YOUR CHOLESTEROL WHY DO YOU CARE? WHAT YOU CAN DO !

WHAT IS CHOLESTEROL? A FAT THAT CIRCULATES IN YOUR BLOODSTREAM SOMETHING THAT CLOGS ARTERIES LEADING TO HEART ATTACKS, STROKES, GANGRENE, ETC.

FRAMINGHAM STUDY 1948 IN SUBURBAN BOSTON MEASURED BLOOD LEVELS OF CHOLESTEROL ETC. LEARNED THAT IT WAS ASSOCIATED WITH CORONARY HEART DISEASE AND STROKE

GOOD VS. BAD CHOLESTEROL TRAVELS IN BLOOD WITH PROTEIN LDL= LOW DENSITY LIPOPROTEIN (BAD) HDL=HIGH DENSITY LIPOPROTEIN (GOOD)

THE WAR WITHIN LDL TRIES TO INJECT THE CHOLESTEROL INTO THE ARTERY WALL TO BLOCK IT HDL TRIES TO COLLECT LOOSE CHOLESTEROL AND PREVENT BLOCKAGE

THE NUMBERS THE LIPID PANEL TOTAL CHOLESTEROL LDL CHOLESTEROL HDL CHOLESTEROL TRIGLYCERIDESRATIOS

NCEP ATP III NATIONAL CHOLESTEROL EDUCATION PROGRAM NATIONAL HEART, LUNG AND BLOOD INSTITUTE (NHLBI) ADULT TREATMENT GUIDELINES-2004, TO BE UPDATED IN 2011

THE NUMBERS LDL IS MOST SIGNIFICANT <130 IS RECOMMENDED <100 IS OPTIMAL <70 IS TARGET IF YOU HAVE HEART DISEASE, DIABETES, OR CHRONIC KIDNEY DISEASE

ATP III GUIDELINES TREAT LDL TO REACH GOALS WEIGHT REDUCTION EXERCISE LOWER SATURATED FAT IN DIET MEDICATIONS

ATP III GUIDELINES DIET FOR LOWERING LDL: REDUCE SATURATED FAT TO <7% OF TOTAL CALORIES TOTAL FAT <25% LESS RED MEAT AND EGGS MORE VEGETABLES, FIBER, FISH AND CHICKEN

THE PLATE DIET DIVIDE PLATE INTO THREE PARTS ONE HALF IS FRUITS/VEGGIES ONE QUARTER MEAT ONE QUARTER CARBS (STARCH)

ATP III GUIDELINES LDL LOWERING: DIETEXERCISE LOSE WEIGHT

THE NUMBERS HDL: THE GOOD CHOLESTEROL HDL IS PROTECTIVE >45 IS IDEAL <40 IS TROUBLE

RAISING HDL QUIT SMOKING EXERCISE, EXERCISE MEDICATION

TRIGLYCERIDES THINK OF IT AS SUGAR/STARCH THAT BECOMES FAT EVENTUALLY < 150 NORMAL HIGH >199 NEEDS HELP!

LOWER TRIGLYCERIDE QUIT SMOKING REDUCE ALCOHOL INTAKE REDUCE CARBS LOSE WEIGHT MEDICATION

METABOLIC SYNDROME HIGH TRIGLYCERIDE LOW HDL INSULIN RESISTANCE HIGH RISK FOR DEVELOPING DIABETES AND HEART DISEASE

METABOLIC SYNDROME CAUSE: OBESITY AND HIGH CARBOHYDRATE DIET TREATMENT: LOSE WEIGHT LESS CARBS EXERCISE

DO YOU SEE A TREND? THE BOTTOM LINE: EXERCISE LOSE WEIGHT REDUCE FATS REDUCE CARBS

FRAMINGHAM STUDY IDENTIFIED RISK FACTORS FOR CORONARY HEART DISEASE: CHOLESTEROL, AGE, SEX, BLOOD PRESSURE, SMOKING 2 & 10 YEAR RISK PREDICTION

FRAMINGHAM STUDY 74 YEAR OLD MALE WITH: CHOLESTEROL 200, HDL 45, NON-SMOKER WITHOUT DIABETES, BP 140/80 TREATED RISK OF HEART ATTACK IN 2 YEARS IS ONLY 3%

FRAMINGHAM STUDY 74 YEAR OLD MALE WITH: CHOLESTEROL 200, HDL 45, SMOKER WITH DIABETES, BLOOD PRESSURE 160 DESPITE MEDICATION RISK OF HEART ATTACK IN 2 YEARS IS UP TO 24%!

FRAMINGHAM STUDY ITS NOT JUST THE CHOLESTEROL THAT DETERMINES YOUR RISK CHOLESTEROL IS A MAJOR MODIFIABLE RISK FACTOR FOR HEART DISEASE EVEN AT AGE 75

MEDICATIONS HELP LOWER CHOLESTEROL WHEN DIET & EXERCISE ARE NOT ENOUGH NOT WELL STUDIED > AGE 75 SIDE EFFECTS CONCERN MANY PATIENTS MANY PROVEN TO HELP

MEDICATIONS STATINS LOWER LDL: CRESTOR SIMVASTATIN, LIPITOR SOME GET MUSCLE ACHES LIVER PROBLEMS RARE PROOF:LOWER RISK OF HEART ATTACK AND STROKE

FIBRATES TRICOR, FENOFIBRATE, TRILIPEX LOWER TRIGLYCERIDE AND RAISE HDL NOT MUCH PROVEN BENEFIT IN PREVENTING DISEASE

MEDICATIONS FISH OIL-OTC AND LOVAZA LOWER LDL, RAISE HDL, LOWER TRIGLYCERIDE LITTLE PROVEN BENEFIT BUT NOT TOXIC AT ALL BURPING-FREEZE THE PILLS!

MEDICATIONS NIACIN B VITAMIN RAISES HDL, LOWERS LDL AND TRIGLYCERIDE FLUSHING BENEFIT QUESTIONABLE

MEDICATIONS FAT BINDERS THAT WORK IN YOUR INTESTINE WELCHOL, QUESTRAN, ZETIA FEW SIDE EFFECTS LOWER LDL BUT LITTLE PROVEN BENEFIT

CONCLUSION CHOLESTEROL IS ONE MODIFIABLE RISK FACTOR FOR HEART DISEASE DIET AND EXERCISE CRUCIAL MEDICATIONS MAY HELP