Should I know my cholesterol and other test level numbers? Will it do any good?

If you want to reduce your chances of heart disease, you must take charge of your lifestyle, and that includes knowing your numbers and keeping track of how they respond to any changes in your eating pattern or medication.

How well will a healthy diet lower my cholesterol?

A healthy diet may reduce your cholesterol by 10%. Obviously the higher your cholesterol at the start, the more likely you will need medications as well, but a period of healthy diet restricting your fat intake for 3 months is normally recommended first (see Chapter 9). However, if you already have heart problems, most doctors advise immediate medication to take full advantage of its cholesterol-lowering effect.

Which is more important - to avoid foods high in cholesterol or saturated fats?

Cholesterol in your food has a smaller effect on the blood cholesterol level than do foods high in saturated fat. It is more important therefore to cut down on foods high in saturated fat. This means, for example, that you can have three to four eggs a week (the yolks are high in cholesterol). Cutting down on saturated fat (and all fats) will help you to lose weight (see Chapter 9).

I am told that I have a high cholesterol level. If I manage to lower this level, will this really prevent heart disease?

We now have overwhelming evidence that lowering your cholesterol level not only reduces your risks of heart disease by an average of over 30%, but also reduces the need for heart bypass surgery and angioplasty (see Chapter 3). If you lower your cholesterol over a 5-year period, you improve your chances of living longer by an amazing 30%. Treating a high cholesterol is one of the most important means of preventing and reducing the complications of coronary artery disease. Some doctors believe it is negligent not to lower a raised cholesterol.

What should I get my cholesterol levels down to in order to see a benefit to my heart?

Most of the benefit occurs when the LDL ('bad') cholesterol is lowered by 30% or more; your aim should be to get this level below 3.0mmol/litre with an ideal of 2.0mmol/litre, or less if you have coronary disease, diabetes or a chronic renal condition. This leads to removal of the soft part of the narrowings in the arteries making them less likely to tear or split. It is known as stabilising the plaque (see the Introduction to this chapter). Unstable plaque that ruptures releases soft cholesterol into the blood which then causes a clot to form and a possible heart attack to occur - removing the soft cholesterol helps to prevent this happening.

I have reduced my cholesterol level so that the tests are now normal. Can I go back to smoking?

No. Risk factors, which increase your chances of developing heart

problems, are independent of each other. If you have more than one risk factor, however, they don't just add up, they multiply.

Table 2.4 Cholesterol-lowering drugs

Cholesterol-lowering drugs

I have seen cholesterol self-testing kits in the chemists. Are these any good?

Not really. They are not as accurate as we had hoped they would be.

Do I need to starve for the blood test?

A blood sample which will show the levels for total cholesterol and HDL can be taken at any time, and this will be a useful screening test. However, the LDL and triglyceride levels are influenced by diet and should be measured after at least nine hours of fasting, but you can drink water.

My doctor has only measured my total cholesterol level. Is this enough, or should I ask for all the different levels to be measured?

When your doctor is giving you a screening test, the total cholesterol level is a good guide. A total cholesterol of 5.0 or less is satisfactory and remember that 5.0 of total cholesterol is equivalent to 3.0 of 'bad' LDL. However, if your doctor is planning your treatment, a full lipid profile is needed to guide therapy properly If you are going to be on medication for a long time, you need to be sure that you are on the right type.

When should I have a repeat cholesterol level test?

When you have been on your new healthy diet for 3 months, the doctor will ask you to come in for another test.

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