Are you concerned about your cholesterol level? If you’re not, you are in the minority as questions about how to reduce cholesterol and triglycerides seem to dominate the medical community at this time. The most common questions center around the cholesterol value that is “safe,” the most effective drug available for reducing cholesterol and the proper diet.
The cholesterol issue is like many other health issues in that our society has condoned certain practices and habits which in the short run do minimal damage but in the long run can have major consequences. Smoking, alcoholism, stress, poor eating habits fall into this category.
The biggest problem with the cholesterol issue concerns our eating habits and the way we prepare foods. Controlling the types of foods in our diets and the amounts of these foods will be a major factor in our success against cholesterol and heart disease in general.
The following concepts are important in relation to diet and should be considered before starting on cholesterol-lowering drug therapy:
• Dietary treatment is the cornerstone of therapy to reduce cholesterol level. A cholesterol-lowering diet can be tasty, satisfying and consistent with good nutrition. Many patients will not need to change their eating habits drastically.
• Advice from a professional dietitian is very beneficial and for many patients dietary therapy should be continued for at least six months before deciding whether to add drug treatment.
• Step 1 of dietary treatment requires saturated fat intake to be less than 10 percent of calories, total fat less than 30 percent of calories, and dietary cholesterol less than 300 mg/day. Step 2 calls for saturated fat intake to be reduced further to less than 7 percent of calories, and cholesterol intake less than 200 mg/day.
• Although the goal of dietary therapy is to reduce low density lipoprotein-cholesterol (LDL-C) concentration, total cholesterol can be used to monitor response to diet for convenience. The medical community has been divided on the level that is considered healthy. Just a few years ago the high range was considered above 240. Most physicians now would like to see the level below 200 to ensure more protection against plaque formation and heart disease.
Some people will have inherently higher levels of cholesterol, just like blood pressure readings, and a high reading for one person may be normal for another. Your success should be based on your initial readings versus the progress over time to lower the readings.
If diet alone has not reduced your cholesterol sufficiently, your physician will probably add a prescription drug to help in the process. The most popular drugs used today include Lopid, Questran, Lorelco, Colestid, Atromid-S, Nicotinic Acid, and Mevacor (Lovastatin). Of all of these, Mevacor has received the most publicity in the recent years. Although it has been shown to be very effective in lowering total and LDL-C, while exerting a favorable effect on HDL-C and triglycerides, its long-term safety has not been established.
Of particular concern with Lovastatin (Mevacor) is the possibility of eye and liver damage. Therefore, eye exams and liver function tests should be performed every six weeks. While all drugs have side effects and certain precautions, the other cholesterol reducing drugs seem to be effective (especially Lopid and Questran) with minimal side effects. Consultation with your physician and pharmacist before and during therapy is essential for proper treatment and protection from undue side effects.
If you want to reduce cholesterol, taking good care of yourself by eliminating smoking, reducing alcohol intake and getting into a good exercise program is the prescription for success against heart disease and related circulatory problems.