Charleston Primary Care 2018

www.CharlestonPrimar yPhysicians.com | www.HealthLinksCharleston.com PC 31 | 63 CHOLESTEROL By the Numbers By the year 2035, 45 PERCENT of the U.S. population, about 131 MILLION people, will have at least one health problem related to heart disease. (www.webmd.com ) All adults age 20 AND OLDER should have their cholesterol checked every four to six years. (American Heart Association) SEVEN TIPS to save your heart: manage blood pressure; control cholesterol; reduce blood sugar; get active; eat better; lose weight; stop smoking. “You should include one egg and the whites of a couple of other eggs,” she suggested. Dr. Edwards, meanwhile, said people should avoid consuming large quantities of eggs and recommended eating only the whites. “I have plenty of patients who eat eggs, but they certainly can contribute to the dietary component of high cholesterol,” he said. Diet and exercise can be helpful, but often they are not enough to lower cholesterol, according to Dr. Brian Whirrett, who specializes in family medicine and sports medicine. Some pa- tients require drugs, in most cases a group of medications known as statins, which can cause side effects. McLain pointed out that 5 percent to 8 percent of people who take them develop myalgias. Dr. Whirrett agreed that muscle aches and pains are a possibility and pointed out that statins can be hard on the liver. Pharmacist Chad Straughan noted that in addition to rhab- domyolysis, which results “from the death of muscle fibers and release of their contents into the bloodstream,” according to www.webmd.com , statins also can cause a patient to suffer from diarrhea and an upset stomach. He said natural alternatives include red yeast rice and Co-enzymeQ10, a herb that provides “significant cardio benefits.” He added that the long-term effects of taking statins have yet to be determined. “I’m sure there is something out there. We just haven’t learned about it yet,” he said. “But it’s risk versus benefit. Do you want to have a heart attack or do you want to have lower cholesterol?” Dr. Whirrett disagreed somewhat, noting that “if you stop or reduce the dose of statins, most of the time the side effects will go away.” Other drugs that are sometimes prescribed to lower cholesterol include bile acid sequestrants and ezetimibe, which works in the stomach and intestines to decrease the amount of cholesterol produced by the liver and from the foods we eat. Patients also are taking PCSK9 inhibitors, self-injectible drugs that help break down bad cholesterol, according to McLain. What is considered to be high cholesterol? Opinions voiced by Drs. Edwards and Whirrett and McLain varied slightly. Both doctors agreed that total cholesterol should be at 200 or below, while Dr. Edwards said HDL – good cholesterol – should be 60 or greater and LDL – bad cholesterol – 130 or lower. Dr. Whirrett put those numbers at 70 and 110, respectively. According to McLain, LDL should be under 125, HDL greater than 45 in men and greater than 55 in women, and triglycerides, an indication of how your body is storing fat, should register at 125 or below. All three agreed that high cholesterol can be a genetic problem as well as the result of living an unhealthy lifestyle. Drs. Edwards and Whirrett suggested that testing for cholesterol be- gin at 25 or 30, but McLain said that, in some cases, preventive action should be taken at a much younger age. “Blood pressure and cholesterol should be checked begin- ning at age 20, but, if there’s a family history of heart attack or stroke, children should be checked at 2 years old. The key to all of this is early prevention,” McLain said. The financial cost of heart disease in the United States is expected to double from $555 BILLION in 2016 to $1.1 TRILLION in 2035. (www.webmd.com )