BROUGHT TO YOU BY KNOW YOUR NUMBERS! What is cholesterol? Do you have high cholesterol? According to The American Heart Association high cholesterol is one of the major CONTROLLABLE risk factors for coronary heart disease, heart attack and stroke. Are you already at risk of coronary heart disease? If you have other risk factors such as smoking, high blood pressure or diabetes, this risk increases even further. The following article explains why knowing your cholesterol levels is important to your overall health.
In This Issue: } Know Your Numbers: Blood Pressure and } High Triglycerides? These Dietary Changes Can Help } How Soluble Fiber Affects Your Know Your Numbers: Blood Pressure and Have high blood pressure? Then you have a higher risk of developing coronary artery disease. Have high cholesterol too? The risk is higher. Video Spotlight: 5 ways to raise your good cholesterol Tips for following a hearthealthy diet One in three Americans has high blood pressure, (HBP) putting them at a higher risk of developing coronary artery disease (CAD). If other conditions, such as elevated cholesterol are also present, the risk for CAD is even higher. What is high blood pressure? Blood pressure is the force of blood as it moves through the arteries. High blood pressure can lead to coronary artery disease, heart failure, stroke, kidney failure and other health problems. If left untreated, it can damage the heart, blood vessels, kidneys and other organs. Because there are generally no symptoms associated with high blood pressure, it s often called the silent killer. A doctor or nurse can measure your blood pressure in his or her office. People who are being evaluated or treated for high blood pressure may also learn how to measure their blood pressures at home and share the results with their doctors. 1 1
Know Your Numbers: Blood Pressure and (continued) Blood pressure is measured in millimeters of mercury, abbreviated mm Hg. Readings are recorded with your systolic pressure on top and your diastolic pressure on the bottom. These two numbers are separated by a line, such as 110/70 mm Hg. How is cholesterol measured? First, a little about cholesterol. Basic cholesterol tests done in your doctor s office will measure four things: H igh-density Lipoprotein (HDL): This is the good cholesterol. It keeps the LDL cholesterol from getting lodged in your artery walls. *Systolic pressure (top number): Measures the pressure in your arteries while your heart is pumping. L ow-density Lipoprotein (LDL): The bad cholesterol, which leads to buildup of plaque inside your artery walls, putting you at a higher risk of a heart attack or stroke. *Diastolic pressure (bottom number): Measures the pressure between heartbeats. According to the National Heart Lung and Blood Institute, the criteria for blood pressure are: T otal : Measures your HDL plus your LDL as well as other lipid components. N ormal: Systolic less than 120 and diastolic less than 80. T riglycerides: Another fatty substance in your blood that affects your risk for heart disease. Prehypertension: Systolic 120-139 or diastolic 80-90. screenings involve a small sample of blood being drawn, generally from your arm. That sample is then analyzed in a lab. Fasting tests are the most accurate, and it s generally recommended that you fast for 9-12 hours before the test. Check with your doctor to see what s recommended for you before your test. S tage 1 High Blood Pressure: Systolic 140-159 or diastolic 90-99. S tage 2 High Blood Pressure: Systolic 160 or higher or diastolic 100 or higher. What is cholesterol? And why is it important to me? Having high cholesterol is another risk factor for coronary artery disease. As someone diagnosed with high blood pressure, you already have an elevated risk of developing coronary artery disease, so it s important to have your cholesterol levels checked and to take action, if necessary. Over the years, doctors have developed a risk calculator to assist in predicting coronary artery disease. They have learned that in addition to blood pressure readings, there are a number of factors that raise the risk of developing CAD, including gender, whether you smoke, your total cholesterol and your LDL cholesterol number. Coronary artery disease happens when plaque builds up inside your arteries, and can, over time, narrow your arteries, reducing blood flow to your heart. Pieces of plaque can break off as well, causing clots to develop on the surface of the plaque which can completely block blood flow to your heart, causing a heart attack. Studies have shown that if you have high cholesterol, lowering it may reduce or even stop the buildup of that plaque in your arteries, lessening your risk of a heart attack. Lowering your cholesterol may also reduce the risk of that plaque breaking off. 2 2
Know Your Numbers: Blood Pressure and (continued) The National Education Program recommends all adults age 20 and over should have a fasting cholesterol test done every 5 years. Those who have other risk factors for heart disease may need more frequent testing. Men over age 45 and women over age 50 may also need more frequent tests. All about numbers Below are the recommended numbers for healthy people. If you already have coronary artery disease or one of it s equivalents, your doctor may give you different goals. According to the American Heart Association, for total cholesterol: Desirable: Less than 200 mg/dl Borderline high: 200-239 mg/dl High: 240 mg/dl and higher. For HDL: Note: HDL is the good cholesterol and you want higher numbers of this type. Low HDL: Less than 40 mg/dl for men and less than 50 mg/dl for women High/Optimal HDL: 60 mg/dl and above (This is associated with a lower risk for heart disease.) For LDL: Optimal: Less than 100 mg/dl Near or above optimal: 100-129 mg/dl Borderline high: 130-159 mg/dl High: 160-189 mg/dl Very high: 190 mg/dl and above For Triglycerides: Normal: Less than 150 mg/dl Borderline high: 150-199 mg/dl High: 200-499 mg/dl Very high: 500 mg/dl and higher Your doctor can help you interpret your results and decide what, if anything, you should be doing to improve your health. How can I lower my cholesterol? If your cholesterol is high, there are a number of lifestyle changes you can make that may help lower your cholesterol. Some of these you ll probably recognize -- since some are the same recommendations for helping to lower high blood pressure. These include: Regular exercise,which can help your body produce more HDL. Always talk with your doctor first before increasing your activity level. Reducing the amount of trans fats in your diet,which can also increase HDL. Eat a nutritious and balanced diet. Stop smoking,and avoid secondhand smoke whenever possible. Medications.Some people may need medicine in addition to good lifestyle practices to help lower their cholesterol. Talk with your doctor to see what s right for you. Since both high blood pressure and high cholesterol are risk factors for coronary artery disease, you should make sure that you know your numbers and that you are following your doctor s recommendations to help lower your risk of a heart attack or stroke. SOURCES: Davidson, M. Focusing on High-Density Lipoprotein for Coronary Heart Disease Risk Reduction. Cardiology Clinics. 2011;29(1): 105-122. National Heart Lung and Blood Institute. What is High Blood Pressure? Accessed: 11/21/2011 American Heart Association. About. Accessed: 11/21/2011 National Heart Lung and Blood Institute. What is? Accessed: 11/21/2011 Copyright 2014 myoptumhealth. 3 3
High Triglycerides? These Dietary Changes Can Help High triglycerides alert: Take steps to lower your risk of a heart attack or stroke. If you think high triglycerides can t affect your health, think again. Most fat in food, as well as in your body, is present in the form of triglycerides. Usually the body can control the amount of triglycerides it makes. But sometimes, unhealthy levels build up in the blood. High triglycerides can increase your risk of a heart attack or stroke, among other health risks. Typically, a high triglyceride level is a signal that your diet needs extra attention. Or, it may be due to an inherited disorder. Triglycerides are often raised in people with poorly-controlled diabetes or kidney problems. They can also be raised in a person with an underactive thyroid. The National Education Program guidelines for fasting triglycerides are: Normal Borderline high High Very high Less than 150 mg/dl 150 to 199 mg/dl 200 to 499 mg/dl 500 mg/dl or higher How to lower your level If your triglycerides are high, it s likely you have other major heart disease risk factors. These can include obesity or high blood pressure. Diet and lifestyle changes can help you lower your triglycerides. They may also keep your body mass, cholesterol, diabetes and blood pressure in check. Here s how to begin: Lose excess weight. If you re overweight, a weight loss of even a few pounds can be helpful. Taking in fewer calories and having smaller portion sizes are good ways to start. Avoid sugary foods and beverages. Like blood glucose levels, triglycerides are affected by the amount of sugar in the diet. Try to avoid sweets, soda, cakes, pastries and cookies. Also, limit other types of processed grains, like white pasta, white potatoes and white bread. Eat plenty of wholesome foods. Fresh fruits (versus juice) Fresh or frozen vegetables Beans, such as lentil, split pea, kidney, pinto and black Small portions of whole grains, such as brown rice, sweet potatoes, barley or oatmeal Lean proteins, such as fish, skinless chicken, turkey, tofu or very lean beef Increase omega-3 fats in your diet. Eat fatty fish, such as salmon, sardines or light tuna at least twice a week. Also include walnuts, flaxseed oil and dark leafy greens for vegetarian sources of omega-3. Other healthy fats include avocados, olive and canola oil, natural peanut butter and nuts (in moderation, as they are high in calories). Use these fats to replace saturated and trans sources of fat. These sources can include butter, cheese, red meat, fried foods, margarine and processed foods. Ask your doctor about an omega-3 supplement. If your triglycerides are high and you re not getting enough omega-3, ask your doctor if a supplement is right for you. The American Heart Association recommends 2 to 4 grams daily of DHA plus EPA (fish oil source of omega-3 fats) under a doctor s supervision. 4 4
How Soluble Fiber Affects Your Soluble fiber is where it s at for helping to get your cholesterol under control. Check out sources and ideas for how to include this fiber in your diet. High Triglycerides? These Dietary Changes Can Help (continued) Avoid or limit alcohol. Alcohol is high in calories and sugar. It can also have a powerful effect on triglycerides. Small amounts of alcohol may increase your level. This can be especially true if you fall into the high or very high category. Exercise regularly. With your doctor s approval, work up to at least 30 minutes of moderate-intensity physical activity at least 5 days a week. That s 150 minutes per week. This can also raise HDL ( good ) cholesterol. Whether it s walking, swimming or biking, choose something you enjoy so you ll stick to it. Consider combining lifestyle changes and medication to treat hypertriglyceridemia. The medications generally used for treating elevated cholesterol (statins) may also reduce triglycerides. However, when the triglyceride levels are high, medication for the treatment of triglycerides may be needed. In this situation, triglyceride medications are used in addition to cholesterol medications. But they do not replace cholesterol medications. SOURCES: American Heart Association. Triglycerides. Accessed: 11/21/2012 American Heart Association. Fish and omega-3 fatty acids. Accessed: 11/21/2012 National Education Program. ATP III guidelines at-a-glance quick desk reference. Accessed: 11/21/2012 National Heart, Lung and Blood Institute. What is cholesterol? Accessed: 11/21/2012 Copyright 2014 myoptumhealth. If you have high cholesterol, your doctor has likely told you to follow a heart-healthy diet. Aside from cutting back on dietary cholesterol, unhealthy fats and salt, you were probably also told to increase your fiber intake. But how much fiber? And what type of fiber is best for helping to get your cholesterol under control? Soluble fiber to the rescue There are two main types of fiber: insoluble and soluble. Both have health benefits, but only soluble fiber lowers the risk of heart disease. Soluble fiber dissolves into a gel-like substance in the intestines. This helps to block cholesterol (specifically, bad LDL) from being absorbed. Soluble fiber can also help to regulate blood sugar for people with diabetes. Research has shown that people who raise their soluble fiber intake by 5 grams to 10 grams a day have about a 5 percent drop in their LDL cholesterol. And eating as much as 10 g to 25 g a day can lower your LDL even more. Most foods have a combination of both types of fiber. Because food sources vary greatly, choose soluble fiber foods carefully to get the highest amount possible. 5 5
How Soluble Fiber Affects Your (continued) Fiber grams in foods Not sure how much fiber you re getting from food? The following list can help you plan how to fill your daily quota, and offers soluble fiber amounts along with the total fiber. Remember, your goal is to aim for at least 5 g to 10 g of soluble, and a total of at least 25 g to 30 g (or more) of total fiber per day. Whole-grain cereals (1/2 cup cooked) Soluble Total Barley 1 4 Oatmeal 1 2 Oat bran 1 3 Psyllium seeds (1 Tbs) 5 6 Fruit: 1 medium (except where noted) Soluble Total Apple 1 4 Banana 1 3 Blackberries (1/2 cup) 1 4 Citrus (orange, grapefruit) 2 3 Nectarine 1 2 Peach 1 2 Pear 2 4 Plum 1 1.5 Prunes (1/4 cup) 1.5 3 Legumes (1/2 cup cooked) Soluble Total Black beans 2 5.5 Kidney beans 3 6 Lima beans 3.5 6.5 Navy beans 2 6 Northern beans 1.5 5.5 Pinto beans 2 7 Lentils (yellow, green, orange) 1 8 Chickpeas 1 6 Black-eyed peas 1 5.5 Vegetables Soluble Total Broccoli 1 1.5 Brussels sprouts 3 4.5 Carrots 1 2.5 Getting your daily dose As always, the trick is to find ways to work these delicious foods into your everyday meal plan. Here are some tips to get you started. Have a bowl of oatmeal or oat bran for breakfast or a mid-afternoon snack. Add walnuts for crunch, plus a dash of cinnamon and a teaspoon of maple syrup for flavor. Mix psyllium seeds into oatmeal, a smoothie or yogurt. Make a split pea or lentil soup on the weekend and serve for lunch or dinner. 6 6
How Soluble Fiber Affects Your (continued) Rinse off canned kidney beans and add a half cup to your salad. Toast cooked garbanzo beans and eat as a snack. Mix black, Lima or pinto beans into rice for a tasty side dish. Add barley to soups instead of pasta. Snack on high soluble fiber fruits such as oranges, grapefruits, pears and apples. Add banana to your morning cereal. Mix prunes into oatmeal for breakfast or simply snack on them with a handful of walnuts. Saute Brussels sprouts in a pinch of olive oil and garlic and add a dash of salt, pepper and Parmesan cheese to taste. Finally, remember that many commercial oat bran products (muffins, chips, waffles) actually contain very little fiber. They may also be high in sodium, total fat, saturated and trans fat. Make sure to read the labels on all packaged foods before you make your selection. SOURCES: National Heart Lung and Blood Institute. Your guide to lowering your cholesterol with TLC. Accessed: 12/18/2009 American Heart Association., fiber and oat bran. Accessed: 12/19/2009 Copyright 2014 myoptumhealth. Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Administrative services provided by United HealthCare Services, Inc. or their affiliates. The information provided in this article is for general informational purposes only and not intended to be nor should be construed as medical advice. You should consult your own doctor to determine what may be right for you. 2014 United HealthCare Services, Inc. UHCEW000000-000 1/14 7 7