Cholesterol Disease State Management

September is National Cholesterol Education Month, and an excellent opportunity to ensure that your patients are taking the appropriate steps to ensure that their cholesterol levels are within nationally accepted guidelines. Cholesterol is a soft, wax-like fat particle (lipid) that is produced in the liver and circulates throughout the body. Cholesterol is an important fat needed in the body and is utilized to produce cell membranes, bile, vitamin D, and other steroids and hormones. The liver has the ability to produce an adequate amount of cholesterol that the body needs, however, the ingestion of foods that contain a high amount of cholesterol can result in an individual having an excessive amount of the fat. Too much cholesterol in the blood can lead to cardiovascular disease, which is considered to be the number one killer in the US.

There are many different guidelines for detection of high cholesterol, but all of them utilize a fasting blood test to measure the following: a patient’s Total Cholesterol, HDL (High-density lipoprotein), LDL (Low-density Lipoprotein), and TG (Triglyceride). Each of the listed blood markers has optimal, borderline, and high thresholds that determine the treatment strategy for a patient. Optimal goals for these markers are as follows:

Total Cholesterol < 200 mg/dL
HDL Cholesterol > 60 mg/dL
LDL Cholesterol < 100 mg/dL
TG < 150 mg/dL

In the event that a patient’s physician has attempted lifestyle modifications such as dietary changes, increased physical activity, and reduction or elimination of tobacco smoking that have not resulted in the reduction of overall cholesterol health there are a variety of prescription medications that can be utilized. Some of the major classes of cholesterol reducing medications are:

Statins or HMG CoA reductase inhibitors - that act in the liver to prevent the bodies continued formation of cholesterol and are most effective in lowering LDL levels.
Resins or bile acid sequestering agents - that work in the intestines to prevent absorption and increase the amount of ingested cholesterol elimination. This class of medications is most effective in lowering LDL levels.
Selective cholesterol absorption inhibitors - that work in the intestine to prevent cholesterol absorption and most effective at lowering LDL levels.
Fibrates - are best at lowering TG levels and increasing HDL.
Nicotinic acid (Niacin) - act in the liver and prevents the synthesis of fatty acids and TG. This class of medication is best at lowering TG and LDL and increasing HDL.

Links - Cholesterol

MedicineNet.com Cholesterol Articles - MedicineNet.com is an online, healthcare media publishing company. It provides easy-to-read, in-depth, authoritative medical information for consumers via its robust, user-friendly, interactive web site.

September is National Cholesterol Month - Learn More about cholesterol.

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