Health Tips

National Cholesterol Guidelines Stress Risk Factors

Last spring, the National Cholesterol Education Program issued new guidelines for the management of patients with or at risk for coronary heart disease (CHD). The overall goal is to lower cholesterol and other risk factors associated with CHD, and encourage individuals to take a proactive approach to heart health by knowing their risk factors. "It is hard to overstate the case: heart disease is by far the leading killer in this country," says Lori Mosca MD, PhD, Director of Preventive Cardiology. "These guidelines include charts that medical professionals and their patients can use to assess risk factors for heart disease. With this knowledge, paired with medical support and patient effort, people can significantly lower their risk for CHD."

The guidelines were shaped by research that has emerged from the famous long-term Framingham study and other important national and international studies. Those at greatest risk for CHD are people who have had a previous heart attack. Diabetics make up the next highest at-risk cohort; having diabetes is considered nearly equivalent to having had a previous coronary heart disease.

"We have an epidemic of diabetes in this country, with people becoming Type II (adult onset) diabetics at a younger age than in the past," says Laura Mahoney, Nursing Director of Preventive Cardiology. "This type of diabetes can be directly related to obesity. If we can prevent obesity, we can decrease what is called the "Dysmetabolic Syndrome." This syndrome is a combination of health problems including obesity, the inability to manage insulin and blood sugar levels, high blood pressure and high cholesterol. Each of these can be related to poor diet."

Cigarette smoking is another important risk factor. "Working on one risk factor, for example, quitting smoking or increasing exercise, often will positively affect the other risk factors," Ms. Mahoney says. "If you treat cholesterol levels, you can also lower blood pressure. That is why lifestyle is so important. We encourage patients to eat a low-fat, high-fiber diet, exercise on a regular basis, and stop smoking. This decreases not only your cholesterol, but also your overall risk for developing heart disease."

For some people with high cholesterol, lifestyle changes may not get a patient to their target level. These patients may be advised by their doctor to take cholesterol-lowering medications. "They should do so in addition to exercising and eating a proper diet, not in place of these important measures," Ms. Mahoney says.

Assess your own risk for coronary heart disease

Visit the National Institutes of Health web site, www.nhlbi.nih.gov/guidelines/cholesterol/pat_pub.htm, calculate your 10-year risk for a heart attack. To do so, it is preferable to have a fasting lipoprotein profile, which measures total cholesterol, LDL ("bad") cholesterol, high-density lipoprotein (HDL, or "good") cholesterol, and triglycerides. (A non-fasting profile measures total cholesterol and HDL values only.) The American Heart Association web site, www.americanheart.org, is also helpful.

Click here for Interactive Quiz: How Much Do You Know About Cholesterol?