Do You Know Your Cholesterol Numbers?
Experts Agree That More Aggressive Screening May Lower Heart Disease
Using these guidelines, Ronald Krauss, MD, chairman of the AHA Council on
Nutrition, Physical Activity and Metabolism, says that doctors now have a
better way to identify people at risk for heart disease and give them the best
"Physicians now have new tools for sharpening up their assessment of
their patients' risk for heart disease or for recurring heart disease,"
says Krauss. "They will have very specific recommendations for using both
diet and medication where needed to achieve targets that are connected to their
One area of risk that deserves emphasis, he says, is the distribution of
body fat, like the like the "apple" body type (fat around the
midsection) which has been linked to a higher risk of heart disease. People
with an apple-shaped distribution of fat may need more aggressive treatment of
borderline cholesterol to lower their risk.
Another condition called the "metabolic syndrome" is another major
risk for heart disease. The metabolic syndrome is a combination of the apple
body type, high blood pressure, a high triglyceride level, low HDL cholesterol,
and high blood sugar.
"Insulin resistance [the inability to use the hormone insulin] is
responsible for metabolic syndrome, which has become more significant over the
years since more Americans are overweight," says Krauss. "The key
treatment for this is to reduce weight and increase physical activity. It
deserves to be aggressively treated." Insulin resistance can lead to
Krauss describes the typical person with borderline metabolic syndrome as a
man with a waistline of 40 inches, a triglyceride level of 180, and an HDL
level of 40. "That person might have sailed through the previous
guidelines," says Krauss. "But now, we will catch that person and
provide the lipid management he needs."
What's more, the guidelines now say that people with diabetes should be
treated as if they have heart disease. The old guidelines considered diabetes
merely a risk for developing heart disease.