Be Mindful Of What You Put In Your Coffee
Though the research is mixed on whether coffee itself can raise your cholesterol levels, researchers do know that saturated fat increases your cholesterol levels. And saturated fat can be found in a lot of things we put in coffee. Here are a few to avoid or enjoy sparingly.
- Cream and half-n-half. The classic coffee lighteners made with whole-fat milk have high levels of saturated fat, which has been shown to increase levels of LDL cholesterol. More cholesterol-friendly choices include nonfat or low-fat options or plant-based milks with no saturated fat.
- Sweet coffee drinks. Those frothy, sugary coffee concoctions popping up at more and more coffee shops have more in common with a milkshake than a cup of coffee and, besides packing in a lot of sugar, may contain ingredients high in saturated fat. Ask about ingredients before you indulge.
- Bulletproof coffee. Popular with fans of the ketogenic diet, bulletproof coffee is a breakfast substitute that calls for adding butter and coconut oil into your daily cup of joe. Both have high levels of saturated fat and there have been several case reports of people who regularly drink bulletproof coffee having sharp rises in their LDL cholesterol.
The bottom line for coffee and cholesterol is the same as many foods and beverages: Enjoy it in moderation, be mindful of how it is made, and know what ingredients are going into it.
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How Long Will I Need Cholesterol Medication
Typically, people who take cholesterol medication need it for the rest of their lives, and youre more likely to need it as you get older. However, children and teens can have high cholesterol, too. Lifestyle changes can often prevent the need for medication or work with medication to lower your risk of coronary artery disease.
Effect Of Low Dose Omega
Initial studies of the effect of fish oil administration on cardiovascular outcomes were favorable, demonstrating a reduction in events including all-cause mortality. However, more recent studies have failed to confirm these favorable results. In these more recent studies the use of other drugs, such as statins, that reduce cardiovascular disease were more intensively utilized. The outcomes studies that will be described below were carried out with doses of EPA and DHA that are lower than the doses used to lower plasma TGs. We will limit our discussion to the administration of fish oil as a drug and not discuss diet studies, such as DART, which had patients increase fatty fish intake .
The above results indicate that low dose fish oil do not significantly and consistently reduce the risk of cardiovascular disease.
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What Causes High Triglycerides
Aside from consuming a high-fat and/or high-carb diet, other lifestyle factors can contribute to high triglycerides, specifically excess weight, lack of exercise, drinking too much alcohol and smoking. Dr. Malaney adds that it can also be a side effect of certain medications, such as some birth control pills, beta blockers, antipsychotics medications, and corticosteroids.
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Lifestyle Management For High Triglycerides
If your triglyceride levels fall into the borderline high category, says Jacoby, Its extremely likely that making lifestyle improvements alone will control your levels. Most often, people with moderate levels have metabolic problems, including prediabetes and diabetes, which also respond well to healthy lifestyle changes.
The AHA/ACC guidelines recommend the following lifestyle changes to lower levels:
- Reduce your body weight
- Reduce your carbohydrate consumption
- Eat omega-3 fatty acids
Combining a low-carb diet with exercise and fish oil is often enough to get control of your triglycerides, says Jacoby, and can have the additional benefit of addressing metabolic problems and reducing body weight. For the majority of people with moderate to severe elevations, triglyceride levels are very responsive to a heart-healthy lifestyle. Its worth trying to normalize through those changes and then move on to medications if lifestyle isnt sufficient, he says.
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A Promising New Treatment For High Triglycerides
- By Gregory Curfman, MD, Assistant Professor of Medicine, Former Editor-in-Chief, Harvard Health Publishing
When you think about fat circulating in the bloodstream, you might immediately think of cholesterol. But theres another type of fat you shouldnt ignore: triglycerides. As with cholesterol, high triglycerides can also increase the risk of having a heart attack. Existing drugs for lowering triglycerides arent that good at reducing heart attack risk. Thats why a report on a new way to lower triglycerides, New England Journal of Medicine, is generating some excitement among cardiologists.
Triglycerides And Cholesterol: What Are High Levels And How To Lower Them To Avoid Heart Disease
In Argentina, only one in three cardiac patients meets the goals of cholesterol control established by the Argentine Society of Cardiology . The data is even more worrying for patients with very high cardiovascular risk, since in this group the level of monitoring decreases to 16%. The high cholesterol -o hypercholesterolemia is one of the so-called silent diseases. It does not cause symptoms, pain or warning signs.
Cholesterol is onefatty substance It is present in all tissues of the human body and is necessary for the normal functioning of the organism. It serves as raw material for cell membranes and for the synthesis of hormones such as estrogens and androgens.
Then, cholesterol is not an enemybut in excess it generates serious consequences for health by increasing the probability of cardiovascular disease. There are other lipid substances in the blood in addition to cholesterol. Among them are the triglycerideswhose elevation also increases the risk of heart conditions.
The cardiologists at Mayo Clinicin the USA, describe the differences between these two types of lipids that circulate in the blood:
Los triglycerides store unused calories and provide energy to the body
The cholesterol is used to build cells and certain hormones
These lipoproteins that remove cholesterol are called HDL , it is popularly known as good cholesterol. Other lipoproteins transport cholesterol from the liver to the rest of the organs. These are called LDL .
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Supplements And Medications To Lower Triglycerides
Some diabetes medications, Actos , for example, will also lower triglycerides, says Shurmur. However, this drug may cause or worsen congestive heart failure, warns the FDA.
Develop Healthy Sleep Habits
Sleeping too little is common but detrimental to your health. In fact, loss in sleep is associated with increased cholesterol levels and related problems, such as high triglycerides and blood pressure. To improve your sleep, aim for consistent bed and waking times, sleep in a cool, dark, comfortable room, and avoid stimulating activities, such as working on a computer, before bed.
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What To Eat: Foods That Lower Cholesterol
There is great evidence to support functional foods that help lower cholesterol, Featherstun says. Add these choices to your diet:
Plant stanols and sterols These are naturally occurring compounds found in plant cell walls, Featherstun says. They interfere with cholesterol absorption in the small intestine and can help lower LDL cholesterol. A study published in October 2012 in Lipids in Health and Disease found that eating 9 to 10 grams of stanols per day can help lower LDL cholesterol by more than 17 and as much as 22 percent. You can get plant stanols and sterols in margarine-like spreads such as Benecol and Smart Balance, available in the dairy section of most grocery stores.
Monounsaturated and polyunsaturated fats These fats can help decrease LDL cholesterol, Featherstun says. To get them, eat fish high in omega-3 fatty acids, such as salmon, tuna, trout, herring, or king mackerel, at least twice a week. Other good sources of unsaturated fats include chia seeds, avocados, almonds, walnuts, and olive oil.
Soy foods Soy proteins contain isoflavones and phytoestrogens, which block both cholesterol absorption and new cholesterol production, Featherstun says. Good sources of soy protein include tofu, soy milk, and edamame. Try to replace one daily animal protein item with a soy protein alternative, Featherstun suggests.
Effect Of High Dose Omega
It should be noted that in this trial mineral oil was used as the placebo. In the placebo group the LDL-C, non-HDL-C, and CRP levels were increased during the trial . The impact of these adverse changes on clinical outcomes is uncertain and whether they contributed to the apparent beneficial effects observed in the individuals treated with EPA is unknown.
4) The OMEMI trial was a randomized trial of 1.8 grams per day of omega-3-fatty acids vs. corn oil placebo in patients aged 70 to 82 years with a recent myocardial infarction . Baseline LDL-C was approximately 76mg/dL, HDL-C was 49mg/dL, and TGs 110mg/dL. The primary endpoint was a composite of nonfatal myocardial infarction, unscheduled revascularization, stroke, all-cause death, and heart failure hospitalization after 2 years of follow-up. The primary endpoint occurred in 21.4% of patients on omega-3-fatty acids vs. 20.0% on placebo . TGs levels decreased 8.1% in the omega-3-fatty acid group and increased 5.1% in the placebo group while changes in LDL-C were minimal in both groups. Thus, similar to the STRENGTH trial no benefits on cardiovascular disease were observed with EPA + DHA treatment.
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Effect Of Niacin On Atherosclerosis
Many of the initial niacin therapy imaging studies combined niacin with other drugs and compared these combinations vs. placebo. These studies showed that niacin in combination with other drugs reduced the progression and/or increased the regression of atherosclerosis. However, because of the use of other drugs it is impossible to determine if niacin therapy per se was beneficial .
Mechanisms Accounting For The Volanesorsen Induced Lipid Effects
Volanesorsen binds to apo C-III mRNA leading to increased degradation and thereby inhibits the hepatic synthesis of apo C-III protein resulting in a reduction in plasma apo C-III levels . Apo C-III has a number of important effects on the metabolism of TG rich lipoproteins . Apo C-III is an inhibitor of LPL and therefore decreasing apo C-III levels will enhance LPL activity. In patients with FCS this will not be important because patients with this disorder have defects in components of the LPL complex that result in the inability to increase LPL activity. Studies have shown that apo C-III stimulates the production and secretion of VLDL by the liver. This effect is also not likely to be of primary importance in patients with FCS as the very high TG levels are primarily due to chylomicrons and not VLDL. Whether apo C-III regulates chylomicron secretion by the intestine is unknown. Finally, and most importantly, Apo C-III inhibits the binding of TG rich lipoproteins to hepatic LDL receptors and LDL receptorrelated protein 1 decreasing the clearance of TG rich lipoprotein particles. A decrease in apo C-III will accelerate the clearance of TG rich lipoproteins, which likely accounts for the ability of volanesorsen to decrease TG levels in patients with FCS.
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What Are Triglycerides
They are important to life and are the main form of fat — they are sometimes called âlipidsâ — in the body. When you think of fat developing and being stored in your hips or belly, you’re thinking of triglycerides.
They are the end product of digesting and breaking down fats in food. Some are made in the body from other energy sources, such as carbohydrates. When youâre between meals and need more energy, your bodyâs hormones release them so you tap those unused calories.
Who Can Take Statins
You might be prescribed a statin if you have heart disease or another disease of the heart and blood vessels, or if you are at risk of developing them in the next 10 years.
If you have high cholesterol
You should be offered a statin if you have high cholesterol and lifestyle changes havent been enough to bring it under control.
Depending on your cholesterol levels and how healthy you are otherwise, you and your doctor or nurse might want you to try to bring your cholesterol levels down with a healthy diet and lifestyle first, before starting statins.
If you are at risk of developing heart disease
You will probably be prescribed a statin if you are at high risk of developing heart disease or a disease of the blood vessels. For example, if you have:
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Mechanism Accounting For The Omega
While not the primary mechanism for the decrease in plasma TGs, studies have shown that omega-3-fatty acids may increase the clearance of TG rich lipoproteins . Post heparin lipoprotein lipase activity is not increased by omega-3-fatty acid administration but the lipolytic activity of non-stimulated plasma is enhanced . Additionally, apolipoprotein C-III levels are decreased with omega-3-fatty acid administration which could also contribute to an increase in the clearance of TG rich lipoproteins .
The increase in LDL-C levels that occurs in patients with marked hypertriglyceridemia treated with omega-3-fatty acids is thought to be due to the enhanced conversion of VLDL to LDL .
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Which Medicines Can Lower Triglycerides
For some people, good habits may not be enough. Medication might be needed. The decision for you and your doctor can be complicated because other health conditions are usually involved. Several types of medicine can improve levels. They include:
- High doses of omega-3s are needed to lower triglycerides and should be taken only under a doctor’s care. Epanova, Lovaza, and Vascepa are prescription forms of omega-3s.
Your doctor may also prescribe a class of drugs called âstatinsâ that lower cholesterol. Examples include: atorvastatin , rosuvastatin , and simvastatin .
You may feel side effects from these drugs. Be sure to talk it over with your doctor or pharmacist.
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Effect Of Niacin On Cardiovascular Outcomes
MONOTHERAPY
COMBINATION WITH FIBRATES
In the Stockholm Ischemic Heart Disease Secondary Prevention Study survivors of a myocardial infarction below 70 years of age were randomized to a control group and a group treated with clofibrate and immediate release nicotinic acid . Serum cholesterol and TG was lowered by 13% and 19%, respectively, in the treatment group compared to the control group. Recurrent myocardial infarction was reduced by 50% within one year . Total mortality was decreased by 26% in the group treated with clofibrate + niacin while ischemic heart disease mortality was decreased by 36% . Notably, the benefit of clofibrate + niacin was only observed in patients with a baseline TG level > 143mg/dl. In the age of statins, the clinical implications of this early study are unclear.
COMBINATION WITH STATINS
Effect Of Fibrates In Combination With Other Lipid Lowering Drugs On Lipid And Lipoprotein Levels
STATINS
Statins are the primary drugs used to treat most patients with dyslipidemia. Statins are very effective in lowering LDL-C levels but have only modest effects on TG and HDL-C levels. Therefore, it is appealing to add a fibrate to patients who on statin therapy have LDL-C levels at goal but still have elevated non-HDL-C and TG levels and decreased HDL-C levels. Therefore, there have been numerous studies examining the effect of the combination of statins and fibrates on lipid and lipoprotein levels. An example is the Safari Trial which compared the effect of simvastatin only vs. simvastatin + fenofibrate in patients with combined hyperlipidemia . The results of this trial are shown in . As anticipated, adding a fibrate results in a further lowering of LDL-C, non-HDL-C, and TG levels with a further increase in HDL-C.
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Medications For High Triglycerides
Many people who have high cholesterol also have high triglycerides . Some medications can help lower this type of fat directly. Once these levels go down, the total amount of cholesterol is often lowered.
A common prescription for high triglycerides is niacin or vitamin B-3. Niacin can help lower bad cholesterol and increase good cholesterol .
This is a good option for people who dont respond well to other medications because the side effects of niacin are mild. People taking this medication might experience the following:
- flushing of the face
When more aggressive treatment is necessary to treat high triglycerides, a class of medications called fibrates is often prescribed.
Also, dietary supplements of omega-3 fatty acids found in fish oil have been shown to reduce triglyceride levels.