge that lowering cholesterol levels can keep your heart
healthier and help you live longer should give you all the incentive you need
to watch your cholesterol levels.

BLOOD CHOLESTEROL AND LIPOPROTEINS

     The kind of cholesterol in your blood is as important as the total
amount.  The different types of cholesterol are described in terms of the way
they are transported through the bloodstream.  Cholesterol is a fat, so it
cannot mix with blood, which is water soluble.  Therefore, cholesterol is
carried through the bloodstream in protein "packets" called lipoproteins.
These are of various sizes and weights (or densities).
     The two most common kinds of cholesterol are large low-density
lipoproteins (LDL) and smaller, denser lipoproteins, called high-density
lipoproteins (HDL).  LDL and HDL account count for most of your blood
cholesterol, but there are other kinds of blood fats as well, including very
low-density lipoproteins (VLDL), intermediate-density lipoproteins (IDL), and
triglycerides.
     Normally, most of the cholesterol circulating in your bloodstream is
carried by LDL.  LDL is often called "bad" cholesterol because it promotes
heart disease.  Extra LDL cholesterol that isn't used by the body in its
normal functions tends to "stick" to the walls of the arteries.  These
deposits can develop into atherosclerosis.
     HDL cholesterol is considered "good" because it appears to carry
cholesterol back to the liver for processing or removal from the body.  HDL
may help prevent the formation of fatty plaques in the arteries, and protect
against heart disease.

'DIETARY' VS. 'BLOOD' CHOLESTEROL

     "Dietary" cholesterol refers to the cholesterol contained in foods you
eat.  Cholesterol is found naturally in all animal tissue, but it does not
occur in any plants.  Fatty meats, dairy products and eggs are the most common
sources of dietary cholesterol.  Cholesterol does not occur in fats made from
vegetable sources, like cooking oil, although some vegetable oils contain
other fats you should avoid.
     "Blood" cholesterol refers to the cholesterol circulating in your
bloodstream.  Your blood cholesterol level is affected by two things.  The
first is your genetic makeup (which determines how much cholesterol your body
produces).  The second is the amount of saturated fat and cholesterol in your
diet.  Generally, the body makes only about 80 percent of its cholesterol, and
the rest comes from the food we eat.  The liver processes dietary cholesterol
and saturated fats into the lipoproteins that make up your blood cholesterol
"profile".


KNOW YOUR CHOLESTEROL NUMBERS

     High blood cholesterol doesn't cause any symptoms.  The only way you can
know if your levels are too high is to have a simple blood test done by your
doctor or other qualified health professional.  All adults over the age of 20
should have their blood cholesterol tested every five years.  A sample of
blood is taken from your finger or arm and tested to determine the blood
cholesterol level.
     Four items get special attention.  These are the total amount of
cholesterol in your blood; the relative amounts of HDL (or "good" cholesterol)
and LDL (or "bad" cholesterol); and total serum triglycerides, which are the
most common type of fat in the body.

     TOTAL CHOLESTEROL:  The National Heart, Lung and Blood Institute has
     classified total blood cholesterol levels into three groups:
     Desirable:  200 milligrams/deciliter or less
     Borderline high:  200-239 milligrams/deciliter
     High:  Over 240 milligrams/deciliter

     The results of your first cholesterol test may be confirmed with a second
one.  Generally, the higher your total cholesterol number, the greater your
risk for heart disease.  If your total blood cholesterol level is high, or if
you have additional risk factors for heart disease, you should have a
lipoprotein analysis done.  This will determine the LDL (low-density
lipoproteins) level in your blood.
     LDL CHOLESTEROL:  LDL is also classified into three groups:
     Desirable LDL:  200 milligrams/deciliter or less Borderline high LDL:
200-239 milligrams/deciliter High LDL:  Over 240 milligrams/deciliter If your
cholesterol numbers are borderline, your doctor will probably suggest that you
start on a cholesterol-lowering diet and have your cholesterol retested in a
year.  He or she may also recommend other lifestyle changes.  For example,
exercising, quitting smoking, and limiting alcohol and coffee consumption can
help reduce blood cholesterol levels and lower the risk of heart disease.  If
the LDL ratio is unusually high, your doctor may prescribe
cholesterol-lowering drugs to bring your blood lipids down to normal levels.
Your doctor also may recommend an aggressive approach if you have other risk
factors for coronary artery disease.

     ADDITIONAL RISK FACTORS

     When high blood cholesterol and certain other circumstances (such as
smoking or high blood pressure) are combined, the risk of coronary heart
disease is even greater.  For example, if your cholesterol level is in the
"high" category and you also have high blood pressure, your risk for coronary
heart disease is six times higher than that of someone without those
conditions.  If you also smoke, your risk increases more than 20 times!
     Besides high cholesterol, high blood pressure and cigarette smoking,
other risk factors for coronary heart disease include a family history of
coronary heart disease before the age of 55, diabetes, vascular disease,
obesity and being male.  Whether your cholesterol level is borderline or high,
you should make some changes in your diet to lower your level.  You should
also modify any additional risk factors.
     Of course, you can't change all of these risk factors--for example, your
sex, or your family's medical history.  If you have risk factors that you
cannot modify, that's all the more reason to work harder at changing the ones
you can--like quitting smoking, losing weight or lowering your blood pressure.
Your doctor may also prescribe additional treatments and regular cholesterol
monitoring.

CAUSES OF HIGH BLOOD CHOLESTEROL

     Several different factors can raise the level of cholesterol in your
blood.  While you can't alter things like your genetic heritage, your age, or
your sex, other factors can be controlled.  Most people can lower their
cholesterol levels with diet alone.
     DIET:  Among the factors you can control, diet has the largest effect on
your blood cholesterol levels.  Diets that are high in cholesterol, saturated
fats and excess calories are linked to high blood cholesterol levels.
Saturated fat raises your blood cholesterol level more than anything else you
eat.
     HEREDITY:  The genes you inherited from your parents also play a role in
determining your blood cholesterol level and can control your ability to lower
your level by diet.  A small number of people have an inherited tendency to
have a low cholesterol level; others have a genetic predisposition to high
levels.  If you have a generic disorder that contributes to high blood
cholesterol (hypercholesterolemia), then your parents, children, brothers and
sisters should also have their cholesterol checked.  Dietary modification is
important even if generic factors contribute to your high cholesterol levels.
     AGE AND SEX:  Cholesterol levels tend to rise with age.  In the United
States, men's cholesterol levels generally rise from about age 20 to age 50,
when they start to decline slightly.  In women, levels also start rising at
age 20, but they generally remain lower than men's until the time of
menopause.  After menopause, women's levels often increase to levels higher
than those of most men.  Pregnancy and certain oral contraceptives also can
increase blood cholesterol levels in some women.
     WEIGHT:  People who are overweight tend to have high total cholesterol
levels.  They also tend to have low levels of the "good" protective HDL
cholesterol.  A low-fat, low-cholesterol diet can help lower their total
cholesterol levels, and weight loss can improve the ratio of HDL cholesterol
in the blot.
     PHYSICAL ACTIVITY:  Regular exercise can help you control your weight and
lower your blood pressure--both important additional risk factors for coronary
heart disease.  In addition, aerobic exercise can increase your "good" HDL
cholesterol level.
     SMOKING:  Besides being an important additional risk factor for coronary
heart disease, smoking may also contribute to high cholesterol levels.  There
is evidence that smoking suppresses HDL levels; if you quit, the level of this
protective form of cholesterol increases.
     STRESS:  High cholesterol levels have been linked to stress, but it is
not clear if stress itself raises cholesterol levels.  One theory is that
tension may somehow stimulate the release of stored fat into the bloodstream.
Another explanation is that during periods of stress, people tend to eat more
foods that are high in saturated fat and cholesterol.
     MEDICATION:  Certain kinds of medications can raise your cholesterol
levels.  Be sure to let your doctor know of any medications you are taking, so
he or she can determine if they might be a factor.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.