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Prevention is the Best Medicine for Bad Cholesterol

By Jim Merritt, Newsday

Prevention is the Best Medicine for Bad Cholesterol

A vaccine currently being tested in Europe may one day provide the magic bullet to immunize adults against high cholesterol, according to one recent news report. But for now, a "heart-healthy" diet, lifestyle changes and prescription drugs are the best medicine for the estimated 71 million American adults with high cholesterol, according to medical experts.

Fewer than one in three Americans know they have high cholesterol, which has no symptoms, yet puts them at greater risk of heart disease, according to the federal Centers for Disease Control and Prevention (CDC).

Genetics Plays a Part

"Many people are genetically predisposed to high cholesterol," says Dr. Christine Fruth, an internist at Mather Primary Care at Port Jefferson. Fruth, who has a special interest in preventive care, considers many risk factors when treating patients with high cholesterol, including gender, age, other illnesses and family history. "We are always looking for examples of premature heart disease" in families, Fruth says.

Your body actually needs cholesterol – a waxy, fat-like substance produced by the liver – to make hormones. However, too much cholesterol from the food we eat can build up on blood vessel walls, causing blockages and leading to heart attacks and stroke.

Your doctor can assess your risk of future health problems with a blood test. "Kids should be tested once between ages 9and 11, then once between 18 and 21," Fruth says. Thereafter, adult men should be tested every five years beginning in their 20s, and women beginning in their mid-30s, Fruth says.

Your Cholesterol Score

The test provides a cholesterol "score," with numbers for high-density lipoproteins (so-called "good" cholesterol), low-density lipoproteins (bad cholesterol), and triglycerides. Fruth says patients should focus on lowering their bad cholesterol levels. Cholesterol can improve by getting regular exercise, maintaining a healthy weight, avoiding tobacco smoke, and eating a diet rich in fruits, vegetables and lean protein, according to the American Heart Association.

Fruth recommends a daily diet that includes a handful of almonds or walnuts, whole wheat bread, whole grain pastas and brown rice. She adds, "the Mediterranean diet is heart-healthy with its emphasis on olive oil and fish."

If medication is needed, a class of drugs known as statins can be prescribed. Patients' blood must be monitored twice a year for side effects such as elevated liver enzymes. Says Fruth: "The latest [treatment] is a new type of injectable medicine, for patients who have failed all of our usual statins."

A Risk Assessment App

To assess your 10-year-risk of developing heart disease, Fruth suggests using The American College of Cardiology Heart Risk Calculator, at You will need to enter your total cholesterol and HDL cholesterol numbers, which can be obtained from your doctor or other health professional.

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