RANDOLPH AIR FORCE BASE, Texas –
During National Cholesterol Education Month in September, health officials emphasize the importance of adults getting their blood cholesterol checked and taking steps to lower it if it is high.
"Your body needs just a small amount of cholesterol to do its metabolic functioning," 1st Lt. Steven Carlsen, 359th Medical Operations Squadron physician assistant, said. "When levels exceed desirable limits, plaque can form on the inside of blood vessels. Too much plaque can lead to a heart attack or stroke."
Cholesterol is a waxy, fat-like substance that circulates in the body, providing material for cell repair and metabolism. Most of it is made by the body, dependent on a person's heredity, and about 25 percent of it comes from foods such as meat, poultry, fish, eggs, butter, cheese and whole milk.
It comes in two forms - LDL (low-density lipoprotein), or bad cholesterol, which forms a thick, hard substance that can clog blood vessels, and HDL (high-density lipoprotein), or good cholesterol, which helps the body get rid of LDL cholesterol.
Checking cholesterol levels is an integral part of regular checkups at the Randolph Family Health Clinic, Carlsen said. The cholesterol screening test, called the blood lipid panel, measures LDL cholesterol, HDL cholesterol and total cholesterol as well as triglycerides, another form of fat in the bloodstream.
"The first goal of treatment is to lower bad cholesterol," Carlsen said.
Health care professionals also look at the cholesterol ratio - total cholesterol divided by HDL. That ratio should be at or below 5:1, with less than 3.5:1 considered the ideal, according to the American Heart Association.
A person who has normal readings generally requires a cholesterol screening every five years, but a patient with less desirable readings or other risk factors - family history, diabetes, obesity, high blood pressure and smoking - needs more scrutiny.
"Family history is an important part of the screening process," Carlsen said. "It helps us screen those we should be more aggressive with. Looking at family history gives us good insight into what we will do for patients."
As an example, he mentioned an 18-year-old whose total cholesterol exceeded 300 milligrams per deciliter.
"His family had a history of cardiovascular disease," Carlsen said.
For some people, those with borderline high readings of total and LDL cholesterol, modifying their diet and getting more exercise can result in lower numbers, he said. A healthy diet includes a variety of fruits, vegetables, whole grains, fish and lean protein; a minimum of 30 minutes of cardiovascular exercise at least three times a week is recommended.
If diet and exercise are not enough to lower those numbers, typically over a six-month period, medication can play a key role in a treatment plan, Carlsen said.
"Drug therapy is effective, depending on the medication you take," he said.
Statins are a class of drugs that lower the level of cholesterol in the body by reducing the production of cholesterol by the liver. The most serious side-effects are muscle pain and liver damage.
"We try to find a good balance between lifestyle modifications and use of medications," Carlsen said.
Patients whose treatment plan involves diet, exercise and drug therapy should be monitored at six weeks, three months, six months and then annually, depending on progress, he said.