Cholesterol lowering
Coronary risk factors
The risk of developing cardiovascular disease is determined by a number of different risk factors. Some risk factors, such as age, sex and family background are outside of your control — they are ‘non-modifiable’. However, there are other ‘modifiable’ risk factors that can be controlled through lifestyle changes or through medical intervention. These include such things as smoking, having high blood pressure, being physically inactive, being overweight or obese, and having raised blood cholesterol levels.
Hypercholesterolaemia
Raised cholesterol, or hypercholesterolaemia, is one of the main risk factors for cardiovascular disease. Studies from Australia and overseas indicate that high blood cholesterol accounts for 30 to 40 per cent of all deaths due to coronary heart disease. This is because too much cholesterol in your blood can cause fatty deposits to build up in the blood vessels, making it extremely difficult for the blood to flow through freely. This blocking of the coronary blood vessels may lead to a heart attack.
Reducing the risk through diet
The good news is that blood cholesterol is a modifiable risk factor for cardiovascular disease. One of the main causes of high blood cholesterol is the consumption of too much saturated fat. Foods containing saturated fats, such as meat fat, full-cream dairy products, processed foods containing palm or coconut oil, and greasy takeaway foods, should be avoided.
Trans fatty acids should also be avoided. These occur in some meats, butter and dairy products in small amounts, and are also formed when vegetable oils are hydrogenated (hardened) to make margarine. The National Heart Foundation of Australia recommends that saturated fats, together with trans fatty acids, should contribute no more than 8 per cent of your total energy/kilojoule intake.
While people with elevated cholesterol levels should also avoid cholesterol-containing foods, such foods have been found to have less of an impact on blood cholesterol levels than foods that are high in saturated fats.
Reducing the risk with medication
Some people have a genetic susceptibility to elevated cholesterol levels (so-called familial hypercholesterolaemia), while others may already have been diagnosed with unacceptably high cholesterol levels or some form of cardiovascular disease. Such people may require medication in addition to lifestyle changes. Even if you are on cholesterol-lowering medication, you should still eat a healthy diet, exercise regularly and maintain an acceptable body weight.
Risk reduction in people with heart disease
Several clinical trials undertaken in recent times have demonstrated that lowering low-density lipoprotein (LDL) cholesterol levels in people with coronary heart disease sharply reduces the risk of them having a heart attack and also of them dying of coronary heart disease. In fact, in people with coronary heart disease, there appears to be very few more effective treatments than cholesterol lowering to reduce their risk of heart attack and death.
Although elevated cholesterol can be controlled by diet and medication, it cannot be cured. It is therefore important that you do not discontinue treatment, as this could result in a rapid return to high cholesterol, and a corresponding increased risk of coronary heart disease.
Last Reviewed: 28 February 2003
- 1. National Heart Foundation. Position statement. Guide for the use of lipid lowering drugs in adults.
2. National Heart Foundation. Risk factors for heart disease.
3. National Heart Foundation. Cholesterol and fat.
4. National Heart Foundation. Dietary fats.
5. National Institutes of Health. NHLBI. Cholesterol lowering in the patient with coronary heart disease. Physician Monograph.
