St. Johns Cardiovascular St. Augustine Florida USA

St. John's Cardiovascular, P.A.

Howard A. Baker III, M.D., F.A.C.C.

St. Augustine Florida USA

 

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Cholesterol

Cholesterol:  What do I do with all these numbers?                                          

 

What Should I Know?

Most men know more about the oil in their car than about the cholesterol that may be clogging their arteries.  If you know only one number, it should be your LDL cholesterol.

What Is My LDL cholesterol? 

The LDL is the low density particle of cholesterol.  Most people think of it as the “Bad Cholesterol” because it is the particle that “delivers the cholesterol to the artery wall.” 

That description is probably too simple, but you will want your LDL low.  Lipid panels that calculate rather than measure LDL must be done fasting.  Some lipid panels measure the concentration of the LDL and measure the number and size of the LDL particles.

How Low Should My LDL Be?

If you have diabetes or any vascular disease (heart disease, carotid disease, or peripheral arterial disease), many experts recommend less than 70.  Most studies suggest that lower is better.

Optimal lipid particle numbers are less than 1000.  Larger particles (Pattern A) carry less risk than smaller particles.

Do I Need To Know The Other Cholesterol Numbers

The HDL is the high density particle of cholesterol.  Most people think of it as the “Good Cholesterol” because it is the particle that “removes cholesterol from the artery wall.”  That description is probably too simple, but you will want your HDL above 40.  Values below 40 increase the risk of heart disease.  Regular aerobic exercise and modest alcohol intake can raise the HDL.

The Total cholesterol is the number you will hear people talking about when they say something like “My cholesterol was 210.”  Because it is the sum of the HDL, LDL, and other cholesterols, it is not as strong a predictor of heart disease as the LDL.  But, each 100 mg rise in total cholesterol confers the same risk as ageing 10 years and each 1% fall in total cholesterol, reduces the risk of death and heart attack by 2%.

The Non-HDL Cholesterol is the difference between the Total and the HDL cholesterol = Total minus HDL.  This number is useful if your triglycerides are high, if you are diabetic, or if you have the Metabolic Syndrome. 

It measures all the particles that can contribute to heart disease and can be calculated even in a non-fasting state.  The Non-HDL cholesterol should be less than 100 if you are diabetic or if you have coronary or other vascular disease and below 130 if you do not.

What About Triglycerides

Triglycerides are simple fats associated with intake of simple sugars or dietary fats.  They are high in diabetics, overweight individuals, and patients with the Metabolic Syndrome.  For most patients, triglycerides can be reduced by avoiding carbohydrates (simple sugars and starchy foods) and losing weight.  If you are counting carbohydrates, the goal would be less than 50 grams of carbohydrates a day.

 

What  About Other Risks?

Because other risks like blood pressure, lack of aerobic exercise, smoking, diabetes control, and obesity multiply the risks of cholesterol, you should be paying attention to your other risks while you are lowering your cholesterol.  http://www.americanheart.org/presenter.jhtml?identifier=4704

 

What Exercise Is Recommended?

You should plan to exercise daily.  You will achieve at least 30 minutes of aerobic exercise most days if you plan for an hour of exercise to accommodate 15 minutes of warm up and 30-45 minutes of continuous aerobic exercise such as walking, swimming, or cycling.  Resistance training with moderate weights two or more days a week will increase muscle and help decrease fat.

 

What Diet Is Recommended?

You should follow a reasonable, low-fat, low-cholesterol diet with good portion-control, such as the TLC diet.  You should eat just enough calories to maintain a healthy weight and reduce your cholesterol.

 

What Is the TLC Diet?

The Therapeutic Lifestyle Change Diet limits total fat to less than 30% of daily calories with less than 7% as saturated fat.  Daily cholesterol is limited to 200 mg. and daily sodium is limited to 2400 mg.

http://www.nhlbi.nih.gov/chd/lifestyles.htm

 http://www.americanheart.org/presenter.jhtml?identifier=4764

 

 

 

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Updated: 06/17/2010 04:47:15 PM

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300 Health Park Blvd. St. Augustine, Florida 32086 (904)  810-1045