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Home / Fitness and Health / Why is my cholesterol high when I eat healthy? A doctor weighs in

Why is my cholesterol high when I eat healthy? A doctor weighs in



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Cholesterol is an essential component of human life and is a building block for cells that make up hormones, bile and other nutrients. However, too much cholesterol in your blood increases the risk of heart attack or stroke Most healthy adults should aim for LDL levels below 130 mg / dL.

In most people, regular exercise and healthy diets lower cholesterol Often not enough, sometimes it's because people can not stand up for the necessary radical changes – a vegan, herbal diet is the best way to lower cholesterol but few are unwilling to completely avoid animal products. (We look at you, Cheese, very, very yearning.)

In many cases, your genes also conspire to keep your cholesterol high. If you have high levels of cholesterol in the family in the past, it is possible that changing your lifestyle will bring your values ​​into a healthy range. What should you do? If your cholesterol level remains high despite the healthiest diet you can tolerate, you'll need to decide if you should take any medications.

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Who should consider the drugs

If you fall into any of these categories, statins are likely to have a significant benefit (ie a longer life and a much lower risk of heart attack or stroke ), talk to your doctor about it if:

You already have plaque in your arteries.

Your LDL target will even be below 130 – it should be at least below 100 mg / dL and ideally below 70 mg / dL.

You have diabetes.

Anyone over the age of 40 should take a statin, as chronic high blood sugar significantly increases the risk of heart disease.

Your LDL is very high (> 190 mg / dL).

You are a time bomb. Statins will likely lower your levels to a safer zone.

Your age, blood pressure, smoking, and cholesterol levels indicate a high probability of difficulty.

Even if you do not meet the above criteria you may still be at high risk for a heart attack or stroke. Docs determine the use of calculators that estimate your 10-year risk of heart disease. (If you know your blood pressure and cholesterol levels, you can plug them in here.) If your ten-year risk is more than 7.5%, you're probably safer with a statin.

Your arteries are filled with calcium.

If the calculator takes your risk in a lower range, but you are still worried (for example, each of your male relatives has a heart attack), you can get one to scan to further assess your risk. For example, a CAT scan of your heart can quantify calcium load or score, and very abnormal results indicate a more urgent need to lower cholesterol.

So what should be as a drug ? You take ?

Statins are by far the best and most studied drugs for lowering cholesterol. On average, they reduce the risk of a heart attack or stroke by 20 to 30 percent.

Although statins have a reputation for causing muscle pain, these concerns have been greatly exaggerated. In controlled experiments, statins cause seizures only slightly more frequently than sugar tablets. Fewer than one in five hundred patients actually have muscle problems and even less the treatment must be stopped.

Moreover, at high statin doses, a very small increase in diabetes risk (approximately 1 in 200) has been observed, but most physicians believe that this risk by far outweighs heart attack and stroke. Oh, and you also have to give up grapefruit juice. It increases the level of statin in your blood. We are sure that you can handle it.

All options in addition to statins ?

Statins have such well-documented benefits that other medicines are usually only used as second-line treatments – they are brought aboard because your cholesterol stays high even with optimal nutrition and statin, or you suffer from unbearable side effects of statins. What You Can Get:

  • A pill called Ezetimibe (Zetia); This is the most common alternative. This drug blocks the absorption of cholesterol from your gut and can further lower your LDL levels.
  • A newer and much more expensive class of drugs known as PCSK9 inhibitor (Alirocumab (Praluent) and evolocumab (Repatha)) can be used if Zetia fails. These medicines increase the amount of LDL your liver draws from your bloodstream. The impact is profound, as your LDL levels can easily decrease by more than 50 percent. The side effects are also minimal. If these medicines were cheap pills, we would probably recommend them to almost all adults. Unfortunately, they are still quite expensive and can only be taken as injections once every two or four weeks.

    About omega -3 s [19659027] Fish Oil [19659027] and niacin ?

    These target triglycerides, which are also measured in the standard cholesterol panel. Triglycerides are not the same as cholesterol, but high concentrations have also been linked to heart disease and stroke.

    Although omega-3 fatty acids (contained in fish oil) and niacin can lower triglyceride levels, it has not been shown to reduce the risk of heart attack or stroke. Although a recent experiment on highly purified fish oil showed some benefits in high risk individuals, it also had some negative effects (such as an increased rate of abnormal heart rhythms). Doctors are therefore not yet fully sold.