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Cholesterol and triglycerides are members of a family of molecules called lipids. Cholesterol is needed by the body to build cell walls, make hormones, and for other important processes. The blood stream carries cholesterol in packages called lipoproteins made up of lipids and proteins. For many Americans there is too much cholesterol circulating in the blood. This cholesterol can accumulate to form plaques in the blood vessels. This condition is known as atherosclerosis. This condition is a major risk factor for the development of heart disease, the number one killer for both men and women in the United States.

VLDL (very low-density lipoprotein) carries fat to different parts of the body. Once the fat is unloaded the remaining cholesterol and protein pieces form LDL.

LDL (low-density lipoprotein) carries cholesterol to different parts of the body. It is considered "bad cholesterol" because the cholesterol it carries can become stuck inside blood vessels causing them to narrow.

HDL (high-density lipoprotein) is considered "good cholesterol" because it picks up cholesterol stuck in the blood vessels and carries it to the liver to be repackaged or broken down. Having high HDL levels can reduce the risk of developing coronary heart disease.

There are no symptoms of hyperlipidemia (high cholesterol). Because there are no symptoms it is critical that screenings are done to ensure that your cholesterol is not too high.

Total Cholesterol
Less than 200mg/dL is desirable
200 - 239 mg/dL is borderline high
Greater than 240mg/dL is high

LDL Cholesterol
Less than 100mg/dL is optimal
100-129mg/dL is above optimal
130-159mg/dL is borderline high
160-189mg/dL is high
Greater than 190mg/dL is very high
* your personal goal for LDL cholesterol changes based on your other risk factors for developing heart disease

HDL Cholesterol
Less than 40mg/dL is low
Greater than 60mg/dL is high
*remember a high HDL level is good, HDL greater than 60mg/dl is considered a factor that reduces the risk of developing heart disease

Triglycerides
Less than 150mg/dL is normal
150-199mg/dL is borderline high
200-499mg/dL is high
Greater than 500mg/dL is very high

• Age - particularly men over 45 years old and women over 55 years old
• Family history of heart problems (heart attacks, coronary heart disease, atherosclerosis) in a brother or father less than 55 years old or a mother or sister less than 65 years old
• High blood pressure either uncontrolled or controlled on medication
• Cigarette Smoking
• Diabetes
• High total and LDL cholesterol and/or a low HDL cholesterol
• Obesity
• Physical inactivity

• Maintain a healthy body weight
• Eat a healthy diet low in saturated fat and cholesterol
• Engage in a regular exercise regimen
• Medications in addition to a healthy diet and exercise may be necessary

HMG-CoA Reductase Inhibitors (also known as "statins") work by blocking a certain step needed for the production of cholesterol.

Examples include:
atorvastatin (Lipitor®)
simvastatin (Zocor®)
pravastatin (Pravachol®)
fluvastatin (Lescol/Lescol XL®)
lovastatin (Mevacor®)

Important reminders when taking these medications:

• take with evening meal or at bedtime for optimal results; the only exception is Lipitor which can be taken anytime during the day
• inform your physician or pharmacist immediately if any muscle pain or weakness occurs while taking these medications
• your liver function should be monitored by your physician while taking these medications

Fibric Acid Derivatives
work by increasing the rate in which triglycerides are broken down

Examples include:
gemfibrozil (Lopid®)
fenofibrate (Tricor®)
clofibrate (Atromid S®)

Important reminders when taking these medications:

• your liver function should be monitored by your physician while taking these medications
• take medication with food
• inform your physician or pharmacist immediately if any muscle pain or weakness occurs while taking these medications

Bile Acid Sequestrants
work by preventing your body form absorbing bile acids form the intestine

Examples include:
colestipol (Colestid®)
cholestyramine (Questran /Questran Light®)
colesevelam hydrochloride (Welchol®)

Important reminders when taking these medications:

• take other medications 1 hour before or 4-6 hours after taking bile acid sequestrants
• gastrointestinal symptoms (abdominal pain, constipation, heartburn, nausea, vomiting) are common with these medications
• drink plenty of fluids with these medications
• mix powder with fluids or applesauce, do not take in the dry powder form

Nicotinic Acid
it is not known for sure how niacin works to reduce cholesterol

Examples include:
niacin (Niaspan®, Nicolar®)

Important reminders when taking these medications:

• may cause gastrointestinal upset (nausea, bloating), take with food
• often causes generalized flushing, taking an aspirin or other non-steroidal anti-inflammatory such as ibuprofen 30 minutes to 1 hour prior to your niacin dose will help reduce the likelihood of this occurring, check with your physician to make sure this is appropriate for you
• do not crush sustained release formulations
• niacin is available over-the-counter, but it can have serious adverse effects, so you should check with your physician before buying and using this product

In order to check your cholesterol level, a blood sample is needed. At Hen House, we obtain a small amount of blood through a finger stick. The test does require a 12-hour fast during which we ask you to refrain from eating or drinking anything except water. Fasting will ensure accurate results.

• Available anytime by appointment at certain Hen House Pharmacy locations
• You will receive a complete lipid panel (total cholesterol, triglycerides, LDL, HDL)
• Results available in just 5 minutes