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 care.
"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 patients' risk."
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 diabetes.
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.