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Home : Your Physical Health : So You Have High Blood Cholesterol...
So You Have High Blood Cholesterol...
From the National Institutes of Health
What Your Blood
Cholesterol Levels Mean...
If You Do Have Heart Disease
"I already have heart disease -- isn't
the damage already done?"
Its not too late to help your heart. In fact, if you already
have heart disease, you should pay even more attention to your cholesterol
level. You have even more to gain. A person with coronary heart disease has a
much greater risk of having a future heart attack than a person without heart
disease. If you lower your blood cholesterol level, you can definitely reduce
your risk of future heart attacks and may, in fact, prolong your life.
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Your Blood
Cholesterol Tests
Since you have heart disease, finding out your blood
cholesterol level is a little different. You will need to have a blood test
called a lipoprotein profile. This test will determine not only your total and
HDL-cholesterol levels, but also your LDL-cholesterol leveland levels of
another fatty substance called triglyceride described on the
next page. In order to take the test you must fast.
That means you can have nothing to eat or drink but water, or coffee or tea
with no cream or sugar for 9-12 hours beforehand.
Check Your
Levels
Since you have heart disease, your doctor will use your LDL-
cholesterol level to decide on the best treatment. Your aim should be to have a
LDL-cholesterol level lower than that of people who do not have heart disease.
Compare your levels to those in the chart below to find out what your next
steps should be.
Your
Next Steps
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If You Do Have
Heart Disease
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| If Your LDL Level is... |
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Then... |
| 100 mg/dL or less |
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You do not need to take specific
steps to lower your LDL, but you will need to have your level tested again in 1
year. In the meantime, you should closely follow a diet low in saturated fat
and cholesterol, maintain a healthy weight, be physically active, and not
smoke. |
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| greater than 100
mg/dL |
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You need to have a complete physical
examination done to see if you have a disease or a health condition that is
raising your cholesterol levels. You will probably need a diet that is lower in
saturated fat and cholesterol, i.e., the Step II diet (see page 21). Since this
diet will be more effective, your doctor will likely encourage you to start
there, as well as to be physically active, to lose weight if you are
overweight, and to not smoke. If your LDL level does not come down, you may
need to take medicine. |
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Profile
Betty
Johnson'sStory
Risk Factors
Betty is 60 years old and
his a history of chest pain for which she has had tests and which her doctor
diagnosed as angina. She is about 35 pounds overweight. She is not physically
active. She has no family history of heart disease. |
Lab Report
| Total cholesterol |
240 mg/dL |
| HDL-cholesterol |
30 mg/dL |
| LDL-cholesterol |
175 mg/dL |
| Triglycerides |
180 mg/dL |
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Evaluation
Betty has a high risk for having a heart attack.
Heres why:
--She already has coronary heart disease.
--Her total blood cholesterol and LDL-cholesterol are high
--Her HDL-cholesterol is low.
--She is overweight.
--She is physically inactive . |
Since Betty has established coronary heart
disease and high total and LDL-cholesterol levels, the doctor decided to try
the Step II diet. he asked her what she usually eats and found that her diet is
high in saturated fat, cholesterol, and calories. She eats out often and likes
to cook and eat big meals with her family. The doctor told her how to gradually
change what she eats in order to follow a Step II diet that is also low in
calories and how it could help her to lose weight.
After talking to the doctor, Betty tried making
changes in what she ate for a few days, but then she stopped, not wanting to
bother with it. She did not make any changes that would reduce the saturated
fat, cholesterol, and calories in her diet. Three months later Betty had a
heart attack.
Reducing Risk
After her
heart attack, the doctor asked Betty whether she would follow the Step II diet
or preferred to try taking medicine. Betty promised herself and the doctor to
follow the Step II diet. She began to eat smaller portions; choose items lower
in saturated fat and cholesterol such skim milk and low-fat dairy products
instead of the full-fat varieties; and baked her foods more often using herbs
and spices. Because she has heart disease, she started with a low-calorie, Step
II diet. When she returned to the doctor,s office 2 months later, she had lost
about 8 pounds. But her total and LDL-cholesterol levels were still too high.
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| Lab Report |
2 months ago |
Today |
| Total cholesterol |
240 mg/dL |
216 mg/dL |
| HDL-cholesterol |
30 mg/dL |
37 mg/dL |
| LDL-cholesterol |
174 mg/dL |
149 mg/dL |
| Triglycerides |
180 mg/dL |
150 mg/dL |
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The doctor felt that she needed more help on her
diet, so he referred her to a registered dietitian for help. He also told her
to begin a morning walking program at the local mall and build up to walking
20-30 minutes, three or four times per week.
In 3 months, Betty lost another 10 pounds and
felt better. She was walking three times per week and following the Step II
diet most of the time. She ate out less often and used the Step II guidelines
in cooking for her family.
Betty followed the Step II diet and was more
physically active. Her blood values were getting close to her goals. |
| Lab Report |
5 months ago |
3 months ago |
Today |
| Total cholesterol |
240 mg/dL |
216 mg/dL |
205 mg/dL |
| HDL-cholesterol |
30 mg/dL |
37 mg/dL |
40 mg/dL |
| LDL-cholesterol |
174 mg/dL |
149 mg/dL |
135 mg/dL |
| Triglycerides |
180 mg/dL |
150 mg/dL |
150 mg/dL |
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But, since her LDL level was still too high
(greater than 130 mg/dL), the doctor decided to put her on a low dose of
medicine. He explained how important it was for her to continue her new eating,
exercising, and weight loss habits, even while taking the medicine. That way
she could take a lower dose. Betty took the medicine, continued following the
Step II diet, and exercised four times a week. Two months later, her blood
cholesterol levels reached their goals. Betty is determined to keep up her good
work and not to have another heart attack. |
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