Policosanol Alcohol

This dietary supplement made from alcohols extracted from sugarcane shows promise as a cholesterol-lowering agent. Though we're not sure exactly how it works, policosanol alcohol seems to block the production of cholesterol. Trials have shown it lowers LDL levels moderately in people with diabetes, postmenopausal women, the elderly, and those with familial hypercholesterolemia, the genetic disorder that causes high cholesterol. That said, most of the trials have been done by one group of...

Bile Acid Binders Resins

Bile acid binders are synthetic resins that bind chemically with cholesterol-rich bile acids in the intestine, preventing their reabsorption. To replace the bile acids lost in this way, the body draws upon its store of cholesterol, thus lowering cholesterol levels in the blood. Medications in this class include cholestyramine (Prevalite, Questran), colesevelam (WelChol), and colestipol (Colestid). Typically, they lower LDL cholesterol by 15 percent to 30 percent, 170, depending on the daily...

Chelation Therapy

Chelation therapy uses infusions, or slow injections, of a chemical called ethylenediaminetetraacetic acid (EDTA). This process is sometimes used to remove toxic levels of lead, iron, or other metals from the body. (The metals exit the body via the urine.) Some experts think that the oxidation of LDL cholesterol requires interaction with such metals. The idea behind chelation for cardiovascular disease is that removing some of these metals from the bloodstream will also reduce oxidation and...

Ezetimibe

One of the newest drugs on the cholesterol-lowering block is Zetia (ezetimibe). Like a statin, ezetimibe reduces total cholesterol, LDL cholesterol, and apolipoprotein B, a protein constituent of LDL cholesterol. It works in a different way than statins, though. Instead of interfering with the body's mechanism for making cholesterol, ezetimibe interferes with the body's absorption of dietary cholesterol from the small intestine. Taking ezet-imibe along with a statin puts two different...

HDL Cholesterol

HDL fights plaque buildup in the heart's arteries, and the more HDL you've got, the better. The NCEP guidelines consider levels of 60 mg dL or above to be high enough to provide protection. HDL levels of less than 40 mg dL are regarded as too low. 92 Some clinicians use the ratio of total cholesterol to HDL choles- I TABLE 5.1 Categorizing Your Cholesterol and Triglyceride Levels *The 2004 update to the NCEP lists 70 mg dL as an optional goal for patients with the highest heart risk to strive...

How Do Statins Work

Statins reduce the amount of cholesterol the liver makes by blocking the key protein needed in that process, HMG CoA reductase (3-hydroxy-3-methylglutaryl-coenzyme A reductase). With less cholesterol made in the liver (and remember that we typically make about 70 percent of the cholesterol in our bodies), the liver tries to recapture more of the LDL cholesterol in the circulation. When it does this by removing LDL particles from the blood, the blood LDL cholesterol level drops (see Figure 8.1)....

Problem in Two Parts High LDL and High Triglycerides

In Chapter 1, I talked about the main cholesterol problem that affects people high LDL levels. Although the numbers vary according to age, gender, and ethnic background, about 5 percent to 10 percent of people with this problem are also plagued by another high triglyceride levels. In these people, triglyceride lev- ,179 els are typically in the 300-600 range. In one landmark study of heart disease risk published more than thirty years ago, it was this combination lipid disorder that was the...

Relaxation Techniques

What Is It Focusing on slow, deep breathing and gently disengaging the mind from distracting thoughts and sensations Especially Beneficial If you have an eating disorder or tend to hold in your stomach (may help you focus on your body in healthier ways) May Not Be Suitable If you have health problems that make breathing difficult, such as respiratory ailments or congestive heart failure What Is It Tensing and relaxing all the muscles of the body from head to toe in a progressive sequence...

Family History Lessons Familial Hypercholesterolemia

There are a variety of genetic disorders that affect how the body makes lipids. In terms of heart disease risk, the most detrimental lipid disorders increase LDL levels and decrease HDL levels. The majority of these disorders are caused by a few problematic genes combined with environmental factors such as obesity or a diet high in saturated fat. As far as treatment goes, it doesn't matter if your high cholesterol is caused by problematic genes or not. Medication and lifestyle changes are still...