Help patients monitor cholesterol to lower heart disease risk

Sara Berg, MS , News Editor

Patients with obesity, high blood pressure and high cholesterol are at an increased risk for heart disease and stroke. Because elevated cholesterol and blood pressure often have no warning signs, patients must take proactive steps to improve their health and well-being.

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And when patients ask, “How can I monitor my cholesterol, blood pressure and weight?” it is also important for physicians to provide ways to reduce cholesterol, BP and weight to lower their heart disease risk.

One way to lower cholesterol and blood pressure is for patients to eat a heart healthy diet that is low in added sugars, sodium, and saturated and trans-fat. A healthy diet will also include a variety of fruits, vegetables, whole grains, low-fat dairy products, poultry, fish, legumes, nontropical vegetable oils and nuts.

Patients should try to eat oily fish, such as salmon, twice a week, while limiting red meats. If a patient chooses to eat red meats, advise them to select lean cuts of meat. It is also important for patients to trim any visible fat. And when eating poultry, patients should remove the skin before eating.

For additional information on how to help patients with dietary improvements, visit “Nutrition Science for Health and Longevity: What Every Physician Needs to Know,” which can help you begin an effective nutrition conversation with patients. The four-hour, self-paced course is developed and hosted by the Gaples Institute for Integrative Cardiology, a nonprofit focused on enhancing the role of nutrition and lifestyle in health care, and distributed in collaboration with the AMA Ed Hub™.

The AMA Ed Hub is an online platform that consolidates all the high-quality CME, maintenance of certification, and educational content you need—in one place—with activities relevant to you, automated credit tracking and reporting for some states and specialty boards.

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When patients live sedentary lifestyles, it can lower their high-density lipoprotein (HDL), sometimes called “good cholesterol.” To improve HDL and reduce low-density lipoproteins, encourage patients to increase the amount of physical activity they are getting each day.

Performing150 minutes of moderate-intensity aerobic exercise a week is enough to lower both cholesterol and high blood pressure. Encourage patients to go on a brisk walk, swim, ride a bicycle or even attend a dance class. These activities are easy to accomplish and may significantly improve their health.

Making key lifestyle changes can help patients lose 3–5% of their body weight, which can result in meaningful health benefits. Larger weight losses of about 5–10% can produce even greater benefits for patients.

To help patients lose weight, it is important to consume fewer calories than used through normal metabolism and physical activity each day. Patients should reduce the number of calories they eat, while increasing physical activity. However, to maintain weight lost or to minimize the amount regained, some people might need to increase the amount of physical activity performed each week to about 200 or 300 minutes.

HDL cholesterol is lowered when a person smokes. But what is worse is when a person with unhealthy cholesterol levels also smokes, their risk of coronary heart disease significantly increases. Smoking also compounds the risk presented by other risk factors for heart disease, such as high blood pressure and diabetes.

By quitting, patients can improve their cholesterol levels and help protect their arteries. For patients who do not smoke, it is also important that they avoid exposure to secondhand smoke.

For some patients, lifestyle changes may prevent or treat unhealthy cholesterol levels. However, for those with high cholesterol, medication may also be needed. Work with your patients to develop a treatment plan that meets their individual needs.

If medication is required, be sure your patients understand the importance of taking their medications correctly. The benefit to your patient’s health is worth making medications part of their normal routine to lower cholesterol and prevent heart disease.

The AMA has developed online tools and resources created using the latest evidence-based information to support physicians to help manage their patients’ high BP. These resources are available to all physicians and health systems as part of Target: BP™, a national initiative co-led by the AMA and American Heart Association.