HEALTH MATTERS: Cholesterol predisposes people to heart diseaseQ. My grandfather is 87 years old and has bacon and eggs for breakfast every morning. He is as healthy as a horse. I thought that cholesterol was bad for you!
By: Dr. Joshua Wynne, Grand Forks Herald
Q. My grandfather is 87 years old and has bacon and eggs for breakfast every morning. He is as healthy as a horse. I thought that cholesterol was bad for you!
A. Congratulations to your grandfather on his good health, and his good luck. Cholesterol is bad for us. It is one of the five factors that predispose someone to heart disease; the other factors are having diabetes, being male, having high blood pressure, and smoking cigarettes.
The presence of these five factors increase the chance of getting heart disease — and the factors are additive. So someone with all five risk factors has a much higher chance of getting heart disease than someone without any. For example, a woman who is still menstruating and has none of the other risk factors for coronary heart disease has less than about a 1 percent chance of having a coronary heart problem. By the way, it turns out that the female hormones that are released while a woman is of childbearing age are protective against coronary heart disease, but that protection is lost during the decade following menopause.
As far as your grandfather and cholesterol, most of the cholesterol in the body is made in the liver. For most adults, we can only lower our cholesterol levels by about 10 or 15 percent through diet, which is helpful in reducing risk. But for people with really elevated cholesterol levels, diet usually is not enough, and doctors usually prescribe one or more medications to bring the levels down toward the target level. The medications we use are quite effective in most patients and can dramatically drop cholesterol levels. It is clear that your grandfather is one of the lucky ones who hasn’t had any ill effects from his dietary indiscretions, so all I can say is bon appétit!
Q. What is hypertension, what causes it, and how is it treated?
A. Hypertension is high blood pressure caused by abnormal constriction of the arteries in the body. It is a common problem and affects many of us. Chronic hypertension can lead to strokes, heart attacks, kidney failure, and heart failure. In the vast majority of cases, no cause is apparent, although occasional cases are caused by tumors, kidney problems, excess alcohol intake, or kinks in a major artery in the body.
Hypertension caused by an identifiable problem is more common in the young and may be cured by appropriate treatment. The rest of us are not so lucky. We need to alter our lifestyle — most importantly by reducing our intake of salt but also by losing weight, exercising and avoiding excess alcohol — and, usually, by taking one or more medications for life.
Many different classes of medications can be used to treat high blood pressure, and many people are put on a combination of medications to optimally treat their condition. Medications are generally well tolerated, but if patients experience side effects, there usually are alternatives that can be used. The most common reason that blood pressure remains high is when patients, for one reason or another, don’t take their medications as prescribed. If you are not taking the prescribed amount of medication or you are experiencing any problems after taking your pills, please talk with your health care provider!
Wynne is vice president for health affairs at UND, dean of the School of Medicine and Health Sciences, and a professor of medicine. He is a cardiologist by training.
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