What Options Do I Have for Treatment, and How Do I Choose?
By Bobbie Hasselbring
Considering Treatment Options Experts recommend the following to treat high blood cholesterol:
- changing what you eat
- increasing your exercise
- in some cases, taking medicine
To decide which treatment options may be right for you, your doctor will consider:
- your age
- your cholesterol levels
- your triglyceride levels
- your history of heart attack or stroke
- other signs of heart or blood vessel disease
- your other risk factors for heart disease, such as high blood pressure, smoking, diabetes, excess weight, and family history
- other health conditions that you have
After considering your cholesterol levels, your medical and family history, and other risk factors for heart disease, your doctor will recommend a treatment plan for you. Your treatment is likely to involve making changes to your lifestyle as well as taking medicine. Your first step is to look at what you eat. If you have not been following a heart-healthy diet, then it's time to make some changes. A heart-healthy diet is low in saturated fat, cholesterol, and calories. Next, see how much exercise you are really getting. If you have not been as active as you can be, then start adding in more exercise. Your doctor can help you come up with an exercise plan that is right for you.
Are Lifestyle Changes for Me?
By improving your diet and exercise habits, you may be able to reduce your total cholesterol by up to 15%. You can also lose excess pounds in the process. Weight loss - even as little as 10 to 20 pounds - may help to improve your cholesterol.
Sometimes dietary changes and exercise alone don't improve your cholesterol levels as much as you need. If this is true for you, or if you have inherited high cholesterol, your doctor may prescribe medicine. Even with medicine, you still need to eat a healthy diet and get regular exercise.
If you have any other illness that can cause high cholesterol, you may need to treat the illness before your cholesterol levels will improve. These illnesses include diabetes and some forms of thyroid, liver, or kidney disease.
Are Intensive Lifestyle Changes for Me?
Some studies have shown that more intensive lifestyle changes can begin to reverse even severe heart disease. Several doctors, with Dean Ornish, MD, being one of the most publicized, have programs for this. Dr. Ornish and others have been working with patients who are willing to make radical lifestyle changes in order to reverse heart disease.
If you do not have heart disease, but do have high blood pressure or high cholesterol, you may also want to consider making more intensive changes to your lifestyle. Doing so may help prevent heart disease. People who had high blood pressure showed benefits from following these programs. Those in the study had lower blood pressure levels when they were resting, as well as when they were under stress. Those who had high cholesterol lowered their levels. They also showed improvement in the amount of atherosclerosis they had.
Dr. Ornish's program includes the following components:
- a very-low-fat and low-cholesterol vegetarian diet
- moderate aerobic exercise several days a week
- daily use of stress-management techniques
- stopping smoking
- group support
Making changes like these is not an easy adjustment for most people. The very-low-fat vegetarian diet, in particular, is hard for many to stick with. Plus, in Dr. Ornish's program, you need to do all five parts at the same time to reap the benefits. For those who are willing to try hard, these changes may present a new way to think about heart health. To get lasting results, you'll need to make these changes forever as part of a new and lasting way of living. Learning new ways to enjoy food and taking the time and energy to develop new habits is the key.
To learn more about how you might gain from following an intensive program, see What Are the Benefits of Making Intensive Lifestyle Changes?
If you and your doctor decide that intensive changes are appropriate for you, follow these links to learn about each part of the intensive lifestyle program.
- How Do I Follow a Very-Low-Fat Vegetarian Diet?
- How Do I Make Intensive Changes to My Exercise Program?
- How Can Emotional Connections Help My Heart?
- How Do I Make Intensive Changes to Manage Stress?
It's important to note that, even though the patients studied in Dr. Ornish's program did not take medicine to lower cholesterol, Dr. Ornish is not totally against taking medicine. In his book, Reversing Heart Disease (Random House, 1990), Dr. Ornish says, "If your cholesterol levels remain elevated and you are unwilling to modify your diet sufficiently, then you may want to consider taking a cholesterol-lowering drug, especially if you have coronary heart disease or several risk factors." Medicines are not Dr. Ornish's preferred first choice, but he recommends that patients discuss this with their doctors.