Christine Lee / Lee / D. Optimal Life: The Essentials of High Cholesterol

1. Auflage 2015
ISBN: 978-0-9861558-2-6
Verlag: Optimal Life
Format: EPUB
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, 155 Seiten

High cholesterol can lead to very serious complications, so it's important to get this condition under control so you can be your healthiest. The Essentials of High Cholesterol will help you understand high cholesterol, and give you a step-by-step guide to bring it under control.

Autoren/Hrsg.

Christine Lee, Pharm. D. , BCPS

Lee, Christine

D., Pharm.

BCPS,

Leseproben

~ CHAPTER TWO ~ Diagnosing High Cholesterol THE ONLY WAY TO KNOW if you have high cholesterol or if you’re at risk of heart disease is to have a blood test. The typical cholesterol test measures three components in your cholesterol and will give you an overall result called total cholesterol. Screening To diagnose high cholesterol, your health care provider will request a cholesterol blood test, often called a lipid panel. The cholesterol blood test provides these results: 1.    Total cholesterol (TC) 2.    Low-density lipoprotein cholesterol (LDL) 3.    High-density lipoprotein cholesterol (HDL) 4.    Triglycerides (TG)   To make sure you get the most accurate results, you must fast (nothing to eat or drink except water) for at least 9 to 12 hours before your blood test. This is because LDL and triglyceride levels are affected by the food you eat. Fasting before your test minimizes the impact of any food you’ve eaten on your test results. All of the components of the test are important, but your LDL reading is particularly important in assessing your risk for heart disease and stroke, and will determine if you need to go on medications. What Doctors Look For LDL is known as the “bad” cholesterol because it brings cholesterol into the bloodstream where it can be deposited along artery walls. HDL is considered the “good” cholesterol because it takes cholesterol out of the bloodstream. The way to remember this is the H in HDL is for “high grades” (you’d like to have many high grades), and the L in LDL is for “low grades” (you don’t want low grades). Triglycerides (TG) are fats that come from food. Total cholesterol (TC) is a summary of all three components, and is arrived at using this equation: TC = HDL + LDL + TG ÷ 5. Health care providers also look at the ratio of total cholesterol, which is calculated by dividing total cholesterol by HDL (TC ÷ HDL). The higher the ratio, the greater your risk of a heart event. This makes sense because the higher your HDL number, the lower the ratio. From studies, it appears that a ratio of 5 or greater is the threshold at which the risk of a heart event increases. An easy rationale behind the TC ÷ HDL ratio is that the HDL cholesterol carries cholesterol out of your bloodstream, decreasing the opportunity for fatty cholesterol to become deposited in your arteries. When you have high LDL cholesterol, more of it needs to be cleared by your HDL cholesterol. If your HDL is low, less LDL will be cleared from your blood, increasing the possibility of progression to atherosclerosis. Another reason to evaluate your cholesterol ratio is that total cholesterol and HDL cholesterol are not affected by food, but LDL cholesterol and triglycerides are. Digging Deeper Is Good Additional cholesterol testing might be advisable for people who have a family history of heart disease or stroke, or who simply want to dig deeper into predicting whether their high cholesterol may cause disease. Here are some other tests doctors use to assess heart disease and stroke.   Coronary calcium score (CCS) identifies people who have no symptoms but who are at medium risk for heart disease. Medium risk means you have a 10% to 20% chance of having a heart attack in the next ten years, based on your risk factors. A CCS may also be helpful when atherosclerosis is present and you are at increased risk for heart disease and stroke. Doctors use a CT scan to determine your CCS. A CT scan is an imaging method that takes X-ray images of the heart in thin sections and looks for calcium deposits in the arteries that supply the heart. A CT scan can detect the presence, location, and quantity of plaque in the arteries. Calcified plaque results from a buildup of fat and other substances in the arteries. It indicates the presence of atherosclerosis. The calcium scores are grouped into four categories: 1.    Less than 10: no risk of atherosclerosis disease 2.    11 to 99: mild atherosclerosis disease 3.    100 to 400: moderate atherosclerosis disease 4.    Greater than 400: severe atherosclerosis disease   Carotid intima media thickness (CIMT) is an ultrasound that can visualize the arterial walls of the carotid arteries located on each side of your neck. This monitors the early stages of the atherosclerosis. This is an easy, noninvasive test for measuring potential heart disease in people with cardiovascular risk factors. It also measures the progression of atherosclerosis, as this is an additional risk factor for heart disease.   Albumin in the urine is a simple urine test that looks for a protein called albumin. Please note that the key word here is albumin, not protein. The presence of albumin indicates that the lining of the renal (kidney) arteries is damaged. However, if there is damage to the renal arteries, it’s likely there is also damage to the heart arteries or other arteries. When the lining of an artery is damaged, it sets up conditions that promote atherosclerosis. If this stress is not relieved, the chance of cholesterol deposits forming in the artery lining causing atherosclerosis is greatly increased. The National Guidelines suggest that a result greater than 30 mg/g increases the risk of heart conditions. Other studies indicate an increased risk occurs at greater than 7.5 mg/g in women and greater than 4.0 mg/g in men. Your health care provider may use either of these standards.   LPa test: Lipoprotein(a) (LPa) has been identified as a risk factor for cardiovascular disease and stroke. LPa transports bad LDL cholesterol through the blood and may directly contribute to cholesterol and plaque deposits in arteries. Also, high levels of LPa increase the chance of blood clots by decreasing the body’s normal clot-breaking mechanism, which can cause heart attack and stroke. There are four tiers of results for the LPa test: 1.   Desirable: less than 14 mg/dL 2.   Borderline risk: 14 to 30 mg/dL 3.   High risk: 31 to 50 mg/dL 4.   Very high risk: greater than 50 mg/dL
Your health care provider might order the LPa test if you •    already have premature cardiovascular disease; •    have high cholesterol levels; •    have a family history of premature cardiovascular disease or high LPa levels; •    have recurrent cardiovascular disease despite treatment with a statin medication; or •    have cardiovascular disease but normal levels of cholesterol, specifically LDL. Other Tests ApoE genotype, zoften called the lifestyle test because it indicates how the body responds to alcohol, exercise, a low-fat diet, and fish oil. In some people, alcohol is not beneficial and may increase the risk of heart disease.   KIF6 genotype test tells you if you will benefit from a statin drug that lowers LDL cholesterol. If you are positive for the KIF6 carrier, any statin is good. If you are negative for KIF6, a specific statin, such as simvastatin or rosuvastatin, is better.   9p21 genotype test is called the heart attack test because, if positive, it increases the risk of atherosclerosis and aneurysm. Therefore, your health care provider would treat you more aggressively.   myPerioID® test looks for disease in your mouth and gums (periodontal disease). If this is positive in men younger than 50 years of age, they have a 72% increased risk of heart disease. There is a 25% increased risk of heart disease for the population if there is mouth and gum disease.   ABO blood type: O blood type has the lowest risk of cardiovascular disease. AB blood type has the highest risk. A and B blood types fall somewhere in between.   Factor V Leiden, if positive, increases your risk for clotting. This is very important for women who want to use birth control pills or are already on oral contraceptives because this medication increases estrogen, which increases the risk of clotting.   CYP2C19 *2*3 test shows that a drug called Plavix, which helps prevent clots, will not be very effective.   CYP2CA9*17* test shows if you metabolize Plavix faster than normal, making it less effective. Plavix is used when a patient cannot take aspirin or it is used with aspirin in certain heart conditions. The following laboratories...