On this page:
Cholesterol is a fatty
substance made by the liver and found in all parts of your body. Your body uses
cholesterol to produce hormones,
vitamin D, and the bile acids that help to digest fat. It takes only a small amount of
cholesterol in the blood to meet
these needs, and your liver makes all the cholesterol your body needs.
High blood cholesterol means that there is too much cholesterol (a fat-like substance)
in your blood. Your risk for getting heart disease or having a heart attack goes up when
your cholesterol level is too high. If you have high blood cholesterol, fatty deposits
called plaque can build up on
the walls of the arteries. This is called atherosclerosis. If the arteries
that carry blood to your heart (the coronary arteries) are affected, less blood
and oxygen can get to your heart. This can cause chest pain (angina) and heart attacks.
Yes. Heart disease is the number one cause of death for both women and men in the
United States. High blood cholesterol levels raise your chances of getting heart disease.
Blood cholesterol levels in both men and women begin to go up around age 20. Before menopause, women have lower
cholesterol levels than men of the same age. After menopause, a woman's cholesterol level
can go up.
Cholesterol travels through the blood in packages called lipoproteins.
Low density lipoprotein (LDL) is called "bad
cholesterol" because it is the main source of cholesterol buildup and blockage in the
arteries. Reducing high levels of LDL has been proven to reduce heart disease risk.
High density lipoprotein (HDL) is known as "good
cholesterol" because it takes the bad cholesterol out of your blood and keeps it from
building up in your arteries. For HDL, higher numbers are better. Low HDL levels
(especially under 40) are linked to a higher risk of heart disease, while HDL levels over
60 protect against heart disease.
It is important to know your LDL and HDL levels in addition to your total cholesterol
level.
The National Cholesterol Education Program (NCEP) of the National Heart, Lung, and
Blood Institute, National Institutes of Health, issued new guidelines for preventing and
managing high blood cholesterol in 2001. NCEP indicates that everyone over age 20 should
have their cholesterol measured at least once every five years. The preferred test for
cholesterol levels is a lipoprotein profile. This is a fasting blood test (where
you fast for 9 to 12 hours before the test is done) to check your cholesterol levels
(measured in mg/dL, or milligrams per deciliter of blood), including:
- your total blood cholesterol level;
- your LDL level (bad cholesterol);
- your HDL level (good cholesterol);
- your triglyceride (another form of fat in the blood) level.
Talk to your health care provider about the results of your cholesterol test. The
following guidelines come from the National Cholesterol Education Program (NCEP) of the
National Heart, Lung, and Blood Institute, National Institutes of Health. Cholesterol
levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood.
HDL (good) cholesterol - a level of 60 mg/dL or more is
good and helps to lower your risk for heart disease. Remember that HDL (good) cholesterol
protects against heart disease, so for HDL, higher numbers are better. A level less than
40 mg/dL is low and increases your risk for developing heart disease.
Triglyceride levels - can also raise your risk for
heart disease. Levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more)
may need treatment in some people.
The main cause of high blood cholesterol is eating too much fat, especially saturated
fat. Saturated fats are found in animal products, such as meats, milk and other dairy
products that are not fat free, butter, and eggs. Some of these foods are also high in
cholesterol. Fried fast foods and snack foods often have a lot of fat.
Being overweight and not exercising can make your bad cholesterol go up and your good
cholesterol go down. Also, after women go through menopause, their bad cholesterol levels
tend to go up. There is also a rare type of inherited high cholesterol that often leads to
early heart disease.
Reducing your LDL (bad) cholesterol and total blood cholesterol levels can greatly
lessen the chances of getting heart disease. Most people can lower their blood cholesterol
by changing their diet, losing excess weight, and exercising more. These changes can also
help reduce your risk for diabetes
and lower your blood pressure.
Change your diet. Choose a diet that is low in saturated fat and
cholesterol to help reduce LDL levels. Most saturated fat and all cholesterol in our diets
come from animal sources (meats including poultry and fish, dairy products that are not
nonfat products, butter, eggs). Trans fat is another type of fat created by hydrogenation
of unsaturated fats, and your intake of trans fats should also be limited. Trans fats are
found in many fried and baked fast foods and snack products and in some margarines.
Lose weight. Losing weight if you are overweight can help lower LDL.
Weight loss is especially important for those with a group of risk factors called metabolic
syndrome. The risk factors of metabolic syndrome include abdominal obesity, defined
as having a large waist measurement (more than 40 inches for men and more than 35 inches
for women), and high triglyceride or low HDL levels.
Be physically active. Regular physical activity (30 minutes on most or
all days of the week) is recommended for everyone. It can help raise HDL and lower LDL
levels. This is especially important for those with metabolic syndrome.
Choose fish, poultry, and lean cuts of meat and remove the fat and skin
before eating. Eat no more than about 6 ounces per day. Broil, bake, roast, or poach foods
rather than frying them. Cut down on high fat meats, including sausage, bacon, and cold
cuts such as salami and bologna. Limit organ meats such as liver, kidney, and brains.
Use skim (fat-free) or low-fat (1%) milk and cheeses, and low-fat or
nonfat yogurt. Instead of butter, use liquid or soft margarine or vegetable oils that are
low in saturated fat and contain little or no trans fat (hydrogenated fat). Use all fats
and oils sparingly. Eat egg yolks only in moderation. Egg whites contain no fat or
cholesterol and can be eaten often.
Eat fruits and vegetables (at least 5 servings a day), as well as
cereals, breads, rice, and pasta made from enriched or whole grains (such as rye bread or
whole-wheat spaghetti).
Many packaged and processed foods are high in saturated fats and some also contain
trans fats. Get in the habit of reading food labels. Look for the "Nutrition
Facts" on the label and choose products that are lowest in fat. Also read product
labels for cholesterol content.
It is usually easier to follow a diet low in saturated fat and cholesterol when
preparing meals at home than when eating out. But it is possible to make careful food
choices and avoid overeating whether you are eating in a restaurant or at home.
Get at least 30 minutes of exercise most days of the week. Even low to moderately
intensive activity, if done daily, can provide benefits. Talk to your health care provider
about the safest and best ways for you to exercise. Some examples of good ways to exercise
include walking, yard work, housework, and dancing.
More vigorous exercise can raise your HDL level and will improve the overall fitness of
your heart. This kind of activity is called aerobic and includes jogging,
swimming, jumping rope, or brisk walking or bicycling. Build up your activity level
gradually over a period of several weeks.
Be sure to check with your doctor before starting a vigorous exercise program.
If you smoke, stop. Ask your health care provider for help if you find
it hard to stop on your own.
If you have high blood pressure
or diabetes, follow your treatment plan. Losing weight, exercising, and eating a healthy
diet can help you control your high blood pressure or diabetes as well as your
cholesterol.
Medicine to lower your cholesterol levels, if needed, is used along with lifestyle
changes. It is still very important to adopt a diet low in saturated fat and cholesterol,
increase your physical exercise, and manage your weight.
The main goal of cholesterol-lowering treatment is to lower your LDL (bad cholesterol)
level enough to reduce your risk of getting heart disease or having a heart attack. There
are several types of drugs available for cholesterol lowering, including statins, bile
acid sequestrants, nicotinic acid, and fibric acids. Your doctor will
prescribe medicine for you if needed.
For more information...
Learn more about high blood cholesterol by contacting the National Women's Health
Information Center (NWHIC) at (800) 994-9662 or the following organizations.
National Heart, Lung, and Blood Institute
Phone Number (s): (301) 592-8573
Internet Address: http://www.nhlbi.nih.gov/index.htm
National Cholesterol Education Program
National Heart, Lung, and Blood Institute
Internet Address: http://www.nhlbi.nih.gov/chd/
The Heart Truth
National Awareness Campaign for Women about Heart Disease
National Heart, Lung, and Blood Institute
Internet Address: http://www.nhlbi.nih.gov/health/hearttruth/index.htm
American Heart Association
Phone Number(s): (800) 793-2665
Internet Address: http://www.americanheart.org/
All material contained in the FAQs is free of copyright restrictions, and may be
copied, reproduced, or duplicated without permission of the Office on Women's Health in
the Department of Health and Human Services; citation of the source is appreciated.
From the U.S. Department of Health and Human Services
Office on Women's Health
October 2002
http://www.4woman.gov/faq/cholesterol.htm
Also see
benefits of cholesterol lowering
cholesterol, diabetes, and the statins
keeping cholesterol under control
modifying fat intake to minimize cardiovascular risk
statins
Pharmacologic Lipid-Lowering Therapy in Type 2 Diabetes Mellitus: Background Paper for the American College of Physicians at the Annals of Internal Medicine
SUMMARIES FOR PATIENTS:
Control of Lipids in Patients with Type 2 Diabetes: Recommendations from the American College of Physicians
at the Annals of Internal Medicine
|
|
|
