There's a new strategy in place against the war on heart disease: new and more aggressive guidelines for testing and treatment of cholesterol. Heart attacks are the number one killer of Americans, including those living in St. Charles County. Here, we will discuss cholesterol, the new guidelines and what it all means for you.

What is cholesterol?
Cholesterol is a waxy substance found in the body that is produced by the liver or ingested when you eat animal products such as milk, eggs or meats. Cholesterol, like fat, is essential to some body functions but can be harmful in large amounts. People need cholesterol for producing new cells, cushioning nerves, and making hormones. Two kinds of cholesterol exist: High density lipoproteins (HDLs), or the good cholesterol can work to remove cholesterol and low density lipoproteins (LDLs), or the bad cholesterol. The good cholesterol removes some of the bad cholesterol, so it is OK if that level is high. When there is too much cholesterol in the body, it can build up in arteries and restrict blood flow to the heart, brain or other parts of the body. If blood flow is blocked to the heart, it causes a heart attack and when it is blocked to the brain, it results in a stroke.

The new guidelines.
The National Cholesterol Education Program of the National Institutes of Health (NIH) released new guidelines regarding cholesterol testing and levels in May 2001. The committee stresses the importance of examining the overall risk for heart attacks. Here are highlights from the new cholesterol guidelines and the most important things you need to know.

• A lipoprotein profile should be used to test cholesterol levels. The profile measures HDL (good) cholesterol, LDL (bad) cholesterol, total cholesterol and triglycerides, another fatty substance found in the blood. NIH recommends being tested at age 20, and every 5 years after that if your cholesterol levels are normal.
  
  
• HDL cholesterol should be at least 40 mg/dL. Anything under this now becomes a risk factor for heart disease. Previously, the recommended level of HDL was 35 mg/dL. A HDL level of 60 mg/dL will decrease your risk factors for heart disease.
  
  
• The optimal level for bad cholesterol is 100mg/dL. Borderline high levels are 130-159 mg/dL and high is considered 160 mg/dL and above.
  
  
• Diabetes is added to the list of conditions that puts a person at an increased risk for heart disease.

• Doctors may recommend adoption of the Therapeutic Lifestyle Changes (TLC) treatment plan for those with high cholesterol levels. TLC emphasizes the role of diet, weight control and physical activity on healthy cholesterol levels. The plan limits saturated fat to 7% of daily calories and cholesterol consumption to no more than 200 mg. People without high cholesterol are recommended to have no more than 10% of calories from saturated fat and 300 mg of cholesterol. Physical activity can raise good cholesterol levels while reducing bad cholesterol. The NIH declares TLC as the first line of therapy and a "turbo-charge" for lowering cholesterol levels.
  
  
• A short assessment, validated by on-going research, will be used to evaluate a persons' 10-year heart attack risk. This assessment is based on factors such as age, gender, weight, blood pressure, cholesterol and tobacco use.
  

What the new guidelines mean for you.
High cholesterol is a common condition, but the good news is that it can be prevented or controlled. If you are over the age of 20 and have never had your cholesterol checked, or can't remember the last time you did, make an appointment with your health care provider. The new guidelines also mean that you may not have been considered to have high cholesterol before, but now you may be in that risk group. It is estimated that the number of people on dietary (TLC) treatment will increase by 13 million and those on drug treatment will increase by 23 million. Talk with a health professional about the best way for you to manage your cholesterol level to decrease your risk for heart attack. Remember that high cholesterol is not the only risk factor for heart disease. Get regular check-ups from your health care provider that include blood pressure and cholesterol screenings. A low-fat, high fiber diet and regular exercise will also decrease your risk for high cholesterol and heart attacks, along with many other diseases.

For more information on heart health contact the Eastern Missouri office of the American Heart Association at (314) 367-8605.

National Institutes of Health News Release: http://www.nhlbi.nih.gov/guidelines/cholesterol/index.htm