By Dr. Michael Seawell
DHR Health Heart Institute
Treatment of high cholesterol is one of the most easily modifiable risk factors for cardiovascular disease, along with regulating blood pressure, exercising, eliminating smoking, and controlling diabetes. There are numerous lifestyle changes and medications, both new and old, at our disposal to help fight high cholesterol. This is a concise review of the common measures that can be taken to decrease our exposure to high cholesterol and the resulting risk for atherosclerotic heart disease.
First and foremost, all of us should emphasize a heart-healthy lifestyle, preferably beginning at a young age and spanning our lives. A heart-healthy diet, regular and moderate exercise (around 1.5 hours per week), and smoking cessation work to maintain low cholesterol, reduce blood pressure, and lose weight. It is never too late to adopt a healthier lifestyle. We now know that exposure, over time, to high cholesterol matters as much as the magnitude of the elevated level. Thus, the earlier cholesterol can be controlled, the better.
Dietary changes are an excellent way to control cholesterol. A heart-healthy diet should include eating more fruits, vegetables, nuts, whole grains, and lean protein–such as chicken and fish. In addition, one must decrease the intake of processed foods, red meat, and refined starches–like rice–and sweetened beverages–like sodas. Fiber intake is also important to lower cholesterol. Psyllium husk fiber, found in many over-the-counter fiber supplements, can serve as additional fiber.
Dietary and lifestyle changes are often not enough to sufficiently lower a patient’s cholesterol. Some patients may require additional lowering of their cholesterol levels due to the presence of diabetes, heart disease, or other risk factors.
Medical therapy is often needed for adequate management and has been exhaustively tested and proven to be safe. The most common medications are so-called statins, such as atorvastatin and rosuvastatin. These effectively lower cholesterol levels and provide additional benefits, as they reduce cardiovascular mortality. There are now other medical options that can decrease the likelihood of cardiac events and drastically lower a patient’s cholesterol level. These medical options can be added to statin therapy if the cholesterol is not sufficiently controlled; in rare cases, when a patient is not able to take a statin drug, it can be used alone. Additionally, if the triglycerides are too elevated, both new and older medications are now available that can effectively control these levels and reduce cardiovascular events from occurring.
High cholesterol is a massive public-health issue in the Rio Grande Valley and is one of several risk factors we can change to lower our risk of heart and vascular disease. We now have multiple options that can lower levels of cholesterol and mortality, as well as new treatments now included in our armamentarium. All medical therapy should be adjunct to heart-healthy practices, diet, and exercise.
Lastly, it is vital to know your risk for coronary artery disease and undergo testing with a physical exam and blood tests to help determine the best treatment plan for you.
If you have questions regarding your heart health, please contact the DHR Health Heart Institute at 956-362-8740, or visit our website at https://www.dhrhealth.com/services/cardiology/.
