HOST NARRATION:
High cholesterol – sometimes called high blood cholesterol – is a major cause of heart disease and stroke. It is also a widespread health problem – the American Heart Association estimates 40 million Americans have total cholesterol levels that put them at high risk of major health problems.
DOCTOR: And have you been doing your walking?
PATIENT: I have.
DOCTOR: How far are you up to now?
HOST ON CAMERA: Cholesterol is a lipid: a soft, waxy fat produced by the liver. While too much cholesterol is bad for your health, cholesterol is actually an important building block of the human body.
LYNNE BRAUN: We have to have cholesterol. We have millions, millions, probably billions of cells within our body and it makes up the membrane or the wall of those cells.
HOST NARRATION:
The body also uses cholesterol to protect nerve fibers …to produce the hormones testosterone and estrogen …and to make the chemicals our bodies need to digest food. Cholesterol is distributed throughout the body via the blood stream. If you have high cholesterol, it means you have excessive amounts of cholesterol in your blood. When this occurs, the circulatory system stores that extra cholesterol in your arteries, eventually damaging them.
MICHAEL VERTA:
An excess amount of cholesterol circulating in the blood is going to deposit somewhere. When it begins to deposit initially, and it can happen as early as the age of 18, it just begins to lie down in the, wall of the artery in between the layers of the wall of the artery that make up the lining
HOST NARRATION:
Over time, cholesterol deposited in the arteries can grow into formations of what is called plaque. If left unchecked, plaque can cause arteries to narrow and harden – a condition known as atherosclerosis. Health problems related to atherosclerosis, such as heart disease, are the leading cause of death in the United States. Doctors have identified many factors that can contribute to high cholesterol. Some of them, like diet, weight and exercise, are controllable. If you eat foods heavy in saturated fats and trans fats ….if you are overweight or obese … or if you don’t exercise regularly ….you are more likely to develop high cholesterol. There are also some causes of high cholesterol that are beyond our control: like age, gender, and heredity. Most people naturally develop higher cholesterol as they age. Women tend to have an increase in cholesterol after menopause. And, for reasons not totally understood, the liver in some people is genetically predisposed to produce unhealthy amounts of cholesterol. The best way to monitor your cholesterol is with a simple test, called a lipid panel.
MICHAEL VERTA: High cholesterol is a fairly easy thing to pick up with a blood test and we screen for cholesterol routinely, now, because it affects so many arteries in so many places.
HOST NARRATION: A lipid panel measures your LDL, known as bad cholesterol …your HDL, known as good cholesterol … your total cholesterol … and your triglycerides.
HOST ON CAMERA: You may be familiar with the terms “good” and “bad” cholesterol. LDL, or bad cholesterol, stands for Low Density Lipoprotein.
HOST NARRATION: LDL is what leads to excess cholesterol in your arteries, which can cause atherosclerosis.
DOCTOR: Let me give you one piece of literature on low cholesterol foods.
HOST on camERA: HDL, which is the so-called good cholesterol, stands for High Density Lipoprotein.
HOST NARRATION: HDL contributes to reduce amounts of cholesterol build-up in the arteries. Higher levels of HDL cholesterol often mean a lower risk of atherosclerosis.
PATIENT: The HDL is 41.
DOCTOR: Okay, that’s good. And the LDL was 106.
PATIENT: Right.
HOST NARRATION:
The National Institutes of Health have issued targets for healthy levels of cholesterol: LDL should be below 100 milligrams per deciliter of blood. HDL should be above 40 milligrams. And total cholesterol should be less than 200 milligrams. Triglycerides are the final measurement taken in a lipid panel. Triglycerides are not cholesterol, but another type of fat found in the blood. High levels of triglycerides can contribute to atherosclerosis, and are closely associated with heart attacks. Your triglyceride level should be less than 150 milligrams per deciliter of blood.
HOST on CAMERA: While it can be difficult to fully appreciate the significance of these numbers, here’s one statistic to keep in mind: elevated levels of bad cholesterol can double your risk of heart disease.
LYNNE BRAUN: It can be considered to be the silent killer. We have very strong data to show that higher cholesterol values means higher coronary heart disease rates and higher deaths from coronary heart disease.
HOST ON CAMERA: But if you have elevated cholesterol levels, remember: many treatment options are available.
DOCTOR: There’s been studies to show that if we drive that LDL even lower, I can actually help you to live longer and healthier.
HOST NARRATION: The first line of treatment is often a change in lifestyle. Eating a heart healthy diet and getting the proper amount of exercise can go a long way toward reducing cholesterol. There is also a wide variety of drugs available to help manage and control the condition.
TIMOTHY SANBORN: The most effective cholesterol lowering medicine that we have right now are the statins . But doctors also have a number of other cholesterol lowering medications available.
HOST ON CAMERA:
Despite its common rate of occurrence, and serious potential consequences, studies show that high cholesterol is a relatively under-treated condition. That’s why it’s important to find out what your cholesterol levels are …what they mean …and to take whatever steps necessary to manage them.
HOST NARRATION:
In the other chapters of this episode, you can learn more about diagnosing high cholesterol …get some science on how cholesterol works in your body…and discover the various treatment options currently being practiced. And in our “Personal Stories” chapter, you’ll meet a real patient, and his doctor, who are successfully managing this condition.
