Cholesterol

What test do I need?

A standard fasting lipid (cholesterol) panel is a good starting point. This test is done after fasting for 10 to 12 hours and measures total cholesterol, LDL (bad cholesterol), HDL (good cholesterol) and triglyceride (floating fat) levels.
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What about more advanced tests?

More advanced testing such as direct cholesterol measurements, lipoprotein(a) and c-reactive protein (CRP) testing are only indicated if the combination of your medical history, family history and your initial cholesterol results (see above) suggest that further testing may be useful. In borderline cases, these tests (available at any PAMF clinic) may help doctors decide if medications or stricter cholesterol guidelines are indicated.
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What is a typical South Asian cholesterol profile?

The cholesterol profile for South Asians has some distinct characteristics when compared to other ethnic groups.

  • Triglyceride levels are usually high
  • HDL (good cholesterol) levels are usually low
  • LDL (bad cholesterol) levels tend to be normal or only mildly elevated*
*Since most physicians emphasize LDL as the primary heart attack risk factor, cholesterol abnormalities in many South Asians may be overlooked. Although keeping your LDL at goal levels is still important, also be sure to keep track of your triglycerides and HDL.

You can read more about cholesterol at www.pamf.org/patients/cholesterol.html. However, this provides general information and guidelines. Please consult with your personal physician for specific guidelines and personal goals.
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What should I do if I have high cholesterol?

First, discuss with your doctor which components of your cholesterol results are abnormal and then make the appropriate changes. Below is a list of some helpful tips for improving your cholesterol. Refer to the nutrition section for more details.

  • High triglycerides
    • Lose weight.
    • Exercise.
    • Replace bad fats with good fats. (Emphasize foods rich in omega-3s, such as fish, walnuts and flaxseed.)
    • Reduce refined carbohydrates. (These bad carbohydrates raise triglycerides as much as bad fats.)
    • Switch to non-fat or low-fat dairy products.
    • Limit or eliminate alcohol intake.
    • Increase fiber in your diet. (Aim for at least 30 grams of soluble fiber per day.)

  • High LDL
    • Replace bad fats with good fats.
    • Increase fiber in your diet. (Aim for at least 30 grams of soluble fiber per day.)
    • Consider using margarine-like spreads like Benecol® or Take Control®, which can help reduce LDL but must be used regularly as directed.

  • Low HDL:
    • Exercise. (Aerobic plus strength training)
    • Lose weight.
    • Quit smoking.
    • Replace saturated and trans fats with healthy fats.
    • Increase fiber in your diet. (Aim for at least 30 grams of soluble fiber per day.)

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Are cholesterol medications safe to take?

If diet and exercise cannot help you achieve your recommended cholesterol levels, then medications are the only other option. While many patients are skeptical about the safety of cholesterol medications like statin medications (such as Lipitor® or Zocor®), South Asians in particular should be thankful that medications exist that can significantly reduce their high risk of a heart attack or stroke.

In fact, statins are safer than many over-the-counter medications. The most common side effects are liver and muscle damage and these occur in less than 1 percent of patients. More importantly, these side effects can be monitored closely with blood tests. Aside from statin medications, South Asians may also benefit from medications including prescription niacin or fibrates (such as TriCor® or Lopid®), which can help reduce triglycerides and raise HDL (good cholesterol). These options can be discussed with your doctor.
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Resources

PAMF offers a variety of resources including health education classes and lectures, as well as Shared Medical Appointments (for PAMF patients) focused on specific health concerns. Learn more about support and resources at PAMF.

Last reviewed: January 2008

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