Cholesterol Updates on Prevention, Recommendations & Management

Cholesterol – New Developments!
Latest recommendations & management

Cholesterol a waxy fat like substance is vital for the body, but when too much of it builds up in the arteries it can lead to heart disease and stroke. This puts people with high cholesterol at twice the risk for heart disease as people with lower levels.

Lowering of raised serum cholesterol levels reduces the risk of heart disease. For example, as per a recent World Health Organization study, a 10% reduction in serum cholesterol in 40-year old men resulted in a 50% reduction in heart disease within five years; and an average 20% reduction in heart disease in 70 year old males.

Alarming updates -

• Approximately one in every six adults in the US haselevated cholesterol levels hence lowering total serum cholesterol is an ideal strategy for reducing the burden of cardiovascular disease.
• According to a recent World Bank study - In India, heart disease is occurring 5–10 years earlier than in other populations around the world, producing devastating consequences for individuals, families, and society.
• (CVD death rate per 100,000 population, ages 35–64 (2000)India - Males 81 Females 55.9

Just about anyone can develop high blood cholesterol, and because it is silent its symptoms often go undiagnosed until it’s too late. But the good thing is that it is highly preventable.

The prevalence of heart disease and high cholesterol in India is driven in part by the country’s increasing urbanization and related lifestyle changes and the genetic predisposition of Indians to high cholesterol. Adding to the problem is a low level of awareness and monitoring of the disease is sub-optimal.

Several controversies surround cholesterol. There is a need to put these into correct perspective. Way back in 1994, the second FAO/WHO Expert Consultation had recommended the upper limit of dietary cholesterol at <300 mg/dl, but we have come a long way since.

Current recommendations on cholesterol levels -
The first step is to get familiar with the current guidelines and recommendations. TheNational Cholesterol Education ProgramATP III (NCEP-ATP III) has set forth the following classification of cholesterol:

Additional facts -
LDL cholesterol is considered as the primary risk factorfor cardiovascular diseases. The other major non LDL risk factors are:

• Cigarette smoking
• Hypertension (BP >140/90 mmHg or on antihypertensive medication)
• Low HDL cholesterol (<40 mg/dL). (HDL cholesterol >60 mg/dL is desirable and reduces the risk of heart disease)
• Family history of premature CHD (CHD in male first degree relative <55 years; CHD in female first degree relative (<65 years)
• Age (men >45 years; women >55 years)

Few key elements that help us control our cholesterol levels are:

• Keep the diet low in saturated fat and cholesterol.
• Increase fiber intake, both soluble and insoluble

Along with this, keeping weight in check and regular physical activity go a long way in preventing heart disease as a resulting from high cholesterol.