1. Cholesterol, blood pressure, and heart disease
Ms. Treto
Physical Therapy Academy

2. About cholesterol Soft, fat-like, waxy substance Bloodstream and cells
Needed for cell membranes and hormones and to make vitamin D
Comes from 2 sources
Body produces it (mostly genetic) in liver (1000 mg day)
Food sources (animal products – meats, poultry, fish, eggs, butter, whole milk, and cheese, not from plant sources) (100 – 500 mg day)
Foods with trans fats or saturated fats may cause the body to produce more cholesterol

3. About cholesterol Must be transported through blood
Carriers are called lipoproteins
Low-density lipoprotein (LDL)
High-density lipoprotein (HDL)
Lipoprotein = protein + fat
LDL, more fat, less protein
HDL, more protein, less fat

4. LDL vs. HDL LDL = “bad” Too much can clog arteries by forming plaque
Atherosclerosis can cause heart attack or stroke

5. LDL vs. HDL
HDL = “good”
Tends to carry cholesterol away from arteries and back to liver
May also remove excess cholesterol from plaque in arteries, slows buildup

6. Triglycerides Form of fat
Also made in body (body fat stored as triglyceride) and from food
Help transport dietary fat, metabolism
Trigger liver to make more cholesterol, rising LDL and total cholesterol

7. Healthy Levels Total cholesterol LDL Optimal – under 200 mg/dL
Borderline high risk – mg/dL
High risk – 240 mg/dL and up
LDL
Optimal – less than 100 mg/dL
Near/Above optimal – mg/dL
Borderline high – mg/dL
High – 160 – 189 mg/dL
Very high – 190 mg/dL
Source: National Cholesterol Education Program, National Heart, Lung, and Blood Institute

8. Healthy Levels HDL Triglycerides Low - less than 40 mg/dL
High – above 60 mg/dL (may lower risk for heart disease)
Women tend to have higher HDL due to estrogen (needs to be over 50 mg/dL)
Triglycerides
Normal – less than 150 mg/dL
Borderline high – 150 – 199 mg/dL
High – above 200 mg/dL
Source: National Cholesterol Education Program, National Heart, Lung, and Blood Institute

9. Common misconceptions
Using margarine instead of butter will help lower my cholesterol
Thin people don’t have to worry about high cholesterol
If a label lists no cholesterol, it’s a “heart-healthy” choice
Eggs – good or bad?
Women don’t need to worry about cholesterol
Only middle-aged people should have their cholesterol checked

10. What affects cholesterol?
Diet
Poly and monounsaturated fats may help lower cholesterol when used in place of saturated fats, but still limit
High carbs, excessive alcohol may increase triglycerides
Soluble fiber may lower LDL, not HDL
Weight
Physical activity
Age
Gender
Heredity

11. Why does it matter?
Coronary heart disease is caused by atherosclerosis
Single leading cause of death
The higher LDL you have plus risk factors increases risk for heart attack
Smoking
High Blood pressure
Low HDL
Family history of early heart disease
Age

12. Prevention of high cholesterol
Get it checked
Watch fats, eat healthy
Consume less than 300 mg of cholesterol a day
Be active
Quit smoking
Some may need medication
Lipitor, Crestor, Zocor
Vytorin
Zetia

13. Blood pressure 1 in 3 adults has hypertension
No symptoms, nearly 1/3 of those people don’t know they have it
No known cause
2 forces
Blood pumps to arteries and through circulatory system
Arteries resist blood flow
Arteries elastic, stretchy
Heart beats times a minute

14. Blood pressure Systolic (top) – heart is beating
Diastolic (bottom) – heart resting
Normal – 120/80 mm Hg
Pre-hypertensive – /80-89 mm Hg
Hypertensive – 140/90 mm Hg
May take several readings
“White coat hypertension”
Hypertension increases risk for heart disease and stroke
Number 1 controllable risk factor for stroke

15. Blood pressure Sodium/salt Potassium
Holds excess fluid in body, heart has to work harder
Potassium
Blunts effects of salt on blood pressure

16. Controlling hypertension
Reduce fat (particularly saturated fat)
Stop smoking
Cut back on alcohol
Be active
May need medication
Stress management

17. Heart disease risk factors
Uncontrollable
Age
Male gender
Heredity (including race) – African Americans = higher blood pressure. Also higher among other races
Controllable
Smoking (2-4x higher than non-smokers)
High cholesterol (high HDL can be positive risk factor)
High blood pressure

18. Heart disease risk factors
Controllable
Physical inactivity
Obesity/overweight (especially in abdominal area)
Diabetes
Other factors
Stress
Too much alcohol
Moderate drinkers = less risk than non-drinkers (may increase HDL cholesterol)

19. Phytonutrients Soy protein may reduce risk of heart disease
Especially when replacing foods high in saturated fat
Plant sterols/stanols
Found naturally in fruits/veggies, plant oils may lower LDL
Omega-3 fatty acids
Two weekly servings of fish may be heart healthy
Folic Acid
May lower homocysteine levels
Antioxidants