HLTH - More stringent cholesterol guidelines issues

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http://www.boston.com/dailynews/136/nation/New_cholesterol_guidelines_not:.shtml

New cholesterol guidelines not cause for alarm, but experts say talk to your doctor

By Malcolm Ritter, Associated Press, 5/16/2001 02:44

So you've heard that new guidelines recommend a more aggressive approach to preventing and managing high cholesterol levels, and that millions more Americans might be told they need treatment

What should you do about it?

First, heart specialists say, don't panic. This is about dealing with a long-term problem, not an emergency.

But one thing people can do right away is get out a tape measure and check their waists, said Dr. Margo Denke of the University of Texas Southwestern Medical Center in Dallas.

Keep the tape measure parallel to the floor. If it shows a waist of more than 40 inches for a man or 35 inches for a woman, make an appointment with a doctor, said Denke, who was on the expert panel that wrote the National Institutes of Health's new guidelines.

The reason is to check for ''metabolic syndrome,'' a condition highlighted in the guidelines as raising the risk for heart attack.

Apart from that, healthy people who've been told they have ''borderline'' cholesterol levels like 200 to 240 for total cholesterol but don't suffer symptoms of heart disease should find a good time to ask their doctors what the new guidelines mean for them, experts say.

They should probably check it out ''sometime in the course of the next year,'' says Dr. Ronald Krauss, spokesman for the American Heart Association. But people with symptoms or particular concerns should feel free to do it sooner, he said.

Dr. Harlan Krumholz, a Yale cardiologist, suggested that people with heart disease check with their doctor in the next three to six months. And healthy people with no known cholesterol problem should ask about the guidelines at their next checkup, he said.

''I don't think these guidelines should elicit a rush where everyone feels they need to find out tomorrow,'' Krumholz said.

For healthy adults in general, the guidelines unveiled Tuesday recommend getting a lipoprotein profile which measures blood levels of ''good'' cholesterol, ''bad'' cholesterol and a fatty substance called triglycerides every five years.

Several doctors noted that many patients will find they're already being treated in accordance with the new guidelines, because the new document is based on information doctors have known about for some time.

Still, the federal government says the guidelines could dramatically increase the number of Americans getting treated for high cholesterol.

Some 36 million Americans might end up on medications to lower cholesterol, about triple the current figure of 13 million, the NIH said. The number on dietary treatment could reach about 65 million Americans, up from some 52 million.

Doctors stressed that diet and exercise remain the first line of treatment. Many people can reduce their ''bad'' type of cholesterol by 10 percent to 20 percent through a dietary approach, Krauss said.

For those who are prescribed drugs to lower cholesterol, the most common kind is a class called statins. Krauss said side effects, such as muscle soreness, are rare and easily reversible. ''It really is a category of drugs patients should not be apprehensive about,'' he said.

-- Anonymous, May 16, 2001


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