It is worthwhile to remember that it is only your age, sex and genes, which are beyond your control.

Know Your Numbers!

High blood cholesterol and triglycerides themselves may not cause symptoms, so many people are unaware that their lipids are high and that that they are at an increased risk. It is extremely important to find out what your lipid numbers are because lowering cholesterol and triglyceride levels and increasing HDL levels lessens the risk for developing heart disease and reduces the chance of a heart attack or dying of heart disease, even if you already have it.

Lowering your blood cholesterol level can slow, stop, or even reverse the buildup of plaque. Cholesterol lowering can reduce your risk of a heart attack by lowering the cholesterol content in unstable plaques to make them more stable and less prone to rupture. This is why lowering your LDL-cholesterol is such an important way to reduce your risk for having a heart attack. Even in people who have had one heart attack, the chances of having future attacks can be substantially reduced by cholesterol lowering.

This is important for everyone--younger, middle age, and older adults; women and men; and people with or without heart disease.

But it is a MUST if you have diabetes!

When you get a blood test for cholesterol levels, your doctor may also check your levels of total, HDL and LDL cholesterol and triglycerides.

How Can I Prevent Cholesterol Problems?

As with many other health problems, prevention is the best medicine. You can help prevent high cholesterol and reduce your risk of cardiovascular disease by:

• Keeping your weight in check.
• Eating no more than 300 mg of cholesterol each day.
• Getting no more than 30% of your daily calories from fat.
• Exercising three to four times a week (vigorously if you can, but moderate exercise is better than none at all).
• Quit Smoking and the use of tobacco in any form.

Treatment

We have seen above that the major part of the blood cholesterol consists of LDL, the "bad" cholesterol. The "good" HDL is just a small portion of the total cholesterol. The main aim is therefore to lower the cholesterol which would decrease the LDL levels, increase the HDL levels, and to normalize the blood levels of the "ugly" triglycerides.

The management of your lipid abnormalities lies in three major areas:

a) Diagnose and treat the associated factors.

You must keep the diabetes and the blood pressure under good control. Often a good control of the blood glucose levels will lead to a rise in the HDL levels and a drop in the raised triglyceride levels. Moreover, this will definitely help in decreasing the complications such as atherosclerosis.

b) Lifestyle Modifications

Diet Your diet should be low on fats and cholesterol rich foods. Your doctor will guide you on the foods which you should cut down on or avoid, if possible.

Exercise Regular exercise helps in lowering the LDL levels. It increases the HDL levels and also causes the triglyceride levels to fall. We have shown above the most important lipid abnormality in a person with diabetes is low HDL and high triglyceride levels. So exercise would be an excellent option for you, especially if you also are overweight with a large waist measurement ( raised Waist to Hip ratio).

Weight If you are overweight and especially if this is "central", i.e. you have a large waist size, it is very important that you use diet and exercise to normalize the weight.

c) Medications There are four major groups of medications which are currently available for use in correcting the lipid abnormalities. These are the bile acid-binding resins, niacin, fibrates, and the HMG-CoA reductase inhibitors ( statins).

Your doctor will decide which is appropriate for you.

Is there some way I can increase the levels of the "good" HDL Cholesterol?

As opposed to lowering your bad cholesterol, it is sometimes more difficult to raise your good cholesterol levels. Most efforts that will lower the bad cholesterol 30% will only increase the good HDL cholesterol 5%. However, remember that even this modest improvement is magnified by the improved ratio of bad to good cholesterol.

Some steps which you can take in addition to whatever your doctor prescribes are:

• Regular exercise.
• Stopping smoking not only lowers the risk of heart disease directly, but also will generally result in an increase in the HDL.
• It is true that an ounce or so of alcohol, particularly red wine will raise HDL, but please don't start drinking alcohol for this reason!

My triglycerides are high. How can that be treated?

If treatment is needed for high triglycerides (hypertriglyceridemia), the principles are similar to that for high cholesterol. That is:

• Reverse any medical conditions or change medication which may be worsening the problem.
• Low fat diet (this is even more important than with high cholesterol)
• Maintain ideal body weight (this is particularly important)
• Exercise regularly (this is particularly important, too)
• Avoid alcohol
• Avoid simple sugars
• Obtain good control of diabetes if present
• Your doctor may prescribe drugs which are more specific in lowering triglyceride levels.