Do you have high cholesterol?
In 2016, Statin medications took up 2 of the top 3 spots for the most frequently prescribed medications in Australia; chances are you, or someone you know, is currently taking one. Long-term, high cholesterol levels are incredibly common, and are directly related to heart disease.
Whilst taking medication as prescribed can be critical to health, so is understanding a little more about what's happening on the inside.
Learning to read your lipid profile: breaking down the numbers on the blood test
The lipid profile you see on your blood test details a collection of tests that are used to determine your relative risk for heart disease. Most commonly, you’ll see values associated with low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides (TG).
LDL: ‘bad’ cholesterol
You might hear LDL cholesterol referred to as ‘bad’ cholesterol. Low-density lipoproteins carry cholesterol in the blood and the LDL value on the blood tests represents the amount of cholesterol bound to these types of proteins, i.e. the amount of cholesterol travelling around in the blood. LDL is commonly thought of as the ‘bad’ cholesterol because whilst travelling through the blood it deposits excess cholesterol within the walls of blood vessels, such as the arteries.
When you consider that heart attacks, stroke, angina, and even high blood pressure may be caused by the narrowing of arteries and blood vessels due to cholesterol deposits known as plaques, you can bet that LDL cholesterol is at play.
HDL: ‘good’ cholesterol
Conversely, HDL are proteins that are responsible for removing excess cholesterol from the body. As with LDL, the HDL value represents the amount of cholesterol currently bound to HDL proteins, i.e. the amount of cholesterol on its way out. Therefore, having a high level of HDL is generally considered a good thing as more cholesterol is being removed from the body.
Total cholesterol
Be mindful when you’re reading your lipid profile that the ‘total cholesterol’ reading may not be all that it appears. The amount of total cholesterol, ideally below 5.5 mmol/L, reflects the total amounts of both HDL and LDL. A more sensitive measure is a ratio that reflects the relative amounts of HDL within the total cholesterol, as it can indicate that your total cholesterol may be raised as a result of high levels of HDL, which is not a bad thing.
Triglycerides
Triglycerides are representative of the body’s storage of fat and most are found, unsurprisingly, in the adipose (fatty) tissue throughout the body. An excess of triglycerides is associated with cardiovascular disease, independent of any other factors.
You can do more than just take a statin and hope for the best...
Get moving
There is a direct relationship between long-term high cholesterol levels and heart disease, and lowering cholesterol is considered critical in regards to preventing heart disease. It’s no wonder then, that atorvastatin and rosuvastatin, two different statin medications, were the number 1 and 3 respectively, most-prescribed drugs in Australia over 2015-16.
Statins are not, however, the only way to reduce cholesterol. Similarly, taking a statin medication does not mean that all other efforts to lower cholesterol may be neglected.
Exercise has been shown to increase HDL cholesterol levels while maintaining LDL and triglyceride levels, improving the overall cholesterol ratio. Although the optimal type, duration, and frequency of exercise for reducing cholesterol levels is yet to be determined, exercise has categorically been shown to reduce cholesterol levels overall.
The main thing to remember is to use your common sense: if you currently have high cholesterol or other forms of cardiovascular disease (i.e. high blood pressure) and exercise is new to you, or you’ve had an extended period of inactivity, it is best to seek medical clearance prior to jumping into high-intensity exercise. Sustained, moderate-intensity (i.e. a daily walk), is likely to be just as effective.
Eat for health
There has been a lot of research into the effects of consuming particular diets on heart disease.
The Mediterranean is one such diet that has received attention in regards to cardiovascular health.
This diet is anti-inflammatory and has been associated with improved lipid profiles and reductions in blood pressure. The diet refers to the traditional diet patterns of populations living around the Mediterranean sea and involves:
Large amounts of fruit and vegetables;
Predominantly obtaining protein from plant sources, i.e. legumes and nuts;
Only consuming small amounts of red meat/meat products; F
Frequently including fish in the diet;
A high-fat intake.
But before you get excited, not all fats are created equal. The Mediterranean diet obtains most of its fat from mono-unsaturated sources (mainly olive oil) and consumes very little saturated fat and no trans fats.
You can read about some other foods that support cardiovascular health here.
What more can a naturopath do?
Seeing a naturopath is a dedicated way of assisting and guiding you towards the healthiest version of yourself. Extended appointment times mean that extra time can be spent locating driving factors of the high cholesterol and providing a framework for improved health over the long term.
In addition to careful dietary analysis and assistance; nutritional and herbal medicines may be successfully applied to manage cholesterol levels either as an adjunct to statin medications or, where appropriate, as a standalone treatment.
Spend the time to locate the driving factors
Before any prescribing takes place, the goal should be to find out the cause of the high cholesterol. Assessing the cause allows for a more targeted treatment plan that acknowledges all patients are different and have varying genetic factors, health histories, diets, lifestyles, and risk factors.
Supplement where appropriate
Using nutritional supplements at therapeutic levels allows for clinical results that just don’t tend to be possible using dietary changes alone. Sometimes dietary tweaks are all that are required but using targeted nutritional strategies can help to support various body processes; including the detoxification of multiple medications which is imperative in regards to longer-term health.
Supplementation can also assist in reducing the inflammation associated with high cholesterol levels (and the often-accompanying plaque deposits). Finally, using specific supplementation can assist in stopping or slowing the progression of disease.
Specific herbal medicines
Herbal medicines also have a role to play in addressing heart disease which is supported by both years of traditional usage, as well as current scientific research. Herbs may be used to improve lipid profiles, reduce blood pressure, support the capacity of the heart muscle itself, improve blood flow, and support overall vitality.
The intention of this article is in no way to play down the role of statin medication, but simply to provide some education around high cholesterol and what else you can do to help alongside your medication.
If you are looking to empower yourself and do more for your heart, please get in touch.
References
Australian Prescriber (2016). Top 10 drugs. Australian Prescriber, 39(6), 220.
Brunner, E., Rees, K., Ward, K., Burke, M., Thorogood, M. (2007). Dietary advice for reducing cardiovascular risk (Review). The Cochrane Library, 2007, 4, 1-113.
Estruch, R., Ros, E., Salas-Salvado, J., Covas, M., Corella, D., Aros, F., Gomez-Gracia, E., Ruiz-Gutierrez, V., Fiol, M., Lapetra, J., Lamuela-Raventos, R., Serra-Majem, L., Pinto, X., Basora, J., Munoz, M., Sorli, J., Martinez, J. & Martinez-Gonzalez, M. (2013). Primary prevention of cardiovascular disease with a mediterranean diet. The New England Journal of Medicine, 368(14), 1279-1290.
Domenech, M., Roman, P., Lapetra, J., Garcia de la Corte, F., Sala-Vila, A., de la Torre, R., Corella, D., Salas-Salvado, J., Ruiz-Gutierrez, V., Lamuela-Raventos, R., Toledo, E., Estruch, R., Coco, A. & Ros, E. (2014). Mediterranean diet reduces 24-hour ambulatory blood pressure, blood glucose, and lipids. One year randomized, clinical trial. Hypertension, 2014(64), 69-76
Mann, S., Beedie, C. & Jimenez, A. (2014). Differential effects of aerobic exercise, resistance training and combined exercise modalities on cholesterol and the lipid profile: review, synthesis and recommendations. Sports Medicine, 44, 211-221.
