Although the body needs cholesterol to make cell membranes and hormones, and for other functions, high levels of cholesterol can create problems. One of several blood fats called lipids, cholesterol has been implicated in heart disease and stroke. Cholesterol is part of the waxy substance called plaque that can build up inside blood vessels walls and cause narrowing or blockage of the arteries.
There are a number of cholesterol and heart disease risk tests available. The Cleveland Heart Lab recently released a test for TMAO (trimethylamine-N-oxide); this metabolite is produced by gut bacteria and is strongly associated with heart disease. The Boston Heart lab offers five distinct tests detailing cholesterol or heart disease risk. True Health Diagnostics provides an extremely detailed advanced cholesterol test. The CardioDx Corus test can quickly assess whether a patient's symptoms are related to heart disease.
Dietary changes used to be at the top of the list for people with high cholesterol, but in 2015, the Dietary Guidelines Advisory Committee of the US Department of Agriculture found that cholesterol is no longer “a nutrient of concern.” Weight loss and increased physical activity are still recommended. Medications used to treat cholesterol include nicotinic acid, fibric acids, cholesterol absorption inhibitors, statins, and bile acid sequesterants. A new class of medications called PCSK9 inhibitors can reduce “bad” or LDL cholesterol. They work well for people with a family history of high cholesterol or those who can't tolerate statin drugs. They must be given by injection.
High cholesterol is only part of the heart disease picture. One of the most important factors is smoking, which dramatically raises the risk of heart attack and stroke. High blood pressure is another risk factor, as is diabetes, so both should be treated to reduce heart disease risk. Eating a heart-healthy diet with lots of fruit, vegetables and fiber improves overall health. A healthy weight, regular physical activity, and stress reduction can also help decrease heart disease risks.
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