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Cholesterol management in your golden years
Individuals more than 65 years of age with coronary heart disease (CHD) or its major risk factors, such as high blood pressure, diabetes, obesity or smoking, should have a heart check-up, including a blood test to measure cholesterol.

How do you know if you are “high-risk”? You have known CHD, which means you have had a heart attack, angioplasty, bypass operation, abnormal stress test, other diagnosis of atherosclerosis or you have diabetes mellitus.

But what if you have not had surgery or a heart attack? You still are at high-risk, if your cholesterol level is high, plus one other major risk factor is present.

Why should you be concerned? Because CHD is the leading cause of death in both men and women over age 65 and can cause long-term disability. Coronary artery disease is caused by the cholesterol build-up in the blood vessels that supply blood to the heart.

“One hundred years ago, people lived to age 47, on average. Now people are living to 77, on average. As life spans increase, we must expand the point at which we offer cardiac preventative measures,” says Palmetto Health Heart Hospital cardiologist Dr. Joe Hollins.

“We are routinely doing stents and cardiac bypass surgeries on older adults. It makes sense to offer preventative measures, not just procedures,” he says.

Current research, although limited, indicates that cholesterol treatment in high-risk individuals who are 65-80 years old is beneficial and reduces the likelihood of a heart attack or other coronary heart disease event. The PROSPER study, for example, evaluated the lowering of total cholesterol, LDL cholesterol and triglycerides in a group of people more than 70 years of age through the use of pravastatin, a cholesterol-lowering drug. At the threeyear follow-up, CHD-related deaths and non-fatal heart attacks were reduced in the study group.

Treatment of high cholesterol in individuals 80 or older is highly individualized, depending on the person’s overall health and heart history. In managing your cholesterol as an older adult, diet is the first step. Your appetite may be hard to tame if you are trying to change eating habits you’ve had for years. Here are the actions to take so that you can live a longer, stronger life:

¦ Limit consumption of fatty foods, especially those high in saturated fats and cholesterol.

¦ Reduce intake of red meat, eggs and fatty dairy products.

¦ Switch to low-fat dairy, such as low-fat milk and cheeses.

¦ Say goodbye to fried foods and sweets.

¦ Eat at least five servings of fresh fruits and vegetables a day (the key word here is fresh.)

¦ Eat whole grains.

Lifestyle changes beyond eating habits also are necessary:

¦ Exercise regularly.

¦ Avoid smoking.

¦ Control high blood pressure.

¦ Manage your diabetes.

To lower your cholesterol, your doctor may recommend cholesterol-lowering drugs. Remember, treatment is individualized. In most cases, it is possible that medication will lower your cholesterol with minimal or no side effects. However, since side effects may occur, regular physician check-ups are necessary.

By managing your risks and making lifestyle changes, you can bring your cholesterol down to a healthy range: a total cholesterol of less than 170 mg/dL and an LDL cholesterol of less than 100. For individuals who already have CHD, your physician may want to lower your cholesterol even more.