Lipitor

Cholesterol is mainly affected by hereditary factors, weight control, smoking and lack of exercise. And although cholesterol is not primarily affected by the foods we eat, in some cases dietary cholesterol does play a part. See our guide below on how to get a handle on your cholesterol by limiting certain foods and eating more of others.

A low-fat, low-cholesterol diet is desired to keep your total fat consumption–saturated, polyunsaturated and monounsaturated–to fewer than 30 percent of your daily intake of calories. Remember to keep your cholesterol intake to fewer than 300 milligrams per day. Saturated fats contained in butter, whole milk, hydrogenated oils, chocolate shortening, etc. should comprise no more than one third of your total fat consumption. To reduce your total fat and cholesterol intake, limit your consumption of meats such as beef, pork, liver and tongue (always trim away excess fat). In addition, avoid cheese, fried foods, nuts and cream, and try to curb your intake of eggs to no more than four per week. Try to eat meatless meals several times a week, use skim milk and include fish in your diet. Eat a wide variety of vegetables, pasta, grains and fruit. Another good tip is to look at the package label of the foods you buy, and restrict your choices to foods containing 3 grams of fat or less per serving.

There is evidence that water-soluble fibers can aid in lowering cholesterol; these foods include the fiber in oat or corn bran, beans and legumes, pectin found in apples and other fruits, and guar that is used as a thickener. Although highly touted by the media and health food stores, the phospholipid Lecithin has not been confirmed as a reducer of blood cholesterol levels.

If you are overweight, trying to lose weight and including aerobic exercise in your routine can help raise those desirable high density lipoproteins levels. Diet and exercise alone can decrease cholesterol levels by up to 15 percent.

Guidelines for lowering your high blood cholesterol with dietary therapies.
* Eat less than 30% of your total daily calories from fat.
* Eat less than 300 mg of cholesterol each day.
* Eat 50-60% of your daily calories from carbohydrates.
* Adjust your caloric intake to achieve or maintain a desirable weight.

Foods to limit:

* Fat. Cutting back on fried foods, puddings, biscuits, crisps, pies and chips can give you a double benefit: lower cholesterol and lower body weight. Instead, choose reduced fat products such as low-fat soured cream and cream cheese, fat-free yoghurt, skimmed milk and granola.
* Sweets or puddings labelled ‘low-fat’. A low-fat brownie is still a brownie, and it still has loads of calories and fat. These types of reduced-fat foods shouldn’t be part of your daily diet.
* Red meat. You don’t have to cut meat out of your diet, just reduce your portion sizes to about three ounces, or the size of your palm. More than that is over the top in calories, fat and cholesterol.
* Some dairy products. Watch out for your intake of foods high in cholesterol like cheese, sour cream and butter.
* Trans fatty acids.You won’t always find these trans fats listed on food labels, but they are mostly found in foods containing hydrogenated oils, meaning they start as liquid and are chemically changed to solids at room temperature. The hydrogenation process is used in making stick margarine and solid vegetable shortening, and hydrogenated fats are used in commercial baked goods such as puddings, biscuits and other snacks. Look for the word ‘hydrogenated’ on the label and try to limit these foods.

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Are you confused about cholesterol?

Wondering which numbers need to go up and which numbers need to go down? If so, you’re not alone. According to the American Heart Association, an estimated 80 million Americans have high levels of LDL “bad” cholesterol, over 44 million have low levels of HDL “good” cholesterol and over 28 million have high levels of triglycerides . Also, 42 million Americans suffer from a disorder called mixed dyslipidemia meaning their levels of triglycerides are high, LDL cholesterol is moderately high and HDL cholesterol is low.

Considering these staggering statistics, chances are you or a loved one may have unhealthy cholesterol levels.

“Despite treatment advances, heart disease is still the leading cause of death in this country,” says Jerome D. Cohen, M.D., of the National Lipid Association. “Because unhealthy cholesterol levels can lead to this devastating disease we need to do a better job educating people about risk factors and what they can do to minimize them.”

It is important to work with your doctor to set healthy goals and measure all cholesterol levels including LDL, HDL and triglycerides.

LDL, HDL and triglycerides are all independent risk factors for heart disease. The risk of developing heart disease doubles when triglyceride levels are above 200. When triglycerides are above 200 and HDL cholesterol is below 40, a person is at four times the risk.

To help lower your risk of heart disease, start by getting your cholesterol levels checked.

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Pick up just about any newspaper or magazine these days and you will probably find mention of cholesterol. Everyone seems to be concerned with lowering his or her cholesterol level, and most people would like to know how they can do this. It is first helpful to know how cholesterol is produced and used by the body.

Cholesterol is a crystalline substance that is technically classified as a steroid. However, becaue it is soluble in fats rather than in water, it is also classified as a lipid, as fats are. It is found naturally in the brain, nerves, liver, blood, and bile of both humans and vertebrate animals. This is why persons who wish to decrease their cholesterol levels are told to stay away from meat and other foods containing animal products or derived from animals.

Despite its current unsavory reputation, cholesterol is actually necessary for the proper functioning of the body. About 80 percent of total body cholesterol is manufactured in the liver, while 20 percent comes from dietary sources. It is used by cells to build membranes, and it is also used in sex hormones and in the digestive process. Cholesterol travels from the liver through the bloodstream to the various tissues of the body by means of a special class of protein molecules called lipoproteins. The cells take what they need, and any excess remains in the bloodstream until other lipoproteins pick it up for transport back to the liver.

There are two main types of lipoproteins: low-density lipoproteins (LDLs) and high-density lipoproteins (HDLs). LDLs are often referred to as “bad cholesterol”; HDLs as “good cholesterol.” An analysis of the function of each will explain why. Low-density lippoproteins are heavily laden with cholesterol, because they are the molecules that transport cholesterol from the liver to all the cells of the body.

Hish-density lipoproteins, on the other hand, carry relatively little cholesterol, and circulate in the bloodstream removing excess cholesterol from the blood and tissues. After HDLs travel through the bloodstream and collect the excess cholesterol, they return it to the liver, where it may once again be incorporated into LDLs for delivery to the cells. If everything is functioning as it should, this system remains in balance. However, if there is too much cholesterol for the HDLs to pick up promptly, or if there are not enough HDLs to do the job, cholesterol can form plaque that sticks to artery walls and may eventually cause heart disease.

The precise ways in which lipoproteins perform their functions are not known, nor is it known whether or how they work with other elements in the body. It is known that persons with high HDL levels and relatively low LDL levels have a lower risk of heart disease. In those who already have clogged arteries or have had a heart attack, an increase in HDL levels and a decrease in LDL levels can result in improvement of arterial obstruction.

The National Cholesterol Education Program has set the “safe” level of total serum cholesterol (including both LDL and HDL) at 200 milligrams per deciliter of blood (mg/dl). A reading above 200 indicates an increased potential for developing heart disease. A level of 200 to 239 is borderline, and those with levels over 240 are considered to be at high risk.

The normal HDL level for adult men in the United States is 45 to 50 mm/dl, and that for women is 50 to 60 mg/dl, may protect against heart disease. An HDL level under 35 mg/dl is considered risky. So if you have a cholesterol reading of 200, with HDL at 80 and LDL at 120, you are considered at low risk for heart disease. On the other hand, even if you have a total cholesterol level well under 200, if your HDL level is under 35, you would still be considered at increased risk of developing cardiovascular disease. In other words, as your HDL decreases, your potential for heart problems intensifies, even if your total is on the low side.

Because LDLs are so undesirable, it is imperative to realize the effect of diet on cholesterol levels. It is only logical that we should decrease our intake of animal products and therefore decrease our overall cholesterol levels. However, dietary cholesterol is only a part of the story. There are other substances that affect cholesterol levels. Saturated fats, for example, have been shown to increase cholesterol levels even more than dietary cholesterol does- so even if a food product label proclaims “No Cholesterol!” the product may still have a negative effect on your cholesterol level. There are other substances that raise cholesterol, too. Sugar and alcohol both raise the level of natural cholesterol (that which the body produces). Although we do need this substance, we do not need to overproduce it, which is what happens when we consume sugar and alcohol. Stress also results in an overproduction of natural cholesterol. Therefore, preventing (or fighting) heart disease requires a comprehensive approach that includes avoiding the consumption of animal products, saturated fats, sugar, and alcohol, and eliminating stress.

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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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How to Lower Your Cholesterol?

Cholesterol Lowering Drugs and Cholesterol Lowering Diet

Whatever the reasons may be for your high blood cholesterol level - diet, heredity, or both - the treatment your doctor will prescribe first is a diet. If your blood cholesterol level has not decreased sufficiently after carefully following the diet for 6 months, your doctor may consider adding cholesterol-lowering medication to your dietary treatment. Remember, diet is a very essential step in the treatment of high blood cholesterol.

Cholesterol-lowering medications are more effective when combined with diet. Thus they are meant to supplement, not replace, a low-saturated fat, low-cholesterol diet.

Summary of Diet Guidelines for Lowering High Blood Cholesterol Levels

* Eat less high-fat food (especially those high in saturated fat)
* Replace part of the saturated fat in your diet with unsaturated fat
* Eat less high-cholesterol food
* Choose foods high in complex carbohydrates (starch and fiber)
* Reduce your weight, if you are overweight

Eat Less High-fat Food

Dietary Fat

There are two major types of dietary fat - saturated and unsaturated. Unsaturated fats are further classified as either polyunsaturated or monounsaturated fats. Together, saturated and unsaturated fats equal total fat. All foods containing fat contain a mixture of these fats.

Reduce Total Fat Intake

One of the goals in your blood cholesterol-lowering diet is to eat less total fat, because this is an effective way to eat less saturated fat. Because fat is the richest source of calories, this will also help reduce the number of calories you eat every day. If you are overweight, weight loss is another important step in lowering blood cholesterol levels (as discussed later in this brochure). If you are not overweight, be sure to replace the fat calories by eating more food high in complex carbohydrates.

Remember: When you decrease the amount of total fat you eat, you are likely to reduce the saturated fat and calories in your diet.

Saturated Fat

Saturated fat raises your blood cholesterol level more than anything else in your diet. The best way to reduce your blood cholesterol level is to reduce the amount of saturated fat you eat.

Animal Fats

Animal products as a group are a major source of saturated fat in the average American diet. Butter, cheese, whole milk, ice cream, and cream all contain high amounts of saturated fat. Saturated fat is also concentrated in the fat that surrounds meat and in the white streaks of fat in the muscle of meat (marbling). Poultry, fish, and shellfish also contain saturated fat, although generally less than meat.

Hydrogenated Fat - Known As Trans Fatty Acids or Trans-Fats

Trans fats are created during the food manufacturing process when cheap vegetable oils undergo a process called “hydrogenation” - they have hydrogen added to them to make them solid and less likely to become rancid. Unfortunately, trans fats are even worse for our heart than saturated fat, as they encourage atherosclerosis (narrowing of the arteries).

Vegetable Fats

A few vegetable fats - coconut oil, cocoa butter (found in chocolate), palm kernel oil, and palm oil - are high in saturated fat. These vegetable fats are found in many commercially baked goods, such as cookies and crackers, and in nondairy substitutes, such as whipped toppings, coffee creamers, cake mixes, and even frozen dinners. They also can be found in some snack foods like chips, candy bars, and buttered popcorn. Because these vegetable fats are not visible in these foods (unlike the fat in meats) it is important for you to read food labels. The label may tell you how much saturated fat a food contains, which will help you choose foods lowest in saturated fats.

Remember: Saturated fats are found primarily in animal products. But a few vegetable fats and many commercially processed foods also contain saturated fat. Read labels carefully. Choose foods wisely.

Substitute Unsaturated Fat for Saturated Fat

Unsaturated fat actually helps to lower cholesterol levels when it is substituted for saturated fat. Therefore, health professionals recommend that, when you do eat fats, unsaturated fats (polyunsaturated and monounsaturated fats) be substituted for part of the saturated fat whenever possible.

Polyunsaturated fats are found primarily in safflower, corn, soybean, cottonseed, sesame, and sunflower oils, which are common cooking oils. Polyunsaturated fats are also contained in most salad dressings. But be cautious. Commercially prepared salad dressings also may be high in saturated fats, and therefore careful inspection of labels is important. The word “hydrogenated” on a label means that some of the polyunsaturated fat has been converted to saturated fat.

Another type of polyunsaturated fat is found in the oils of fish and shellfish (often referred to as fish oils, or omega-3 fatty acids). This type of polyunsaturated fat is found in greatest amounts in such fatty fish as herring, salmon, and mackerel. There is little evidence that omega-3 fatty acids are useful for reducing LDL-cholesterol levels. However, fish is a good food choice for this diet play anyway because it is low in saturated fat. The use of fish oil supplements are not recommended for the treatment of high blood cholesterol because it is not known whether long-term ingestion of omega-3 fatty acids will lead to undesirable side effects.

Olive and canola oil (rapeseed oil) are examples of oils that are high in monounsaturated fats. Like other vegetable oils, these oils are used in cooking as well as in salads. Recently, research has shown that substituting monounsaturated fat, like substituting polyunsaturated fat, for saturated fat reduces blood cholesterol levels.

Remember: Unsaturated fats when substituted for saturated fats help lower blood cholesterol levels.

Eat Less High-Cholesterol Food

Dietary cholesterol is a waxy, fat-like substance found in foods that come from animals. Although it is not the same as saturated fat, dietary cholesterol also can raise your blood cholesterol level. Therefore, it is important to eat less food that is high in cholesterol. While cholesterol is needed for normal body function, your liver makes enough for your body’s needs so that you don’t need to eat any cholesterol at all.

Dietary Cholesterol in Food

Cholesterol is found in eggs, dairy products, meat, poultry, fish, and shellfish. Egg yolks and organ meats (liver, kidney, sweetbread, brain) are particularly rich sources of cholesterol. High-fat dairy products, meat, and poultry all have similar amounts of cholesterol. Fish generally has less cholesterol, but shellfish varies in cholesterol content. Foods of plant origin, like fruits, vegetables, grains, cereals, nuts, and seeds, contain no cholesterol.

Since cholesterol is not a fat, you can find it in both high-fat and low-fat animal foods. In other words, even if a food is low in fat, it may be high in cholesterol. For instance, organ meats, like liver, are low in fat, but are high in cholesterol.

Because many foods such as dairy products and some meats are high in both saturated fat and cholesterol, it is important to limit the amount of these high-fat foods that you eat, choosing lean meats and low-fat dairy products whenever possible.

Remember: Organ meats and egg yolks are high in cholesterol. High-fat dairy products, meat, and poultry have similar amounts of cholesterol. Some fish has less. Foods of plant origin like fruits, vegetables, vegetable oils, grains, cereals, nuts, and seeds contain no cholesterol.

Substitute Low GI Carbohydrates for Saturated Fat

Breads, pasta, rice, cereals, dried peas and beans, fruits, and vegetables are good sources of complex carbohydrates (starch and fiber). Low-GI varieties are excellent substitutes for foods that are high in saturated fat and cholesterol. The type of fiber found in foods such as oat and barley bran, some fruits like apples and oranges, and in some dried beans may even help reduce blood cholesterol levels.

Contrary to popular belief, high-carbohydrate foods (like pasta, rice, potatoes) are lower in calories than foods high in fat. In addition, they are good sources of vitamins and minerals. What adds calories to these foods is the addition of butter, rich sauces, whole milk, or cream, which are high in fat, especially saturated fat. It is important not to add these to the high-carbohydrate foods you are substituting for foods high in fat.

Remember: Foods that are high in complex carbohydrates, if eaten plain, are low in saturated fat and cholesterol as well as being good sources of vitamins, minerals, and fiber.

Maintain a Desirable Weight

People who are overweight frequently have higher blood cholesterol levels than people of desirable weight.

You can reduce your weight by eating fewer calories and by increasing your physical activity on a regular basis. By reducing the amount of fat in your diet, you will be cutting down on the richest source of calories. Substituting foods that are high in complex carbohydrates for high-fat foods will also help you lose weight, because many high-carbohydrate foods contain little fat and thus fewer calories.

Fat Contains Twice the Calories of Carbs and Protein

Fat has more than twice the calories as the same amount of protein or carbohydrate. Protein and carbohydrate both have about 4 calories in each gram, but all fat-saturated, polyunsaturated or monounsaturated fat - has 9 calories in each gram. Thus, foods that are high in fat are high in calories. And all calories count. So, to maintain a desirable weight, it is important to eat no more calories than your body needs.

Remember: To achieve or maintain a desirable weight, your caloric intake must not exceed the number of calories your body burns.

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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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Cholesterol is a fatty lipid, steroid and an alcohol found in the body tissues and blood plasma of vertebrates. It is the essential part of the outer membranes of human body cells, and it circulates in the blood.

Cholesterol in the human body comes from two major sources. About three-quarters of the body’s total cholesterol is produced within the body, while only one-quarter comes from cholesterol in food.

Higher concentrations of cholesterol are present in body tissues which have more densely packed membranes - i.e. the liver, spinal cord, brain, atheroma, adrenal glands and reproductive organs.

The liver is the most important site of cholesterol biosynthesis. It is secreted from the liver in the form of an acidic secretion known as ‘bile’.

Diets rich in animal fats, meat, poultry, fish, oils, egg yolks and dairy products are a rich source of dietary cholesterol. Organ meats, such as liver and kidney, are extremely rich in cholesterol content, but foods of plant origin contain no cholesterol.

High cholesterol levels in the bloodstream can influence the pathogenesis of certain conditions. Recent studies have revealed that the abundance of protein complexes called lipoproteins, are responsible for the cholesterol build-up in the blood vessels.

Cholesterol gets attached to these lipoproteins. The high-density lipoprotein (HDL) carries cholesterol out of the bloodstream for excretion, while the low-density lipoprotein (LDL) carries it back into the system for use by various body cells.

LDL cholesterol is called bad cholesterol, because elevated levels of it are associated with an increased risk of coronary heart disease. LDL deposits cholesterol on the artery walls which leads to the formation of a hard, thick substance called cholesterol plaque. Over time, cholesterol plaque causes thickening of the artery walls and narrowing of the arteries, a process called atherosclerosis.

The levels of both HDL cholesterol and LDL cholesterol may also determine risk for heart disease; however current medical opinion is that the ratio of HDL cholesterol to LDL cholesterol is much more important than the level of cholesterol.

Methods to control your cholesterol levels:

Lower your consumption of foods containing saturated fats - fried fast foods, butter, cream, cheese, and fat on meat - to help reduce cholesterol. Add more plant foods to your diet - vegetable oils, nuts, legumes, breads, cereal grains, fruits and vegetables. A low cholesterol diet, combined with regular exercise is the best way to lower cholesterol levels.

Medications can also help lower cholesterol levels. HMG-CoA reductase inhibitors, ‘Statins’, such as lovastatin and atorvastatin (Lipitor) are the most effective and widely used medications to lower LDL cholesterol. Other medications include nicotinic acid, fibrates such as gemfibrozil, resins such as cholestyramine, and ezetimibe. These medications should be taken after consulting the experts.

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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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Cholesterol is the raw material used to produce your hormones. When your endocrine system is not functioning properly to make the hormones your body needs, it can compromise your immune system and raise the risk of Alzheimer’s.

Research presented at the American Academy of Neurology 60th Anniversary Annual Meeting in Chicago, April 12–19, 2008 shows that people with high cholesterol in their early 40s are more likely to develop Alzheimer’s disease than those with low cholesterol.

“Our findings show it would be best for both physicians and patients to attack high cholesterol levels in their 40s to reduce the risk of dementia,” said study author Alina Solomon, MD, with the University of Kuopio in Finland. Solomon collaborated with Rachel Whitmer, PhD, senior author of the study and a research scientist with Kaiser Permanente Division of Research in Oakland, CA.

The study involved 9,752 men and women in northern California who underwent health evaluations between 1964 and 1973 when they were between the ages of 40 and 45 and remained with the same health plan through 1994. From 1994 to 2007, researchers obtained the participants’ most recent medical records to find 504 people had a diagnosis of Alzheimer’s disease and 162 had vascular dementia.

The study found people with total cholesterol levels between 249 and 500 milligrams were one-and-a-half times more likely to develop Alzheimer’s disease than those people with cholesterol levels of less than 198 milligrams. People with total cholesterol levels of 221 to 248 milligrams were more than one-and-a-quarter times more likely to develop Alzheimer’s disease.

“High mid-life cholesterol increased the risk of Alzheimer’s disease regardless of midlife diabetes, high blood pressure, obesity, smoking and late-life stroke,” said Solomon.

Solomon says conclusions regarding high mid-life cholesterol and the risk of vascular dementia were difficult to formulate as there are several types of vascular dementia that may have slightly different risk factors.

The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, epilepsy, multiple sclerosis, Parkinson’s disease, and stroke.

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