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A GUIDE TO WOMEN'S HEALTH: Heart health: From the American Heart Association

Patient Education Guide: The low down on cholesterol

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Heart disease can hurt you and really slow you down. A main cause of heart disease is high cholesterol. Cholesterol is a type of fat found in the blood. The body needs it to work properly. But it doesn't need too much, and the liver makes all the cholesterol the body needs. Cholesterol can build up in the blood vessels that carry blood to the heart muscle. This buildup forms plaque. Plaques can grow and rupture, causing clots to form, and then stop the blood flow to the heart.

You won't know you have a high cholesterol level unless you get tested. You can go to your health care provider, or look for free cholesterol testing being done in your area. Make sure that the company giving the free tests is a trusted one, and remember to share your numbers with your health care provider.

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How high is too high?

Experts think any number over 240 is high. Having a cholesterol level over 240 can hurt you because it puts you at higher risk for heart disease. Be aware that if you have other risks, like smoking, your risk is raised even more.

The ranges for cholesterol numbers are set by the National Cholesterol Education Program (NCEP), a program of the National Heart, Lung, and Blood Institute. Find out where you stand with your cholesterol level. If needed, ask your health care provider how you can lower your level.

Total cholesterol level Desirable

Less than 200 mg/dl

Borderline high

200 to 239 mg/dl

High

240 mg/dl or higher

HDL “good” cholesterol High (best)

60 mg/dl or higher

Intermediate

40 to 59 mg/dl

Low

Less than 40 mg/dl

LDL “bad” cholesterol Desirable

Less than 100 mg/dl

Near goal

100 to 129 mg/dl

Borderline high

130 to 159 mg/dl

High

160 to 189 mg/dl

Very high

190 mg/dl or higher

Triglycerides

Normal

Less than 150 mg/dl

Borderline high

150 to 199 mg/dl

High

200 to 499 mg/dl

Very high

500 mg/dl or above

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How is cholesterol tested?

There are two kinds of cholesterol tests:

* nonfasting blood test. This simple test uses a small sample of blood from a finger stick. You should get the results right away. The results are basic, showing you your total cholesterol number and high-density lipoprotein (HDL) cholesterol number. This test isn't as accurate as a fasting blood test.

* fasting lipoprotein profile. You can't eat for 9 to 12 hours before having this test done (fasting). Blood will be drawn from your arm for the test. The results take a few days, but they give you more information than you would have with the nonfasting blood test. Besides your total cholesterol and HDL cholesterol numbers, you'll also learn your low-density lipoprotein (LDL) cholesterol and triglyceride numbers.

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How can I lower my cholesterol?

Start with what you eat. The NCEP recommends that you eat less than 200 mg/day of cholesterol. Fat should make up 25% to 35% of your total calories, with saturated fat less than 7% of all the fat you eat in a day. You should eat 20 to 40 grams of soluble fiber per day and limit the carbohydrates you eat to less than half your total calories per day.

* Fewer saturated fats. Cut back on foods heavy in fats, such as whole milk, cheese, and fatty meat.

* More healthy oils. Use canola or olive oil, which are much better for you than butter, shortening, and stick margarine. Stay away from coconut or palm oils.

* More fiber. Eat whole-grain breads and cereals. Try to eat five servings of fruit and vegetables a day.

* Less meat. Avoid fatty cuts of red meat. Minimize meats like ground beef, chicken with skin, bologna, sausage, and hot dogs.

* More exercise. Get in motion. Check with your health care provider first to find out what kind of exercise is right for you. Whatever you do, do it for at least 30 minutes a day, most days of the week.

* Medication, if needed. Medication can help you control your cholesterol. Ask your health care provider if you need to take medication to help lower your numbers.

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What else can I do?

Consider joining the American Heart Association's Cholesterol Low Down program. As a member, you'll receive a free booklet that will tell you all you need to know about cholesterol and heart disease. It will include questions you can ask your health care provider and questions to ask yourself to help you know your risk of heart disease.

Return the card in the back of the booklet and you'll also get:

* newsletters that will tell you how your health care provider will check your cholesterol, show you what foods you can eat to help your heart, and answer some common questions about cholesterol.

* a cookbook that will give you ideas for meals you can cook that are healthy and taste great.

* a book called To Your Health with tips for heart-smart living.

For more information or to join, call 1-800-AHA-USA-1 (1-800-242-8721) or visit the Web site http://www.americanheart.org/cld.

© 2003 Lippincott Williams & Wilkins, Inc.

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