The risk factors included in this check list are:
* age (men - more than 45, women - over 55 years or post-menopausal) * hypertension * diabetes * smoking * HDL below 35 mg./dl * family history of coronary artery disease in first degree relatives (male relatives below 55 years, female relatives below 65 years) * If HDL is above 60 mg./dl , subtract one from the number of positive risk factors
The American Heart Association is also promoting a Step 1 diet - comprising less than 30% fat intake, less than 10% saturated fat, less than 300 mg./day of cholesterol - and weight control with regular physical activity as important preventive measures against heart disease.
Goals of Cholesterol Control Programs
The primary goals of the primary prevention approach are:
LDL below 160 mg./dl, if 0-1 risk factors are present
OR
LDL below 130 mg./dl, if 2 or more risk factors are present
Secondary goals are
* HDL above 35 mg./dl * Triglycerides below 200 mg./dl
Reaching the goal
The American Heart Association has also recommended a program to achieve these end points slowly and steadily.
Atherosclerosis is the disease process that causes hardening and narrowing of arteries. One of the risk factors for atherosclerosis is a high blood level of cholesterol, a form of fat that becomes deposited on the artery wall forming a plaque.
Cholesterol is a rather complex subject. There are different kinds of this substance, classified based on density.
Low density lipoprotein (LDL) cholesterol
LDL is the most dangerous form, and is responsible for atherosclerotic plaque formation and growth. Intermediate density (IDL) and Very low density (VLDL) lipoproteins are also other harmful forms, and are made up of varying combinations of cholesterol and triglycerides.
High density lipoprotein (HDL)
HDL, on the other hand, is a beneficial form that actually carries cholesterol away from the plaque to the liver. A higher level of HDL cholesterol, therefore, protects you from atherosclerosis. That is why it is sometimes called "good" cholesterol.
Monitoring Serum Cholesterol
With the increasing awareness of the role that serum cholesterol levels play in causing heart disease, a routine enquiry into dietary habits has become a part of most medical physical examinations. The AHA recommends that
* total and HDL cholesterol levels be measured in all adults over 20 years of age * positive and negative risk factors for heart disease be evaluated at least every five years.