Cholesterol Testing Recommendations
Health professionals recommend testing cholesterol based on risk. That is, where family members have a history of high cholesterol, coronary artery disease (CAD), and arterial plaques or blood clots. This applies to men and women over 20 – and especially over 35 – who smoke; have high blood pressure or diabetes; are overweight and largely sedentary; who have any of the symptoms of metabolic syndrome (large waist in proportion to other areas); women who developed gestational diabetes while pregnant; or individuals whose jobs and/or lives are very stressful. In some cases of high risk, doctors may even recommend cholesterol testing for children and teens.
Cholesterol Treatment via Medications
The first line of treatment for high LDL cholesterol levels is usually some form of medication. This is because diet and exercise can take a while to lower cholesterol and reduce the risk of CAD. Only where LDL cholesterol levels are gradually rising into the danger zone will doctors recommend diet and exercise to control bad cholesterol, and hold off on statins, which have some undesirable side effects.
Statins are the prescription medication of choice in treating high cholesterol. In some people, these compounds can lower the risk of heart disease by 25 to 35 percent. Statins work by blocking a liver enzyme that is responsible for producing cholesterol. Statin drugs approved by the FDA for use in the U.S. include:
• Crestor (generic name rosuvastatin)
• Lipitor (generic name atorvastatin)
The most commonly used are Crestor and Lipitor. Cholesterol-lowering drugs, or statins, have side effects – some ordinary (headache, insomnia, flushing, and abdominal cramping, for example), and others that are highly disconcerting, like muscle inflammation (myositis; rhabomyolysis) and kidney failure.
Other disturbing symptoms include memory loss, mental confusion, reduction in the effectiveness of diabetes medications, and interactions, sometimes severe, with other medications.
Other High Cholesterol Treatments
For some – even some with LDL cholesterol levels above 350 milligrams per deciliter (mg/dL) – it may be possible to reduce bad cholesterol by proper diet and exercise. In fact, losing a mere five or 10 pounds by diet and exercise can lower cholesterol levels and overall risk by almost 40 percent in some people.
Fats, Trans Fats, Fish, Nuts, Whole Grains
In addition to choosing monosaturated fats (olive, peanut, or canola oil); eliminating trans fats (found in margarine, store-bought cookies, crackers and snacks); and avoiding all sources of hydrogenated oils; individuals with high LDL cholesterol levels can choose fish over meat. Fish contains omega-3 fatty acids, which improve heart health overall, as do most nuts, particularly almonds and walnuts.
A heart-healthy diet also includes whole grains like oat bran – a soluble high-fiber food that “soaks up” LDL fats. The same is true of avocados, barley, beans, chocolate (organic cacao powder, for example), garlic, pears, prunes, spinach, and whey protein.
Perhaps the most important factor – and another one patients control by themselves – is exercise. Of course, where cholesterol levels are nearing, or over, 500, running a mile might provoke a heart attack, so those with high levels of LDL cholesterol and triglycerides are advised to start small.
Aerobics, yoga, and even a moderately paced five-minute walk are good ways to start. Once individuals start feeling stronger, graduate to 10 minutes. Eventually, 30 minutes of exercise – walking, biking, swimming, even a rowing machine or stair stepper – will help keep bad cholesterol levels in line.