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Atherosclerosis is the build up of fatty substances in the walls of the arteries that can lead to a heart attack. High levels of these substances, called lipids, can lead to heart disease. High lipid levels can begin forming plaques in the arteries as early as childhood. Plaque can narrow the arteries, causing symptoms like chest discomfort. For reasons we do not completely understand, the plaque can rupture causing a heart attack. Abnormal lipid levels, as well as age, family history of heart disease, high blood pressure (BP), smoking, diabetes, and obesity, are all risk factors for atherosclerosis.


Types of lipids

The two main types of lipids are cholesterol and triglycerides. Cholesterol is made in the liver and helps cells to function normally. Excess cholesterol comes from food. The liver really produces all of the cholesterol our bodies need.


When you eat more calories than the body needs, the rest are stored as triglycerides. Elevated triglycerides are an important sign of increased heart disease risk, especially among women. There are no symptoms of abnormal levels of cholesterol and triglycerides until the arteries become very narrow or a heart attack occurs.


What should my lipid levels be?

There are four different numbers you should know:


* total cholesterol (ideally under 200 mg/dL)


* triglycerides (ideally under 150 mg/dL)


* high-density lipoprotein cholesterol (HDL) (ideally, for men, 40 mg/dL or over; for women, 50 mg/dL or over)


* low-density lipoprotein cholesterol (LDL) (ideally, under 100 mg/dL)



When you talk to your healthcare provider about your test results, find out not only whether your numbers are "good" or "high," but also exactly what your numbers are and what you should do about them, if anything.


What can I do to lower my cholesterol?

Lifestyle changes are always a good first step to improve your lipid profile.


* Achieve and maintain your ideal weight through regular physical activity. It can lower BP, improve lipid levels, and reduce stress. Exercise for 30 minutes a day, even if you just take a walk during your lunch break. You should check with your healthcare provider about starting new activities if you have been inactive for awhile or have any health problems.


* Eat a low-fat, low-cholesterol diet.


* Use healthy fats when cooking. Monounsaturated oils such as olive oil are especially good at lowering LDL and raising HDL. Instead of butter, choose a soft margarine. Look for ones that contain plant stanols and sterols, which can help lower cholesterol levels when used daily.


* Choose low-fat dairy products when you buy milk, cheese, or yogurt.


* Choose baked, broiled, or grilled meats rather than fried, and keep the portion sizes to 4 ounces. Fish like tuna and salmon are especially heart-healthy. The omega-3 oils found in fish are also in nuts and flaxseed, which can be added to cereal.


* Eat more fruits and vegetables-at least five servings per day.


* Increase fiber intake by eating whole grain breads, pasta, rice, and cereal.


* Stay away from processed foods when you do your grocery shopping. The most nutritious items in the grocery store are usually found in the outside aisles.


* Limit alcoholic drinks to no more than two servings per day for men and one for women. (A serving = 12 ounces of beer, 5 ounces of wine, or 1 1/2 ounces of alcohol.) Excess alcohol adds calories, can increase your BP, and can harm the heart muscle.


* Avoid soft drinks, many sport drinks, and juice beverages.



If lifestyle changes are not enough[horizontal ellipsis]

There are many drugs available that can help lower your cholesterol. Even more important, many of these medicines may actually reduce the risk of heart attack, second heart attack, or stroke.


In almost all cases, cholesterol-lowering drugs need to be taken for a lifetime. If your healthcare provider recommends cholesterol-lowering medicine for you, you will want to ask about any possible side effects, and also what else you must do to make sure the medicine is working and not causing any problems.


Improving heart health

Treatment of high cholesterol should be a part of improving your overall heart health and reducing the risk of heart disease. Even if you have already had a heart attack, prevention can help lower your chances of heart problems in the future. Remember to know your BP and follow your healthcare provider's advice on treatment. BP medicine is usually taken for a lifetime.


If you don't smoke, don't start. If you already smoke, think about quitting, and ask your healthcare provider to help you quit when you are ready. Tobacco is the #1 risk for heart disease. The chemicals in cigarettes damage the lining of the artery walls, and decrease the amount of oxygen that can be carried by the blood cells.


Finally, ask your healthcare provider about being screened for diabetes, especially if you are overweight or have a history of heart disease in your family. Become an active partner with your healthcare provider to keep your lipids and other risk factors in control. Your heart health depends on it!!

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Other resources

Web sites:


* National Heart Lung and Blood Institute:


* CardioSmart:


* HeartHub for Patients:



Fast fact:

A high LDL cholesterol level is a major risk factor for heart disease. If your LDL is too high, it can cause atherosclerosis, a dangerous accumulation of fatty deposits on the walls of your arteries.


Fast fact:

Even mild activities, if done daily, can help lower your cholesterol. You can benefit from simple exercise like walking, gardening, housework, or dancing. Talk to your healthcare provider about getting started, especially if you've been inactive.


Did you know?

Below are 4 foods that can help you lower your cholesterol:


1. Oatmeal and oat bran


2. Walnuts and almonds


3. Fish


4. Olive oil