IMPROVING CHOLESTEROL LEVELS
Your primary goal should be to reduce your LDL to healthy levels. Important dietary changes for reducing LDL levels include choosing unsaturated fats instead of saturated and trans fats and increasing fiber intake. Decreasing saturated and trans fats is particularly important because they promote the production and excretion of cholesterol by the liver. Exercising regularly and eating more fruits, vegetables, fish, and whole grains also help. Many experts believe that cholesterol-lowering foods may be most effective when eaten in combination rather than separately. You can raise your HDL levels by exercising regularly, losing weight if you are overweight, quitting smoking, and altering the amount and type of fat you consume.
Physical Inactivity An estimated 40-60 million Americans are so sedentary that they are at high risk for developing CVD. Exercise is thought to be the closest thing we have to a magic bullet against heart disease. It lowers CVD risk by helping to decrease blood pressure and resting heart rate, increase HDL levels, maintain desirable weight, improve the condition of the blood vessels, and prevent or control diabetes. One study found that women who accumulated at least three hours of brisk walking each week cut their risk of heart attack and stroke by more than half. (See Post 3 for more information on the benefits of cardiorespiratory exercise.)
Weight training should be part of any fitness program, but it can raise your blood pressure, at least temporarily. Be sure to balance weight training with aerobic exercise, which can lower blood pressure over the long term.
Obesity The risk of death from CVD is two to three times higher in obese people (BMI $ 30) than it is in lean people (BMI 18.5-24.9), and for every five-unit increment of BMI, a person’s risk of death from coronary heart disease increases by 30%. Excess weight increases the strain on the heart by contributing to high blood pressure and high cholesterol. It can also lead to diabetes, another CVD risk factor (see the next section). As discussed in Post 6, distribution of body fat is also significant: Fat that collects in the abdomen is more dangerous than fat that collects around the hips. Obesity in general, and abdominal obesity in particular, is significantly associated with narrowing of the coronary arteries, even in young adults in their twenties.
A sensible diet and regular exercise are the best ways to achieve and maintain a healthy body weight (see Post 9 for an extensive discussion of weight control). For someone who is overweight, even modest weight reduction can reduce CVD risk by lowering blood pressure, improving cholesterol levels, and reducing diabetes risk.
IMPROVING CHOLESTEROL LEVELS Photo Gallery
Diabetes As described in Post 6, diabetes is a disorder in which the metabolism of glucose is disrupted, causing a buildup of glucose in the bloodstream. People with diabetes are at increased risk for CVD, partly because elevated blood glucose levels can damage the lining of arteries, making them more vulnerable to atherosclerosis. Diabetics also often have other risk factors, including hypertension, obesity, unhealthy cholesterol and triglyceride levels, and platelet and blood coagulation abnormalities. Even people whose diabetes is under control face an increased risk of CVD. Therefore, careful control of other risk factors is critical for people with diabetes. People with pre-diabetes also face a significantly increased risk of CVD.
Contributing Risk Factors That Can Be Changed
Other CVD risk factors can be changed, including triglyceride levels, psychological and social factors, and drug use.
High Triglyceride Levels Triglycerides are blood fats that are absorbed from food and manufactured by the body. High triglyceride levels are a reliable predictor of heart disease, especially if associated with other risk factors, such as low HDL levels, obesity, and diabetes. Factors contributing to elevated triglyceride levels include excess body fat, physical inactivity, cigarette smoking, type 2 diabetes, excess alcohol intake, very-high-carbohydrate diets, and certain
Stress and social isolation increase the risk of cardiovascular disease. A strong social support network improves both health and overall wellness.
diseases and medications. A full lipid profile should include testing and evaluation of triglyceride levels (see Table 11.2).
For people with borderline high triglyceride levels, increased physical activity, reduced intake of sugars, and weight reduction can help bring levels down into the healthy range. For people with high triglyceride levels, drug therapy may be needed. Limiting alcohol use and quitting smoking are also helpful.
Psychological and Social Factors Many of the psychological and social factors that influence other areas of wellness are also important risk factors for CVD. They include chronic stress, chronic hostility and anger, lack of social support, and others. The cardiovascular system is affected by both sudden, acute episodes of mental stress and the more chronic, underlying emotions of anger, anxiety, and depression. See Post 10 for more information on stress, the effects of stress, and ways to combat these effects.
Alcohol and Drugs Drinking too much alcohol raises blood pressure and can increase the risk of stroke and heart failure. Stimulant drugs, particularly cocaine, can also cause serious cardiac problems, including heart attack, stroke, and sudden cardiac death. Injection drug use can cause infection of the heart and stroke.
Major Risk Factors That Can’t Be Changed
A number of major risk factors for CVD cannot be changed. They include heredity, aging, being male, and ethnicity.
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