Article Medically Reviewed By:
David L. Katz, MD, MPH, FACPM, FACP
Associate Professor, adjunct, Public Health Yale University School of Medicine Director, Yale Prevention Research Center New Haven, CT
Overview
What Is It?
Cholesterol is found in cells or membranes throughout the body and is used to produce hormones, vitamin D and the bile acids that help digest fat. The body is able to meet all these needs by producing cholesterol in the liver.
High blood cholesterol is a major women's health issue. Nearly half of women over age 20 need to lower their blood cholesterol, and about 15 to 18 percent of American women have blood cholesterol levels high enough to pose a serious risk for coronary heart disease.
Overall, an estimated 98.6 million American adults have total blood cholesterol levels of 200 milligrams per deciliter (mg/dL) and higher, which is above desirable levels. Of these, 34.4 million have levels of 240 mg/dL or higher, which is considered high risk for heart disease. This is important because cholesterol levels are a contributing factor to heart disease, which develops over years.
But don't fool yourself into thinking that high blood cholesterol is a problem only for middle-aged or elderly men and women. High cholesterol is a problem for some children and teenagers, too. A recent study published in the journal Circulation found that more than one in 10 teenagers has high total cholesterol, which can lead to heart disease in adulthood.
Guidelines released by the National Cholesterol Education Program (NCEP), a division of the National Heart, Lung and Blood Institute (NHLBI), in May 2001 and in July 2004, substantially expanded the number of American women and men who need treatment for high cholesterol. The next update is due out in 2010.
Based on mounting evidence that deaths from heart disease could be cut with aggressive treatment of high cholesterol, the NCEP guidelines spotlight elevated low-density lipoprotein (LDL) or "bad" cholesterol. Elevated LDL cholesterol injures blood vessel walls and has been identified as a major cause of CHD.
NCEP recommendations include:
- More aggressive cholesterol lowering treatment and better identification of those at risk for a heart attack
- Use of a complete lipoprotein profile as the first test for high cholesterol
- A revised optimal level for LDL cholesterol for the population
- More aggressive treatment of high cholesterol for those with diabetes
- More intensive LDL cholesterol goals and treatment options for people at very high, high and moderately high risk for heart attack
- Intensified use of nutrition, physical activity and weight control to treat elevated cholesterol levels. Medication may also be recommended for individuals at moderate to high or very high risk of developing heart disease, based on their cholesterol ranges. This integrated approach, called the Therapeutic Lifestyle Changes (TLC) treatment plan, was introduced in the 2001 N...
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