Lipitor

Cholesterol is a lipid, a type of fat found in the body. Having high “bad” cholesterol means you have too much LDL in your blood. LDL is low-density lipoprotein, or “bad” cholesterol.

Too much cholesterol in the blood, or high cholesterol, can be serious. People with high cholesterol are at risk of getting heart disease. This can lead to a heart attack or stroke.

Only about 20% of cholesterol comes from the foods you eat. The other 80% is made by your body. Things such as age and family health history affect how much cholesterol your body makes.

Cholesterol levels tend to rise as you get older. Unfortunately, there are usually no signs that you have high cholesterol. But it can be detected with a blood test. These tests can also help your doctor predict what your risk for heart disease may be.

Total Cholesterol

Your blood test report will show your cholesterol levels in milligrams per deciliter of blood (mg/dL). The total number is based on:

* LDL (”bad” cholesterol)
* HDL (”good” cholesterol)
* Triglyceride (a type of fat found in your blood) levels

Total Cholesterol Levels / What It Means

Less than 200 mg/dL / Desirable
200-239 mg/dL / Borderline high risk for heart disease
240 mg/dL and above / High risk for heart disease

The 2 Types of Cholesterol: LDL and HDL

Bad cholesterol: Low-density lipoprotein (LDL)

Too much LDL in your blood can clog arteries. This can increase the risk of heart attack and stroke.

Good cholesterol: High-density lipoprotein (HDL)

High levels of HDL can help protect you from a heart attack or stroke. HDL carries cholesterol from the body’s tissues to the liver. So, low levels of HDL can increase the risk of heart disease.

If you’re worried about high cholesterol and heart disease, make an appointment to speak with your doctor. LIPITOR is clinically proven to lower bad cholesterol 39-60%, when diet and exercise are not enough (average effect depending on dose).

LIPITOR is a prescription drug. It is used in patients with multiple risk factors for heart disease such as family history, high blood pressure, age, low HDL (”good” cholesterol) or smoking to reduce the risk of heart attack and stroke. When diet and exercise alone are not enough, LIPITOR is used along with a low-fat diet and exercise to lower cholesterol.

LIPITOR is also used in patients with type 2 diabetes and at least one other risk factor for heart disease such as high blood pressure, smoking or complications of diabetes, including eye disease and protein in urine, to reduce the risk of heart attack and stroke.

LIPITOR is not for everyone. It is not for those with liver problems. And it is not for women who are nursing, pregnant or may become pregnant.

If you take LIPITOR, tell your doctor if you feel any new muscle pain or weakness. This could be a sign of rare but serious muscle side effects. Tell your doctor about all medications you take. This may help avoid serious drug interactions. Your doctor should do blood tests to check your liver function before and during treatment and may adjust your dose. The most common side effects are gas, constipation, stomach pain and heartburn. They tend to be mild and often go away.

When diet and exercise alone are not enough, adding LIPITOR can help. LIPITOR is one of many cholesterol-lowering treatment options that you and your doctor can consider.

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Drugs that are commonly used to lower cholesterol can block the proliferation and promote the destruction of esophageal cancer cells in the laboratory, according to a report in the American Journal of Gastroenterology by UK researchers.

The esophagus is the tube that carries food, liquids and saliva from the mouth to the stomach - and adenocarcinoma is the most common type of cancer in this organ.

Statins, a type of popular cholesterol-lowering agents, which include drugs such as Lipitor, achieve this effect by inhibiting the signaling pathways that lead to the formation of the cancer cells, co-authors Dr. Olorunseun O. Ogunwobi, from Norfolk and Norwich University Hospital, and Dr. Ian L. P. Beales, from the University of East Anglia in Norwich, note.

A rapid rise in the number of esophageal cancers and deaths has been seen worldwide, leading many researchers to look for drugs that can prevent this cancer from occurring, report indicates.

Prior research has shown that statins, which have a good safety record, can reduce the availability of various biosynthetic intermediate molecules that are critical for cancer cell signaling. Whether this might translate into a beneficial anti-cancer effect, however, was unclear.

Using laboratory cultures of esophageal cancer cells, the researchers found that adding simvastatin, lovastatin, and pravastatin reduced the number of esophageal cancer cells and inhibited their growth. The higher the dose of the statin, the greater was the destruction of the cancer cells.

“As yet, it is not possible to extrapolate from our laboratory studies to clinical scenarios, but the current data do suggest that any effects of statins taken by patients with esophageal cancer and Barrett’s esophagus are possibly beneficial,” the investigators note.

Further examination of statins or other agents that inhibit the same signaling pathways that lead to the formation of esophageal cancer cells — in experimental models or in clinical trials with patients — should continue so researchers can “better define whether this class of drugs has a definite role in prevention or treatment of esophageal cancer,” the authors conclude.

SOURCE: American Journal of Gastroenterology, April 2008.

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Chocolate is the most widely craved food in the world. But, who says that it’s fattening? A new study has revealed that it lowers cholesterol levels. Researchers in the United States have found that eating two chocolate bars daily not only cuts down cholesterol levels but also controls high blood pressure, the ‘Journal of Nutrition’ reported in its latest edition.

“Eating two dark chocolate bars a day not only lowers cholesterol, it has the unexpected effect of lowering systolic blood pressure,” according to lead researcher Prof John Erdman of the University of Illinois.

For the study, they recruited 49 people with slightly elevated cholesterol and normal blood pressure. Subsequently, the participants were divided into two matched groups who were given CocoaVia two types of chocolate bars — one with plant sterols and one without.

The participants ate one CocoaVia formulation twice daily for four weeks, then switched to the other bar for an additional four weeks. Cholesterol levels, blood pressure, body weight, and other cardiovascular measures were tracked throughout the eight-week study.

“We saw a marked differential effect on blood cholesterol, with the sterol-containing products doing better than those without sterols,” co-researcher Ellen Evans was quoted by the journal as saying. The researchers attributed the drop in cholesterol levels to the plant sterols that are added to chocolate bars and drop in blood pressure due to the substantial presence of flavanols.

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Doctors and dieticians stresses on following a special diet chart to the people suffering from cholesterol problem. And if the disease is low-density lipoprotein or LDL, that is, the worst form of cholesterol, the person has to take extra care of his health and diet. A proper diet to lower LDL cholesterol must include food that contain lots of soluble fibre, polyunsaturated fatty acids, Omega-3 fatty acids, sterols or stanols, and soy protein.

The soluble fibre mentioned in a proper diet to lower LDL cholesterol is found in high percentage in oatmeal and oat bran. Foods like kidney beans, Brussels sprouts, pears, apples, barley, psyllium and prunes are also very rich in soluble fibres. These foods reduce the absorption of intestinal cholesterol by helping the body to excrete the dietary cholesterol and excess bile.

A proper diet to lower LDL cholesterol must have five to ten grams of fibre per day to lower the cholesterol by five percent. A person suffering from high cholesterol must consume one-and-a-half cups of cooked oatmeal that contains 4.5 grams of soluble fibre. Besides fibre, polyunsaturated fatty acids help to reduce blood cholesterol. These fatty acids, mostly found in walnuts and almonds, keep the blood vessels healthy, well oxygenated and elastic.

A proper diet to lower LDL cholesterol must include one-third cup of walnuts or almonds every day. This counts to about 240 calories or 20 per cent of the total calorie intake in a day. If consumed at a regular basis, these nuts help to lower cholesterol within one month.

In a proper diet to lower LDL cholesterol, it is very important to have omega-3 fatty acids that are mostly found in fish, and whale and seal meat. Apart from these sources, the other omga-3 fatty acids enriched vegetarian edibles are flaxseed, canola oil, walnuts and Soya bean oil. However this element is best found in fishes and fish oil. The highest carriers of these fatty acids are salmon, sardines, albacore tuna, mackerel, and lake trout.

A proper diet to lower LDL cholesterol must include baked or grilled fish that reduces blood clotting and blood pressure due to their ability to reduce triglyceride. Fat, especially trans and saturated ones are a big no-no for a cholesterol patient. Beside a controlled and healthy diet, regular exercises are also important. In case the cholesterol level shoots up, one must take proper medication.

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Question: I’m 58, split firewood with a mallet, ride a bike, walk, and carry my bag while playing golf. I take the cholesterol-lowering drug Lipitor along with vitamin E, vitamin C, beta-carotene and an aspirin every day. The problem is that my good cholesterol (HDL) is low and my bad cholesterol (LDL) is high. Should I:

1. Keep taking Lipitor and forget vitamin E?
2. Forget Lipitor and take vitamin E?
3. Take Lipitor and forget all the others?
4. Increase the amount of chocolate I eat and feel happy?

Answer: I like your humorous outlook (and active lifestyle), but go a little easy on the chocolate portion of option number 4. As for your multiple choice quiz, I’d add the following option and check it: 5. None of the above (explanation follows).

Your main concern seems to be whether your vitamin E supplement might interfere with the effect of Lipitor. I’ve received similar questions since the media reported that vitamin E might impair the expected ability of cholesterol-controlling drugs to raise levels of HDL cholesterol (the good kind). Actually, the clinical study in question implicated a group of antioxidants, which included vitamin E. The effect was modest, and there was no way to single out the role of vitamin E.

Vitamin E supplements show promise in Alzheimer’s disease, cancer, arthritis and a number of other conditions, so it seems unwarranted to give up your vitamin E unless your physician advises otherwise.

One thing I might question is your use of beta-carotene supplementation, which research suggests may actually increase the risk of heart disease (in smokers) and lung cancer (in smokers and asbestos workers). Since beta-carotene needs are easily met by eating fruits and vegetables, it seems best to get it this way. The nutritional doses present in typical multivitamin supplements should be safe.

A diet low in saturated fats and cholesterol will lower LDL cholesterol (the bad kind). Adding soluble fiber (e.g., barley oats, soy, psyllium) and plant stanol/sterol-containing margarines (e.g., Benecol, Take Control) enhances this effect.

Typically, you should keep your LDL cholesterol below 130 if you’re at moderate risk for cardiovascular complications, or below 100 if you already have heart disease or diabetes. If dietary changes aren’t enough, your physician may adjust the dose of your Lipitor or add a second cholesterol-lowering agent.

You want as much HDL cholesterol as possible because it helps the body round up and remove rampant cholesterol.

The first step in boosting HDL cholesterol levels is to increase physical activity and lose weight (if overweight).

A number of other factors can push down HDL cholesterol, including high triglycerides, smoking, very high carbohydrate intake (this also raises triglycerides), drugs (e.g., anabolic steroids, beta-blockers, progestins, loop diuretics, phenothiazines) and medical conditions (e.g., hyperthyroidism, diabetes, high blood pressure, cholestasis, nephrotic syndrome, chronic renal failure).

Lipitor has only a modest effect on HDL cholesterol, so if your levels stubbornly remain low (below 40), your physician might consider adding a drug that increases HDL cholesterol, such as niacin or a fibrate (e.g., gemfibrozil, fenofibrate).

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Pfizer Inc announced today that Lipitor® (atorvastatin calcium) 80 mg reduced the risk of heart attack and stroke by 32 percent in patients who have heart disease and chronic kidney disease compared with patients taking the 10 mg dose of Lipitor. This analysis, designed and completed following the closure of the five-year Treating to New Targets (TNT) study, was published in the “Journal of the American College of Cardiology.”

“People with chronic kidney disease are more likely to die from heart disease than to develop kidney failure,” said Dr. James Shepherd, a member of the TNT steering committee and clinical academic consultant, department of pathological biochemistry, University of Glasgow Medical School. “It is critical for us to find new ways to reduce cardiovascular burden in these patients. Intensive statin therapy seems to be at least part of the solution.”

The primary endpoint of the TNT study was the reduction of major cardiovascular events, including death from heart disease, non-fatal heart attacks, resuscitated cardiac arrest, and fatal or non-fatal strokes. This sub-analysis studied 3,107 patients with moderate to severe chronic kidney disease, as defined using a standard measure of kidney function. The efficacy results in this analysis were primarily driven by reductions in heart attack and stroke. Both doses of Lipitor (80 mg and 10 mg) were well tolerated. Lipitor 80 mg is not a starting dose. The safety of Lipitor 80 mg in patients with chronic kidney disease was similar to that reported for the overall TNT population, with no unexpected safety concerns identified.

“The results of this analysis complement the large body of evidence from multiple clinical trials demonstrating the cardiovascular benefits of Lipitor,” said Halit Bander, Ph.D. senior director of Pfizer’s global cardiovascular metabolic medical team.

About Chronic Kidney Disease

An estimated 26 million Americans and 50 million people worldwide have chronic kidney disease, or permanent kidney damage due to injury or disease. Patients with chronic kidney disease do not effectively filter toxins from the blood. When chronic kidney disease progresses to kidney failure, either dialysis or a kidney transplant is needed. Chronic kidney disease recently has been recognized as an important risk factor for cardiovascular disease, the leading cause of death and illness in patients with kidney disease.

About the TNT Study

The TNT study was a landmark investigator-led trial coordinated by an independent steering committee and funded by Pfizer. It was the largest study to date evaluating the efficacy and safety of Lipitor 80 mg. The study enrolled 10,001 men and women with coronary heart disease aged 35 years to 75 years in 14 countries and followed them for an average of five years. The safety of Lipitor 80 mg in patients with chronic kidney disease was similar to that reported for the overall TNT population, with no unexpected safety concerns identified.

About Lipitor

Lipitor is the only statin proven to provide a combination of impressive average LDL (“bad” cholesterol) lowering of 39 percent to 60 percent, significant and proven cardiovascular event reductions, and a well-established safety profile across a broad range of patients.

It is the most prescribed cholesterol-lowering therapy in the world, with nearly 151 million patient-years of experience. Lipitor is supported by an extensive clinical trial program involving more than 400 ongoing and completed trials with more than 80,000 patients.

Important U.S. Prescribing Information

Lipitor is a prescription medication. It is used in patients with multiple risk factors for heart disease such as family history, high blood pressure, age, low HDL (“good” cholesterol) or smoking to reduce the risk of a heart attack, stroke, certain types of heart surgery and chest pain.

Lipitor is also used in patients with type 2 diabetes and at least one other risk factor for heart disease such as high blood pressure, smoking or complications of diabetes, including eye disease and protein in urine, to reduce the risk of heart attack and stroke.

Lipitor is used in patients with existing coronary heart disease to reduce the risk of heart attack, stroke, certain kinds of heart surgery, hospitalization for heart failure, and chest pain.

When diet and exercise alone are not enough, Lipitor is used along with a low-fat diet and exercise to lower cholesterol.

Lipitor is not for everyone. It is not for those with liver problems. And it is not for women who are nursing, pregnant or may become pregnant.

Patients taking Lipitor should tell their doctors if they feel any new muscle pain or weakness. This could be a sign of rare but serious muscle side effects. Patients should tell their doctors about all medications they take. This may help avoid serious drug interactions. Doctors should do blood tests to check liver function before and during treatment and may adjust the dose. The most common side effects are gas, constipation, stomach pain and heartburn. They tend to be mild and often go away.

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Lipitor is a statin, not a beta-blocker.

Pfizer announced today that Lipitor (atorvastatin calcium) 80 mg showed unexpectedly potent reduction in myocardial ischemia (a condition defined by insufficient blood supply and oxygen to the heart) in patients with chronic stable angina (chest pain). These results were presented today at the annual meeting of the American College of Cardiology.

Lipitor significantly reduced the average number of ischemic events by nearly 70 percent and total duration of events by more than 60 percent from baseline to week 18 of the study, and sustained these effects until the end of the trial at week 26. In 60 percent of the patients treated with Lipitor, all ischemic events were completely eliminated by the end of the study. This resulted in a substantial decrease in angina attacks and need for nitroglycerin treatment.

“Ischemia is a serious condition in which the collective effect of minor untreated events can lead to a weakening of the heart muscle and the death of heart cells,” said Professor John Deanfield, British Heart Foundation Vandervell Chair of Congenital Heart Disease, professor of cardiology at University College London and lead investigator of the Double-Blind Atorvastatin Amlodipine (DUAAL) study. “These findings were a pleasant surprise because statins are not part of the current standard of care for the treatment of angina.”

About the DUAAL Study

The DUAAL study was a randomized, double-blind, multi-country study comparing Lipitor (n=103), Norvasc([R]) (amlodipine besylate) (n=104) and a combination of the two (n=104) in patients with coronary artery disease and chronic stable angina. Patients received intensive usual care therapy for their coronary artery disease including beta- blockers, long acting nitrates and aspirin.

Lipitor also caused a significant reduction in C-reactive protein, a marker of inflammation that helps in identifying and stratifying individuals at risk for cardiovascular disease. The anti-ischemic results demonstrated by Lipitor alone were remarkably similar to those in patients taking Norvasc alone. Norvasc, a high blood pressure and anti-angina medication in the calcium channel blocker class, is a part of the standard of care for this patient population, so it was expected to have benefit on the patients studied. Norvasc also significantly reduced the average number of ischemic events by approximately 70 percent and total duration of events by more than 60 percent. This was mirrored by a substantial decrease in angina attacks and need for nitroglycerin treatment.

The combination of Lipitor and Norvasc also offered a significant reduction in ischemic events, but there was not an incremental benefit with the combination versus either Lipitor or Norvasc alone. Given the patient characteristics in this study along with the magnitude of ischemic benefits demonstrated by Lipitor and Norvasc individually, no additional benefits were demonstrated in the combination arm. The number of angina attacks and the need for nitroglycerin use was reduced to a similar degree as the ischemic events.

“Previous studies have suggested an anti-ischemic effect with Lipitor, but the magnitude of the benefit seen in this study is notable,” said Dr. Rochelle Chaiken, vice president of Pfizer global medical. “This study complements the cardiovascular benefits of Lipitor in a broad range of patients as demonstrated in more than 10 completed cardiovascular outcomes trials involving Lipitor.”

About Ischemia and Angina

Symptomatic myocardial ischemia is characterized by angina and affects more than 9 million Americans. People with any cardiovascular risk factor are at risk for developing ischemia.

Standard of care for the treatment of symptomatic ischemia typically focuses on reducing the heart’s need for oxygen or improving the supply of oxygen to the heart. This may include taking medications that slow the heart rate, reduce blood pressure and relax the blood vessels. Medication classes for ischemia include beta blockers, calcium channel blockers and nitrates.

About Lipitor

Lipitor is the only statin proven to provide a combination of impressive average LDL (”bad” cholesterol) lowering of 39 percent to 60 percent, significant and proven cardiovascular event reductions, and a well-established safety profile across a broad range of patients.

It is the most prescribed cholesterol-lowering therapy in the world, with nearly 144 million patient-years of experience. Lipitor is supported by an extensive clinical trial program involving more than 400 ongoing and completed trials with more than 80,000 patients.

Important U.S. Prescribing Information

Lipitor is a prescription medication. It is used in patients with multiple risk factors for heart disease such as family history, high blood pressure, age, low HDL (”good” cholesterol) or smoking to reduce the risk of a heart attack, stroke, certain types of heart surgery and chest pain.

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LIPITOR is indicated as an adjunct to diet for reduction of elevated total-cholesterol, LDL-cholesterol, apolipoprotein-B, and triglyceride levels in patients with primary hypercholesterolaemia; mixed dyslipidaemia; and heterozygous familial hypercholesterolaemia.

LIPITOR is also indicated to reduce total-C and LDL-C in patients with homozygous familial hypercholesterolaemia as an adjunct to other lipid-lowering treatments (e.g. LDL apheresis) or if such treatments are unavailable.

Therapy with lipid-lowering agents should be a component of multiple-risk-factor intervention in individuals at increased risk of atherosclerotic vascular disease due to hypercholesterolaemia. Lipid-altering agents should be used in addition to a diet restricted in saturated fat and cholesterol only when the response to diet and other non-pharmacological measures has been inadequate.

Prior to initiating therapy with LIPITOR, secondary causes for hypercholesterolaemia (e.g. poorly controlled diabetes mellitus, hypothyroidism, nephrotic syndrome, dysproteinaemias, obstructive liver disease, other drug therapy, and alcoholism) should be excluded, and a lipid profile performed to measure total-C, LDL-C, HDL-C, and TG.

Are there other drugs for lowering cholesterol?

Yes, the most common are the other statins besides atorvastatin. Statins are also referred to as HMG CoA reductase inhibitors and include: simvastatin, rosuvastatin, atorvastatin (Lipitor), fluvastatin, lovastatin, and pravastatin, all of which are sold under their respective brandnames. There are also generic versions of the following statins available: simvastatin, pravastatin and lovastatin.

Another class of drugs that lower cholesterol is the bile acid sequestrants which include: colesevelam, cholestyramine, colestipol, and nicotinic acid (niacin).

Other cholesterol lowering drugs include gemfibrozil, and two drugs discontinued in the US, probucol and clofibrate (Atromid-S).

Rhabdomyolysis with or without renal impairment has been reported with the use of HMG-CoA reductase inhibitors.

Myalgia has been reported in patients treated with LIPITOR. Myopathy, defined as muscle aching or muscle weakness in conjunction with increases in creatine phosphokinase (CPK) values greater than 10 times the upper limit of normal, should be considered in any patient with diffuse myalgias, muscle tenderness or weakness, and/or marked elevation of CPK. Patients should be advised to report promptly any unexplained muscle pain, tenderness or weakness, particularly if accompanied by malaise or fever. LIPITOR therapy should be discontinued if markedly elevated CPK levels occur or myopathy is diagnosed or suspected.

As with other HMG-CoA reductase inhibitors, the risk of myopathy during treatment with LIPITOR is increased with concurrent administration of immunosuppressive drugs, including cyclosporine, fibric acid derivatives, nicotinic acid, azole antifungals or erythromycin.

LIPITOR therapy should be withdrawn in any patient with an acute, serious condition suggestive of a myopathy or having a risk factor predisposing to the development of renal failure secondary to rhabdomyolysis, (eg, severe acute infection, hypotension, major surgery, trauma, severe metabolic, endocrine and electrolyte disorders, and uncontrolled seizures).

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High cholesterol affects about 17% of Americans ages 20 and older, contributing to atherosclerotic heart disease, which is the single leading cause of death and disability in the developed world. This medical dictionary covers the terms used in the report, What to do about High Cholesterol, and includes details on how to lower and watch your cholesterol through tests and diets.

* antioxidant: A substance that inhibits oxidation.

* apolipoproteins: Proteins that combine with cholesterol and triglyceride to form lipoproteins.

* atherosclerosis: Development of cholesterol-rich plaque on the inner walls of arteries, which can eventually obstruct blood flow.

* atherosclerotic plaque: A cholesterol-rich deposit on an artery wall.

* biological variability: Fluctuations that occur naturally over time in the levels of a substance such as cholesterol in a person’s body.

* cholesterol: A fatlike substance that is produced by the liver and found in all food from animal sources; an essential component of body cells and a precursor of bile acids and certain hormones.

* chylomicron: A large, extremely low-density lipoprotein that transports triglyceride from the intestine to fat tissue in the body.

* combined hyperlipidemia: A condition in which LDL and triglyceride levels are very high.

* familial combined hyperlipidemia: An inherited disorder in which the liver overproduces VLDL, causing high levels of cholesterol or triglycerides, or both.

* familial hypercholesterolemia: An inherited disorder in which the liver cannot properly remove LDL particles from the blood, causing a very high cholesterol level.

* fasting lipid profile: A laboratory test to determine the relative levels of HDL, LDL, and total cholesterol in the blood. Also referred to as a lipoprotein analysis, full lipid profile, or cholesterol profile.

* fatty acids: The primary building blocks of lipids.

* foam cells: Lipid-laden cells, named for their foamy appearance under the microscope, which contribute to the formation of atherosclerotic plaque.

* high-density lipoprotein (HDL): A lipoprotein that protects the arteries by transporting cholesterol from body cells to the liver for elimination.

* hydrogenation: The addition of hydrogen to a compound, particularly to solidify unsaturated oils.

* lipids: Fats, oils, and waxes that serve as building blocks for cells or as energy sources for the body.

* lipoproteins: Protein-covered fat particles that enable cholesterol to move easily through the blood.

* low-density lipoprotein (LDL): A lipoprotein that transports cholesterol from the liver to the rest of the body, which can cause the buildup of plaque in the arteries.

* monounsaturated fats: Fatty acids; abundant in olive, peanut, sesame, and canola oils.

* oxidation: A process in which oxygen combines with a substance, altering its structure and changing or destroying its normal function.

* platelets: Minute, colorless disks in the blood that are instrumental in clotting.

* polyunsaturated fats: Fatty acids that are abundant in soybean, corn, cottonseed, safflower, and sunflower oils.

* saturated fats: Fatty acids that are abundant in red meat, lard, butter, cheese, and some vegetable oils, in which each molecule carries the maximum number of hydrogen atoms.

* trans fats: Fatty acids (such as those found in solid margarine) that have been reshaped by hydrogenation; also called trans fatty acids.

* triglyceride: The primary type of fat in the body and in the diet, formed from three fatty-acid molecules and one glycerol molecule.

* unsaturated fats: Fatty acids in which some of the hydrogen atoms in each molecule have been replaced by double bonds; includes monounsaturated and polyunsaturated fats.

* very-low-density lipoprotein (VLDL): A lipoprotein that transports triglyceride manufactured in the liver to fat tissue in the body; eventually becomes low-density lipoprotein (LDL) after the triglyceride has been removed.

In foods, cholesterol is found in eggs, dairy products, meat, and poultry. Egg yolks and organ meats (liver, kidney, sweetbread, and brain) are high in cholesterol. Fish generally contains less cholesterol than other meats, but some shellfish are high in cholesterol.

Foods of plant origin (vegetables, fruits, grains, cereals, nuts, and seeds) contain no cholesterol.

Fat content is not a good measure of cholesterol content. For example, liver and other organ meats are low in fat, but very high in cholesterol.

Therapeutic Lifestyle Changes (TLC) is a set of things you can do to help lower your LDL cholesterol. The main parts of TLC are:

* The TLC Diet. This is a low-saturated-fat, low-cholesterol eating plan that calls for less than 7% of calories from saturated fat and less than 200 mg of dietary cholesterol per day. The TLC diet recommends only enough calories to maintain a desirable weight and avoid weight gain. If your LDL is not lowered enough by reducing your saturated fat and cholesterol intakes, the amount of soluble fiber in your diet can be increased. Certain food products that contain plant stanols or plant sterols (for example, cholesterol-lowering margarines) can also be added to the TLC diet to boost its LDL-lowering power.
* Weight Management. Losing weight if you are overweight can help lower LDL and is especially important for those with a cluster of risk factors that includes high triglyceride and/or low HDL levels and being overweight with a large waist measurement (more than 40 inches for men and more than 35 inches for women).
* Physical Activity. Regular physical activity (30 minutes on most, if not all, days) is recommended for everyone. It can help raise HDL and lower LDL and is especially important for those with high triglyceride and/or low HDL levels who are overweight with a large waist measurement.

Foods low in saturated fat include fat-free or 1percent dairy products, lean meats, fish, skinless poultry, whole grain foods, and fruits and vegetables. Look for soft margarines (liquid or tub varieties) that are low in saturated fat and contain little or no trans fat (another type of dietary fat that can raise your cholesterol level). Limit foods high in cholesterol such as liver and other organ meats, egg yolks, and full-fat dairy products.

Good sources of soluble fiber include oats, certain fruits (such as oranges and pears) and vegetables (such as brussels sprouts and carrots), and dried peas and beans.

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There’s more to managing cholesterol than just lowering your LDL. According to the American Heart Association, an estimated 80 million American adults have high LDL (bad) cholesterol, and more than 44 million Americans, or one in six, have low levels of HDL, the good cholesterol the body uses like a broom to sweep the bad cholesterol from the blood.

“Managing cholesterol involves many things, not just lowering LDL,” according to Dr. Christie Ballantyne of the Methodist DeBakey Heart and Vascular Center. “There is a serious need for medicines that both raise good cholesterol and lower the bad components of cholesterol.”

The Food and Drug Administration recently approved Abbott’s SIMCOR, a combination of two widely prescribed cholesterol therapies – Niaspan (Abbott’s proprietary niacin extended-release) and simvastatin – in a single pill. When used along with diet, SIMCOR treats bad cholesterol (LDL) and good cholesterol (HDL) when treatment with Niaspan or simvastatin monotherapies is considered inadequate.

“SIMCOR represents a new option to help patients reach their treatment goals and target all their cholesterol levels,” says Ballantyne.

More than 105 million Americans have total blood cholesterol levels at or above 200 mg/dL, which is considered high. Statin therapy, which has primarily been used to lower bad cholesterol, is an important treatment option, but many patients might need additional lipid treatments to help them reach their goals. In order to manage all of your cholesterol levels, you need to learn your numbers first.

This is why it’s important to know all of your cholesterol levels and talk with your doctor about how to manage them. Start by getting your cholesterol checked today.

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