Focus – Cholesterol

As plaque builds up in the arteries, blood flow is reduced. In the arteries to the heart, this process is known as coronary heart disease (CHD) or coronary artery disease (CAD). In the main arteries to the brain, it is called carotid atherosclerosis. If the arteries become completely blocked, or the plaque becomes unstable, blood flow to the heart or brain is blocked, causing a heart attack or stroke. While other factors such as high blood pressure, diabetes, smoking, or a family history contribute to CHD, more than half of all heart diseases are associated with lipid abnormalities. (The lipid profile is a group of tests that are often ordered together to determine the risk of coronary heart disease.) The tests that make up a lipid profile are tests that have been shown to be good indicators of whether someone is likely to have a heart attack or stroke caused by a blockage of blood vessels (hardening of the arteries).

Symptoms of CHD

The earliest symptoms of CHD are chest pain, called angina, or shortness of breath. CHD varies widely in severity, ranging from people with no symptoms at all to those with such steady pain that everyday activities are difficult.

Episodes of angina occur when the heart’s need for oxygen increases beyond what is being provided by the blood flow. It is most commonly triggered by physical exertion, when the heart has to work harder. It usually feels like a pressing or squeezing pain, usually in the chest under the breastbone, but sometimes in the shoulders, arms, neck, jaw or back. Angina will usually subside with rest, or sometimes anti-angina medication is prescribed to control the pain.

Sometimes the symptoms of angina are unusual, and it is often confused with other disorders such as a stomach upset or indigestion. The presence of angina does not necessarily mean that a heart attack is happening, or about to happen. However, it does mean that CHD is present.

How is CHD diagnosed?

Because CHD affects different people in different ways, the approach that doctors use to diagnose and treat it also vary widely. There is no single test to diagnose it − instead, your doctor will select one or more of the following, depending on your history and his or her findings on your physical examination:

• • An ECG, which is a graphic record of the electrical activity of the heart, can show abnormal beats, some areas of damage, inadequate blood flow and enlargement of the heart.

• • A stress test, also called a treadmill test or exercise ECG, records the heartbeat during exercise, since some heart problems only show up when the heart is working hard.

• • Nuclear scanning is sometimes used to detect damaged parts of the heart or problems with its pumping action.

• • Coronary angiography (or arteriography) is the most accurate test to diagnose and assess the extent of CHD. In this test, a fine tube called a catheter is inserted into an artery in the arm or leg and passed through into the arteries of the heart. The heart and blood vessels are then filmed while the heart is pumping. The picture produced, called an angiogram or arteriogram, will show problems such as a blockage caused by atherosclerosis.

Our Employee Wellbeing Programme (EWP) is available 24 hours a day if you want to discuss your high cholesterol.

General tips

Saturated fats should be avoided or reduced, and trans fats (found mainly in animal-based fats and processed foods) should be cut out if possible. Fats are high in kilojoules, but you don’t need to scrutinise your diet by counting kilojoules. Instead, work towards phasing out kilojoule-heavy foods and replacing them with healthier alternatives.

• • Switch from normal soft drinks to diet soft drinks.

• • Use skim milk instead of whole or reduced fat milk.

• • Replace butter with low fat butter substitutes.

• • Switch to ‘lite’ foods.

Right foods to eat

• • Oatmeal lowers your LDL without lowering your HDL.

• • Fish is a good source of omega 3 fatty acids, lowers LDL, raises HDL and lowers triglycerides.

• • Nuts are high in monounsaturated and polyunsaturated fats and they lower LDL.

• • Soy has been shown to lower LDL.

• • Fibre lowers your cholesterol. It can be found in kidney beans, green peas, broccoli, apples, brown rice and whole-grain breads.

• • Antioxidants in foods, such as vitamins A, C and E, lower the chances of LDL building up in your arteries. You can get your antioxidant vitamins in foods such as strawberries, oranges and melons.

Cooking tips

• • Use whole-grain flour instead of white flour.

• • Buy lean meats, such as turkey or chicken, instead of red meat, and trim all the visible fat from it before cooking.

• • Cook with vegetable oil, which is high in polyunsaturated fats, and olive and canola oils, which are high in monounsaturated fats.

• • Instead of frying, boil, broil, bake, roast, poach or steam meats, and drain off all fat before eating.

• • Reduce your salt intake by using herbs to flavour your meals, and avoiding salty snack foods, pickles, cured meats and cheeses.

Eating out

• • Don’t be afraid to ask how your food is prepared and to voice how you want it prepared.

• • Ask restaurants to not add salt.

• • Get foods that are steamed, broiled, baked, grilled, poached or roasted.

 

Our Employee Wellbeing Programme (EWP) is available 24 hours a day if you want to discuss high cholesterol and your diet.