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Cholesterol levels are divided into total cholesterol, triglycerides (triglycerides), HDL cholesterol, and LDL cholesterol.
Cholesterol tests should be taken on an empty stomach. This is because triglyceride (triglycerides) levels are heavily influenced by diet. If a blood test is taken immediately after eating, the level will rise rapidly, and after 8~12 hours, the level will drop. Recently, postprandial triglycerides (triglycerides) are more important than fasting triglyceride levels, but it is difficult to apply them in the medical field because clear standards have not yet been proposed.
In addition, total cholesterol, LDL cholesterol, and HDL cholesterol are not significantly affected by diet, but LDL cholesterol has traditionally been calculated using triglycerides (triglycerides), so a post-meal test may give the wrong results.
Of the four cholesterol levels, the one you should pay the most attention to is LDL cholesterol. This is because it creates debris in the blood vessels and plays the most decisive role in the aging of blood vessels. On the other hand, contrary to LDL cholesterol, the higher HDL cholesterol, the lower the risk of cardiovascular disease, so it can be said to be good cholesterol.
Dyslipidemia* is classified slightly differently from person to person. For example, if the LDL cholesterol level is the same as 126 mg/dL, one person may be normal and the other person may need to be vigilant. This is because the risk varies depending on the risk factor for arterial disease, diabetes, and cardiovascular disease. Therefore, when treating dyslipidemia, it is important to consider not only cholesterol levels, but also how many other bad factors can damage blood vessels.
*Dyslipidemia: A condition in which there is an excess of lipids or fats in the blood.
There are five risk factors for cardiovascular disease. The first is advanced age. This is because blood vessels age from the age of 45 for men and 55 for women. The second is a family history of early onset of coronary artery disease. If you have close parents and siblings who develop cardiovascular problems relatively early, before the age of 55 for men and 65 for women, you are classified as a risk factor. The third is hypertension. A systolic blood pressure of 140 mmHg or higher, or a diastolic blood pressure of 90 mmHg or higher, is a risk factor. This is true even if your blood pressure is controlled by blood pressure medication. The fourth is smoking. And finally, if the level of HDL cholesterol is lower than 40 mg/dL, it is a risk factor. Conversely, HDL cholesterol levels higher than 60 mg/dL may be a protective factor for cardiovascular disease, offsetting one other risk factor.
The Korean Society of Lipid Atherosclerosis suggests dietary therapy to improve dyslipidemia. One thing to keep an eye on is the alcohol intake. In the past, it was considered okay for men to drink two drinks a day and women to drink one drink a day, but now abstinence is recommended if possible.
You also need aerobic exercises, strength training, and flexibility exercises such as yoga, tai chi, and Pilates.Exercise does not have a significant effect on LDL cholesterol levels, which are the most important cholesterol in the body. However, among LDL cholesterol, there are small and dense LDL that go deep into the blood vessels and larger LDL, and there are studies that show that exercise changes them for the better, and exercise is very effective in lowering triglycerides and raising HDL cholesterol. In particular, exercise is important because it is very difficult to raise HDL cholesterol with medication.
Statins are the most popular cholesterol-related medications. According to a 2018 survey of people in Korea, as many as 7.7 million people took cholesterol-related medications. Of those, 91.8% were taking statins. Other than that, it was followed by ezetimibe, fibrate, and omega-3.
Statins are a class of medications that inhibit the liver's ability to make cholesterol. There are people who need cholesterol medication even though they are eating a good meal, because the liver produces a lot of cholesterol due to their constitution. Taking statins can reduce LDL cholesterol levels by as little as 2~30% and as much as 4~50%. On the contrary, ezetimibe is a drug that prevents cholesterol from entering through food. Nowadays, there are also drugs that are a combination of statins and ezetimibe. Statins and ezetimibe are the most popular, but fibrates and omega-3s are also taken in addition to their effectiveness in lowering triglycerides.
You may be wondering if there are any side effects to statins. The probability of side effects with statins is much less than the indicators of improvement. People who have been at high risk of developing diabetes are at high risk of developing diabetes, and there is no evidence of adverse effects related to cognitive function. Therefore, you should take it as recommended by your doctor. Just like the placebo effect, where you feel like you're feeling better even though you've taken a fake pill, there's a nocebo effect where you feel like you've had a side effect after taking the medicine, so we recommend that you don't worry too much.
Increasing the dose of the drug will have a greater effect. However, the effect is not increased in proportion to the dose. For example, if you take twice as much of the drug, it won't be twice as effective. Therefore, depending on the situation, additional drugs with different mechanisms may be taken.
While some medications are good to take at certain times, some of the more recent medications tend to be effective for a long time when you want them to be taken throughout the day.
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