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Coronary Heart Disease
 
 

Coronary heart disease (CHD) is a type of heart disease caused by narrowing of the blood vessels that bring blood to the heart. High blood cholesterol is one of the major risk factors for CHD. The higher your cholesterol, the greater your risk for developing heart disease or having a heart attack.

Cholesterol
Cholesterol is a fat-like substance found in all cells of the body. It is needed by the body for cell development and is also used to make hormones and other substances that help to digest food. The most important types of cholesterol that affect your heart are high-density lipoprotein (HDL) or “good” cholesterol and low-density lipoprotein (LDL) or “bad” cholesterol. Triglycerides, other fat-like substances in your blood, are also important.

The Role of cholesterol in CHD
As LDL cholesterol and triglycerides accumulate in blood vessels, they form plaques (fatty build-up in the blood vessels). If a plaque ruptures, a clot can form and can slow or even stop blood flow to the heart. If blood flow to the heart is slowed or blocked, this can lead to angina (chest pain) or a heart attack. Lowering your LDL cholesterol levels decrease your chance for having a plaque rupture and causing a heart attack. Lowering LDL cholesterol may also slow down, reduce, and even stop plaque from building up. Increasing HDL cholesterol helps reduce risk as well. HDL cholesterol circulates in the blood and helps pick up LDL cholesterol and take it back to the liver for processing.

Treatment
If your cholesterol levels are not where they should be, work with your doctor to set a goal for yourself. The main purpose of cholesterol-lowering treatment is to lower your LDL enough to reduce your risk of developing heart disease or having a heart attack. Your doctor may suggest lifestyle changes, drug treatment, or both.

Lifestyle changes
Lifestyle changes that may help you reach your cholesterol goal include: eating foods low in fat and cholesterol, losing weight if needed, and exercising regularly. Unfortunately, genetics also play a role, and despite good diets and exercise, some people still have elevated cholesterol.

Drug therapy
There are a variety of medicines available to treat high cholesterol. Some of the most common types of medications include:

  • HMG-CoA reductase inhibitors (statins)
  • Nicotinic acid (niacin)
  • Bile acid sequestrants
  • Fibrates
  • Cholesterol-absorption inhibitors

If your doctor recommends medicine to lower your cholesterol, be sure to continue lifestyle changes as part of your overall treatment.

How you can help
While there are risk factors you cannot change (such as your age and sex), there are many steps you can take to improve the health of your heart and blood vessels.

  • Don't smoke, and if you do smoke, make an action plan to quit.
  • Change your diet. Certain foods have types of fat that raise your cholesterol. Try to limit foods high in saturated fat and cholesterol (for example, egg yolks, meat, and cheese). Talk to your doctor before changing your eating habits.
  • Lose weight. Extra weight can raise cholesterol levels. Losing weight can help lower LDL-cholesterol.
  • If you have diabetes, follow your doctor's advice and keep your sugar under control
  • Become more physically active. Regular exercise can help you lose weight, lower your LDL, and raise your HDL level. Talk to your doctor before starting any type of exercise routine.
  • Take your medicine. If you have been prescribed medicine to help manage your cholesterol, it is important to remember that this medicine does not “cure” high blood cholesterol. Therefore, you must continue taking your medicine to keep your cholesterol at the level recommended by your doctor.
  • See your doctor regularly. It is important that your doctor check your cholesterol levels regularly. With regular checkups, your doctor can evaluate your condition and adjust your treatment as needed so you get the full benefit of your therapy.

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