A decade ago you decided to watch your cholesterol, so you avoided eggs, switched from butter to margarine and finally stopped eating much fat at all. Since then you've learned that eggs might not be as bad for you as everyone thought, margarine could be more deadly than butter, and not all fats are created equal.
You want to tear your hair out when you hear that lowering your cholesterol too far below the recommended level might not be the best thing to do. Studies have suggested a link between very low cholesterol and depression.
To make matters worse, you don't understand how there can be "good" cholesterol (HDL), which helps clear out your blood vessels, as well as "bad" cholesterol (LDL), which clogs them. You know cholesterol is a fat-like substance in your blood. How can that ever be good?
And what are triglycerides anyway?
If you weren't confused enough, the government -- specifically the National Heart, Lung and Blood Institute -- has come out with complicated new guidelines for treating cholesterol, based on a number of studies done over the past 10 years.
Many more people fall in the high-risk category than under previous guidelines -- Consumer Reports estimates triple the number -- which could put millions of Americans on expensive cholesterol-lowering medicines for the rest of their lives.
"We put a lot of attention on cholesterol because it's one of the factors we can modify," says Dr. Stuart Bell, a general internist in Baltimore.
The new recommendations, like the old ones, call for lifestyle changes and drugs to lower levels of LDL and triglycerides -- another form of fat in the blood -- and elevate HDL; but they also identify three new groups at high risk for heart disease and recommend aggressive treatment for them.
People with diabetes are now considered as much at risk for cardiovascular disease as someone who has already had a heart attack. Under the old guidelines, if you were a diabetic with no history of heart disease, your target level of bad cholesterol (LDL) was less than 160 milligrams of cholesterol per deciliter of blood (mg/dL). Now it's less than 100 mg/dL, a significant difference.
Americans with "metabolic syndrome" are now considered high-risk. This syndrome involves a group of seemingly unrelated symptoms, including a waist bigger than 40 inches for men or 35 inches for women, too-low good cholesterol (HDL) and too-high blood pressure and triglycerides.
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