Harvard Health Publications Focus on Cholesterol: Part 3

ISSUE #3 OF 6 IN AN E-MAIL SERIES

Featured Report Get your copy of Healthy Eating for a Healthy Heart In this report, you will find practical eating guidelines based on the best science available. You'll read about how to achieve a healthy weight and eat well at the same time. You'll learn about the basics of a healthful (and tasty) diet, how to plan a balanced meal at home, and what to eat when you dine out. Finally, you'll learn about wholesome snacks and food substitutions, so that you don't feel deprived on the road to better eating. As an added bonus, we've included 40 heart-healthy recipes from EatingWell Media Group, publisher of EatingWell Magazine, healthy cookbooks, andEatingWell.com. Click here to read more » In the Next Issue Should you take a statin even if you have normal cholesterol? Additional Resources •   Beating Heart Disease: Strategies for a healthy heart Could heart-healthy HDL cholesterol also be good for the brain? High-density lipoprotein (HDL) is the "good" cholesterol particle. Under the right conditions, HDL scoops up cholesterol from the bloodstream and brings it to the liver, where it gets broken down. That's why having high levels of HDL cholesterol is a good thing. But wait, there's more! Studies suggest that HDL may stop inflammation, prevent blood clots from forming, and prevent other heart-harmful events in the body. And there is now evidence that HDL might be good for the brain, too. A small but growing number of studies suggest that high levels of HDL might decrease the risks for stroke and dementia. For example, a re-analysis of data from the Vitamin Intervention for Stroke Prevention study showed that people with high HDL levels were more likely to fully recover from a mild or moderate stroke. Other studies have found that high HDL lowers people's chances of having certain kinds of strokes. And there's some interest in experimenting with HDL levels to treat strokes. HDL and dementia Studies have identified an association between low HDL levels and dementia. Of course, that does not mean that low HDL levels cause dementia. Still, there is some evidence that HDL may hinder the development of beta-amyloid plaques. These plaques, many experts believe, are a primary cause of Alzheimer's disease. How to raise HDL levels Here are a few ways to increase your HDL levels. First we'll talk about lifestyle choices, then medications. Five lifestyle choices that boost HDL Exercising Drinking moderate amounts of alcohol. That means one drink a day if you're a woman, and one to two if you're a man. And only drink alcohol if you can do so safely and responsibly. Losing weight, if you're overweight. Avoiding trans fats. If you see "partially hydrogenated oil" on a food's ingredient list, then it has some level of trans fats. Processed foods and fried foods from restaurants tend to be the biggest sources of trans fats. Eating a diet high in fruits, vegetables, and low-fat dairy products can increase HDL levels. Mediterranean-style diets (large amounts of olive oil, whole grains, fruit, and vegetables) are also HDL boosters. Four medications that can boost HDL Niacin. In large doses (1 to 2 grams per day), niacin can increase HDL by 20% to 30%. One problem with niacin is that it can cause flushing, a sudden reddening of the skin that can be very uncomfortable. Taking aspirin 30 minutes or so before niacin can prevent flushing. Fibrates (clofibrate, fenofibrate, gemfibrozil). These medications lower triglycerides and raise HDL, making them a good choice if you have high triglycerides (200 to 499 mg/dL) as well as low HDL (40 mg/dL or lower). Side effects are a worry: taking both a fibrate and a statin increases the risk of muscle weakness. Fenofibrate (Antara, Tricor, other brands) is the best fibrate to take with a statin. Statins. These drugs are most often prescribed to lower "bad" LDL cholesterol, but they also increase HDL. However, the effect on HDL varies with the statin and is most pronounced at high doses. Rosuvastatin (Crestor) seems to be more effective at boosting HDL than simvastatin (Zocor), and simvastatin may be more effective than atorvastatin (Lipitor). Statin-niacin combinations. These have been shown to increase HDL by 18% to 21%. Muscle weakness can be a problem with statins, but adding niacin to a statin doesn't seem to increase this risk. One combination pill, Advicor (niacin and lovastatin), is already on the market.

Featured In This Issue Healthy Eating for a Healthy Heart Featured Content: • Losing weight to help your heart • Putting theory into practice • Recipes • Sample meal plan for a week Click here to read more »