Cholesterol: Overview and History

By: Eunice Gaelek

There is a very good reason that high cholesterol is a concern for so many people. Increased levels of cholesterol can present serious risks to an otherwise healthy person. While monitoring cholesterol with proper diet and exercise is important, the first step to conquering cholesterol is having a clear understanding of the facts.

In May 2001, the National Cholesterol Education Program (NCEP) issued important clinical cholesterol guidelines. This update was the first in ten years, and was prepared with hopes of helping adults manage their cholesterol levels, and prevent an increase.

The NCEP, in cooperation with the National Heart, Lung and Blood Institute, used research and study results to develop the new cholesterol guidelines. The significant changes in these guidelines are as follows:

* More insistent treatments to reduce cholesterol

* The identification of patients posing a high risk of heart disease

* A new stage at which low HDL, or low high-density lipoprotein, can pose a major high risk factor for heart disease

* New therapeutic lifestyle changes that increase the ability to improve cholesterol levels

* A greater focus on the cluster of heart disease risk factors known as "the metabolic syndrome", as related to insulin resistance

* Increased awareness concerning the treatment, and more aggressive treatment of high triglycerides.

By following these guidelines, the NCEP anticipated a considerable increase in the number of Americans undergoing treatment for high cholesterol. These numbers, in fact, did increase. The number of patients taking dietary treatments rose from 52 million to 65 million. In addition, an estimated 36 million patients were taking cholesterol-reducing drugs, up from the previous number of 13 million.

The 2001 report showed that diabetes poses a great risk of heart disease, and also suggested that people with diabetes should undergo the same intensive treatment as those suffering heart disease. These treatment methods include lifestyle changes and medication.

As a result of the new cholesterol guidelines, there is now a widely used tool that can help to predict a patient's chance of developing heart disease within a ten-year span. The tool can calculate the risk of women and men separately. It is highly recommended by a group called the Adult Treatment Patients (ATP), and is used to assess patients who present two or more risk factors of heart disease.

There were other changes presented in the new cholesterol guidelines, as follows:

* A more high cholesterol treatment for diabetics. Type 2 diabetes poses a high short-term risk of having a coronary episode, and a higher risk of heart attack fatality

* Using a lipoprotein profile as the first step in testing for high cholesterol. This is the measurement of the levels of HDL, LDL, total cholesterol, triglycerides and other fatty substances found in the bloodstream.

* Increased use of nutrition, weight control and physical activity to act as treatments of high blood cholesterol levels.

* Identification of "metabolic syndrome" as risk factors relating to insulin resistance.

* Advising patients to refrain from using hormone replacement therapies (HRT) as substitutes for cholesterol-reducing medicines.

Throughout a ten year span, there were great advancements made in high cholesterol treatment methods. The findings of the 2001 National Cholesterol Education Program have provided a greater understanding of the effects of high cholesterol. As a result, doctors are able to access and take advantage of better treatment options.