Question: Do I need to worry about lowering my blood cholesterol now that I'm over 65?
Answer: A study published in 1998, the Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) study, examined the effects of cholesterol lowering in people with CHD (those who had already experienced a heart attack or had been hospitalized for angina) and who had relatively average cholesterol levels. The LIPID study used a statin drug to lower cholesterol levels in the treatment group, which included people up to age 75. All study participants were counseled about following a cholesterol-lowering diet. The LIPID results showed that a drop of 18 percent in total cholesterol and 25 percent in LDL-cholesterol produced a 24 percent decrease in deaths from CHD among the treatment group compared with the control group. Similarly, cholesterol-lowering in the treatment group reduced the overall death rate by 22 percent, heart attacks by 29 percent, the need for bypass surgery or angioplasty by 20 percent, and stroke by 19 percent. Cholesterol lowering in the LIPID study resulted in significant reductions in CHD-related deaths and events without increasing non-CHD deaths.
Question: Should I be concerned about my child's blood cholesterol?
Answer: Children from families in which a parent or grandparent has developed heart disease at an early age (before age 55 in father or grandfather, or before age 65 in mother or grandmother) should have their cholesterol levels tested. If a child from such a "high-risk" family has a cholesterol level that is high, it should be lowered under medical supervision, primarily with diet. By following a low-saturated fat and low-cholesterol eating pattern, by being physically active, and by avoiding obesity, even healthy children can lower their risk of developing heart disease as adults.
Question: How useful is it to know my cholesterol ratio?
Answer: Although the cholesterol ratio can be a useful predictor of heart disease risk, especially in the elderly, it is more important for treatment purposes to know the value for each level separately because both LDL- and HDL-cholesterol separately affect your risk of heart disease and the levels of both may need to be improved by treatment. If you have LDL-cholesterol of 100 mg/dL or above, lowering your LDL-cholesterol is the main goal of treatment. Your doctor will, however, also consider your HDL when deciding on treatments and goals. The ratio is useful if it helps you and your doctor keep the entire picture of your LDL and HDL levels in mind, but it should not take the place of knowing your separate LDL and HDL levels.
Question: What if I need heart surgery?
Answer: Bypass surgery or balloon angioplasty will improve the blood supply to the heart, but it does not mean you can ignore your cholesterol level or the other CHD risk factors. Even though surgery restores blood flow in the heart, poor life habits will clog your new arteries even faster than they clogged your old ones. So pay attention to your risk factors especially after surgery. Trying to lower LDL-cholesterol to less than 100 mg/dL is an important goal for CHD patients. Many patients who have bypass surgery or balloon angioplasty have not actually had a heart attack. Cholesterol-lowering treatment in these patients is very important to lessen the chances of a future heart attack.
Question: What if I have the warning signs of a heart attack?
Answer: You should know the symptoms of a heart attack so that you can get immediate medical help. The most common symptoms are:
- Uncomfortable pressure, fullness, squeezing or pain in the center of the chest that lasts more than a few minutes, or goes away and comes back.
- Pain that spreads from the chest to the shoulders, jaw, or arms.
- Chest discomfort with lightheadedness, fainting, sweating, nausea, or shortness of breath.
These symptoms may be severe from the start, or they may be mild at first, then gradually worsen. In some people, the warning symptoms come and go.
If you experience any symptoms of a heart attack, get medical help immediately. Be sure you know the phone number so you can get emergency transportation to the hospital. If you are having a heart attack, getting to the hospital fast is very important. Medical treatment, including clot-dissolving medicine, can save lives and reduce damage to the heart muscle, but only if it is started very soon after a heart attack occurs.
Talk with your doctor about the symptoms of a heart attack and what to do if you experience them.
Question: My last cholesterol level was within my goal. Does that mean I do not have to worry about my cholesterol any more?
Answer: High cholesterol and heart disease are not cured but are only controlled by diet and drug therapy. Stopping your treatment quickly returns your cholesterol to the level that existed before therapy was started.