Dr. LaFleur is a research assistant professor in the University of Utah College of Pharmacy Pharmacotherapy Outcomes Research Center within the Department of Pharmacotherapy.

Has your doctor told you that you have high cholesterol? Cholesterol is a normal component of the human body?our bodies make some, and we get some from the foods we eat. Our cholesterol levels may get out of balance if (1) our body makes too much, or (2) our body does not remove it efficiently. High cholesterol is not a disease in and of itself, but if left unmanaged, it can be a cause of heart disease or stroke.

Your doctor may have talked to you about good cholesterol, bad cholesterol, and cholesterol goals, or some numbers describing low-density lipoprotein (LDL), high-density lipoprotein (HDL), or total cholesterol. All this information may be confusing and overwhelming. With a few simple facts, however, you can navigate your way back to good cholesterol levels.

Health care professionals use many measures of cholesterol. These measures are determined from laboratory tests using a sample of your blood. Table 1 describes the different types of cholesterol measures.

Table 1

Exercise

Exercise is generally recommended to everyone?regardless of cholesterol level?because regular exercise reduces the risk of heart disease, stroke, diabetes, and even some cancers. In addition, exercise can help you lose weight, which may lower your LDL ("bad") cholesterol and triglycerides. Exercise also increases your HDL ("good") cholesterol.

If you do not normally exercise much, begin slowly with shorter durations (10-15 minutes) and lower-intensity exercise (like walking leisurely). As your fitness improves, increase the duration, frequency, and intensity. Set a goal of 30 to 60 minutes of exercise 4 to 6 times per week.

Diet

Some diet changes may help you control your cholesterol by decreasing the amount of new cholesterol you ingest. By avoiding trans fats (foods that have partially hydrogenated oils on the ingredient list) and saturated fats, you can reduce your LDL cholesterol. To avoid saturated fats, reduce the amount of animal products you eat, such as butter, cheese, and red meats. Increasing your intake of fruits, vegetables, and whole grains and taking a daily multivitamin also can help reduce your risk of heart disease.

Medication

If you have high cholesterol, your doctor probably will prescribe medication based on your particular cholesterol profile. For example, he or she may prescribe a fibrate if you have high triglycerides or a statin for a high LDL cholesterol level. He may even prescribe more than one medication if you have more than one measure that is not at goal. Table 2 summarizes information about many medications. If your doctor prescribes a medication, try to understand what it is supposed to do, how you should take it, and what some potential side effects might be. Your pharmacist is a good source of information about medications.

Table 2

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If your doctor prescribes medication, he may talk to you about adherence, or the degree to which you take your medicine as prescribed. Many patients stop taking their cholesterol medicines before they benefit from them. Patients stop taking their medicines for many reasons, including forgetfulness, inconvenience, expensive copayments, or disagreeable side effects. Whatever the reasons, if you find it difficult to take your medications, talk to your doctor or pharmacist about ways to overcome the barriers, as improved adherence will help reduce your risk of heart disease.

Summary

High cholesterol is a risk factor for heart disease and stroke, but it is manageable if you take a few simple steps to change your lifestyle. If a prescription is needed, try to be informed about your medications. If you encounter any problems with your medications, ask your pharmacist to help you to address them, instead of stopping them altogether.

For more information on cholesterol, visit the following Web sites: www.nhlbi.nih.gov/health/public/heart/chol/hbc_what.htm and
www.hearthub.org/hc-cholesterol.htm.