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Too much cholesterol, a soft, fatlike substance, clogs up the arteries, restricting blood flow to the heart and other parts of the body. Not all types of cholesterol, however, are bad. HDL (high-density lipoprotein) is the good guy, transporting fats and HDL (low-density lipoprotein) deposits to the liver to be broken down.

Conversely, high levels of LDL or "bad" cholesteraol leads to the formation of plaque, which clog up the arteries and elevate the risk of heart disease. The aim is to reduce your LDL level and raise your HDL level. Dietician recommends keeping your diet low in saturated fats and cholesterol for example, eating lean meat in moderate portions and removing the skin from chicken.

Choose low-fat or skimmed dairy products, and avoid foods high in cholesterol, such as egg yolk and offal. Another tip: A grapefruit a day can reduce cholesterol levels in the blood. In a recent study by Israeli scientists involving 57 patients, those who received single servings of red or white grapefruit a day for 30 days showed considerable reduction in blood lipid levels, compared to those who did not eat grapefruit.

High Cholesterol

What Is It: Cholesterol, a substance essential for various bodily functions, is produced by the liver and all of the body's cells. The body produces all it needs so we do not need excess dietary cholesterol. Certain types of food-saturated fat in red meat and trans fat from hydrogenated oils - can raise cholesterol levels. A high level of cholesterol greatly increases chances of developing coronary heart disease, which leads to heart attacks. There are many kinds of cholesterol but the most important ones are: low-density lipoprotein (LDL) or "bad" cholesterol and high-density lipoprotein (HDL) or "good" cholesterol.

Risk Factors: Family history of high cholesterol, excessive intake of processed food high in trans fats and saturated fat, lack of exercise.

Complications: Heart disease, stroke and peripheral arterial disease affecting the blood vessels of the lower limbs.

Symptoms: High cholesterol is usually identified.

Alert: Not Enough Just To Lower Bad Cholesterol

Scientist say there is a need to rethink using just lipid-modifying treatment such as statins to reduce heart disease. This call comes in the wake of a recent European survey which showed many patients, already on statins, remain at high risk of heart attack and stroke - even when the treatment lowered their low-density lipoprotein cholesterol (LDL-c) or bad cholesterol.

The data from the survey also showed that the levels of good cholesterol, known as high-density lipoprotein cholesterol (HDL-c), remained low in this group of patients, making the decrease in HDL-c a risk factor for coronary heart disease. Among the participants, 40 per cent of women and 33 per cent of men still have low levels of good cholesterol, making them at high risk of heart disease despite the fact that they are on statins.

This means that the use of statins alone to lower the risk of atherosclerosis (the progressive narrowing and hardening of arteries) can no longer be the gold standard as the condition continues to progress when the level of good cholesterol is not raised. The first pan-European survey, which started in 2004, involved 8,545 patients from 11 European countries.

The patients are aged 18 and above and are overweight, with most leading sedentary lives. Almost half suffer Type 2 diabetes, another 45 per cent have coronary heart disease and 72 per cent have hypertension. All are receiving treatment for dyslipidaemia - where blood lipids are excessively high and is usually associated with diabetes and high blood pressure - and had received diet and exercise counselling and drugs to modify their lipid levels.

Professor James Shepherd of the University of Glasgow and Royal Infirmary said that as the survey suggests dyslipidaemia is not a single defect, the focus should be to raise HDL-c and, at the same time, reduce LDL-c. "Statin therapy on its own fails to address the cardiovascular risk associated with low HDL-c and elevated triglycerides," he said. Triglycerides are a type of fat found in the blood.

The survey's principal author, Professor Eric Bruckert of the University Hospital PitieSalpetriere in Paris, noted that vascular disease accounted for half of the four million deaths in Europe annually. "We should actively consider therapy to raise the good cholesterol at the same time," he said. Raising good cholesterol levels has been underestimated in the management of dyslipidaemia patients.

One way is to adopt a combined therapy of statin and nicotinic acid, a water-soluble Vitamin B. Professor John Chapman of Hospital Pitie-Salpetriere said managing heart disease also has much to do with lifestyle and cholesterol modification.


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