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Joe Poelker

Release Date: 3/3/2014

Help with new cholesterol guidelines

Carmen McCarthy, APRN, BC, Nurse Practitioner

Carmen McCarthy, APRN, BC, Nurse Practitioner

By Carmen McCarthy, APRN, BC, Nurse Practitioner

Many of my patients have recently been asking me about the new guidelines around cholesterol. In November, the American Heart Association and the American College of Cardiology announced new guidelines that healthcare providers should follow when treating patients with high cholesterol. It’s the first update in a decade.

Cholesterol is a fat-like substance that is mostly produced in the liver, though some of it does come from the food we eat. Cholesterol is needed to produce certain hormones and can help act as insulation for our nerves. It also helps digest fats.

Too much cholesterol, however, can lead to a buildup of fat or plaque in the arteries. Reduced blood flow to the heart can cause a heart attack. Reduced blood flow to the brain can cause a stroke. Both are the number one and number two causes of death in the world, respectively.

More than 70 million American adults have high cholesterol, which doubles their risk for heart disease. Less than half of people in this group take statins, a cholesterol-lowering drug.

Previous guidelines used to encourage practitioners to only look at the cholesterol levels when determining treatment. Now, they are focused on the patient’s overall risk of heart disease and stroke. That would include looking at factors like age, gender, race, whether a patient smokes, blood pressure and whether it’s being treated, whether a person has diabetes, and family history.

The guidelines indicate drug treatment is recommended for people with a high risk — and that more aggressive medications are best for those with the highest risk.

The guideline now recommends statin therapy for the following groups:

  • People without cardiovascular disease who are 40 to 75 years old and have a 7.5 percent or higher risk for having a heart attack or stroke within 10 years.
  • People with a history of a cardiovascular event (heart attack, stroke, and angina).
  • People 21 and older who have a very high level of bad cholesterol (190 mg/dL or higher).
  • People with Type 1 or Type 2 diabetes who are 40 to 75 years old.

Of course, a healthy lifestyle should always accompany medications when treating high cholesterol levels. That includes eating a heart-healthy diet with more lean meat and less red meat, being physically active on a regular basis, and maintaining a healthy weight for your height. As always, smoking cessation is encouraged to reduce the overall risk for developing cardiovascular disease. The cholesterol guidelines encourage providers to help their patients in making lifestyle changes.

One of the most important things we can do to manage our cholesterol level is to actually know our numbers. Your cholesterol numbers can be obtained through a simple blood test. Get checked regularly. Be proactive with your health.

By following the new guidelines to identifying people at risk and treating them accordingly, we could prevent millions of heart attacks and strokes over the next few decades. And one of them could be yours.

If you have any questions about your cholesterol levels check with your medical provider. If your cholesterol is difficult to manage, your doctor can refer you to The Heart Specialty Associates at St. Anthony’s Medical Center at 314-ANTHONY 

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