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The Latest on Cholesterol

separator Good cholesterol, bad cholesterol, how much of each kind, high-fat, low-fat, medication or not? It seems like new cholesterol information comes out every few months or so. It’s hard to keep up and hard to know what to believe.

Reading between the lines
Some of the study results you might read about can leave you more confused than you were before. For example, one study claimed that a higher carbohydrate/lower-fat diet, which is what the American Heart Association recommends, actually lowers the levels of good cholesterol, or HDL. So people who read that kind of headline might think, “Okay, now I’m going to forget about limiting fat." Bring on the gigantic steak with baked potatoes and butter!”

But a report presented in May at the American Heart Association’s 5th Annual Conference on Arteriosclerosis explains that high carbohydrate/low fat diets also lower the levels of LDL cholesterol, so the lower HDL number isn’t really cause for alarm. That part didn’t make the headlines though.

Studies come out all the time with information that can be interpreted in lots of different ways. For the general public, it makes the most sense to be aware of what your own cholesterol levels are and what your doctor thinks you should do about it, if anything.

What everyone should do
The American Heart Association and the National Heart, Lung, and Blood Institute recommend that every five years, everyone age 20 and older should have a blood test called a “lipid profile.” This test gives you the numbers that tell you whether your blood fats are in the healthy range or whether you need to take action to bring the numbers down. There are three numbers to be concerned about, according to the most recent guidelines:

Low density lipoproteins (LDL, or “bad” cholesterol): This is the kind of cholesterol that causes blockages in the arteries. If your number for LDL cholesterol is 100 milligrams per deciliter (mg/dL) or higher, there’s a good chance your doctor will talk to you about ways to lower this number. Cholesterol-lowering medications (statins), dietary changes and increased activity levels are likely to be part of this discussion.

High density lipoproteins(HDL, or “good” cholesterol): This cholesterol helps carry the LDL cholesterol away from the arteries and back to the liver. In the liver, the cholesterol is removed from the body. So HDL is a kind of “clean-up man,” helping to keep the arteries free and clear for easier blood flow. For men, a good HDL number is 45 mg/dL or higher. For women, it’s 55 mg/dL or higher.

Triglycerides: This is a form of fat that’s carried throughout the bloodstream. But actually, most of this fat is stored in your body’s tissue. The role of triglycerides in heart disease is still not completely clear, but here’s what researchers do know: people with high triglyceride numbers often also have low levels of good cholesterol and/or a tendency to have diabetes. These two elements are risk factors for heart disease. Levels in the range of 150 to 199 mg/dL are now considered “borderline high,” and levels in the 200 mg/dL or higher range are considered high.

If you have angina or have had a heart attack…
Studies results published this spring showed that people who already have had a heart attack or who have angina may do well to keep their LDL (“bad”) cholesterol levels even lower than 100 milligrams per deciliter of blood. And some experts are wondering whether people in other categories should treat their cholesterol more aggressively as well.

Truly, the best way to make sure you’re doing everything you can to keep your cholesterol numbers in the healthy range is to have detailed discussions with your doctor.

The American Heart Association; American Heart Association’s 5th Annual Conference on Arteriosclerosis ; The National Heart, Lung, and Blood Institute’s National Cholesterol Education Program.
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