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American Family Physician

Patient Information
Please note: This information was as current as we could make it on the date given above. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education Web site.

An article on this topic is available in this issue of AFP.

What Should I Know About Cholesterol?

Why should I be concerned about my cholesterol level?

Heart attacks and strokes are the number one cause of death in the United States. Having high cholesterol levels puts you at greater risk for having a heart attack or stroke. Your risk also is higher if you:

Smoke

Do not exercise

Are a man older than 45 years or a woman older than 55 years

Have high levels of "bad" cholesterol or LDL (short for "low-density lipoproteins" [say: lip-oh-pro-teens])

Have low levels of "good" cholesterol or HDL (short for "high-density lipoproteins")

Have diabetes

Have high blood pressure (140 over 90 or higher)

Have a parent, grandparent, brother, or sister who had heart disease before age 60

Have a body mass index (also called BMI) of at least 30. Ask your doctor if you don't know your BMI.

When should my cholesterol levels be checked?

Your doctor will decide how often you should be checked, based on your age and risk factors.

What should my cholesterol level be?

Your best cholesterol level depends on other risk factors you may have for heart disease. Your doctor will use your LDL level to decide if you need to take medicine. The more risk factors you have for heart disease, the lower your LDL level should be. If you already have heart disease or diabetes, your LDL level should be less than 100 mg per dL. Even if you don't have heart disease, it is good to get your LDL level as low as you can.

If your LDL level is:

Your risk rating is:

Less than 100 mg per dL*

Best

100 to 129 mg per dL

Near best

130 to 159 mg per dL

Almost high

160 mg per dL and above

High

*-Optional goal is less than 70 mg per dL.

Can I prevent heart disease?

A healthy lifestyle will lower your risk of having a heart attack or stroke. If you smoke, ask your doctor to help you quit. Daily exercise and a low-fat, low-cholesterol diet also help lower your risk. The Mediterranean diet may lower your risk of heart attacks, strokes, and other health problems. The Mediterranean diet is made up of:

• Moderate portions of fruits, vegetables, whole grain breads, beans, nuts, and seeds

• Olive oil as the main source of fat

• Small amounts of dairy products, fish, and poultry, and almost no red meat or eggs

Wine in low to moderate amounts.

Portion sizes are different for everyone. Ask your doctor how much food and wine make up one serving for you.

Medicines that lower your cholesterol levels can help keep you from having a heart attack or stroke. Some herbal medicines such as garlic, fiber, red yeast rice, soy, artichoke, and fenugreek may help lower your cholesterol levels. But they have not been shown to lower your risk of having a heart attack.

Where can I find more information about high cholesterol levels?

Your doctor

American Heart Association
Web site: http://www.americanheart.org

National Cholesterol Education Program
Web site: http://www.nhlbi.nih.gov/about/ncep/

Date: ______ My cholesterol level is:

Total: ______ LDL _______ HDL ______




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