More than any other time in history, healthcare providers can help you retain and in some instances regain your health. The aggressive and excellent treatment of lipid abnormalities is one of the ways this can happen. SETMA has designed a state-of-the-art cholesterol clinic to help you avoid heart disease and/or to improve the function of your heart. The treatment and educational tools with which the Cholesterol clinic will provide you and your family will help you "take charge" of your own health. Using the information and data published in the most recent and authoritative journals and sources, SETMA has built electronic supports for the treatment of cholesterol and triglyceride disorders which are effective in helping your healthcare provider assist you in getting to recommended target goals.
Whether you are sixteen or sixty; whether you are thirty-eight or eighty-eight, if you have increased risk of heart disease, the current state of scientific knowledge is that raising your HDL (high density lipoprotein -- the good cholesterol) and lowering the LDL (low density lipoprotein -- the bad cholesterol) will improve your risk and your health. Whether it is through SETMA's LESS Initiative -- lose weight, exercise, stop smoking -- or through specific dietary counseling, or medication, SETMA's Metabolism Clinic and Cholesterol clinic can help you improve and/or maintain your health.
The first step in effectively treating your cholesterol is a clinical history. Knowing whether or not a first degree family member had premature coronary artery disease is very important. Also, knowing whether or not a first-degree family member had cholesterol abnormalities is important, as well as knowing about any family history of high blood pressure or diabetes.
The second step is proper evaluation of your own "lipid profile" -- a measure of your cholesterol, triglycerides, HDL and LDL. In some instances it is important to measure your lipids beyond these elements and there are specialized tests for this. SETMA's state-of-art reference laboratory provides accurate and rapid evaluation of your blood.
The third step is to have a thorough physical examination to determine the presence of any complicating factors and/or cardiovascular or metabolic abnormalities other than elevated cholesterol or triglycerides.
The fourth step is to determine the Type of lipid or cholesterol abnormality you have. SETMA's Cholesterol Clinic does this electronically and is able to give you immediate and specific, personal, education information on your lipid profile and what it means to your health.
The fifth step is to calculate your risk for the development of cardiac disease over the next ten years. This will help you and your health care provider determine how aggressively your lipids should be treated. Your ten-year risk is determined by using the data from the Framingham Heart Study. The federal government's Framingham Heart Study has gone on since 1948. It follows a representative sample of 5,209 adult residents and their offspring aged 28-62 years in Framingham, Massachusetts. These people have been tracked using
- standardized biennial cardiovascular examination,
- daily surveillance of hospital admissions,
- death information and
- information from physicians and other sources outside the clinic.
The study's goal is to learn the circumstances under which cardiovascular diseases arise, evolve and end fatally in the general population. This information will help researchers find out, over a long time, how those who develop cardiovascular diseases differ from those who don't. In 1971 the study enrolled a second-generation group to participate in similar examinations. It consisted of 5,124 of the original participants' adult children and their spouses. This second study is called the Framingham Offspring Study.
Framingham Risk Score
Determining 10-year (short term) risk for developing CHD is carried out using Framingham risk scoring. The risk factors included in the Framingham calculation are age, total cholesterol, HDL cholesterol, systolic blood pressure, treatment for hypertension, and cigarette smoking. Because of a larger database, Framingham estimates are more robust for total cholesterol than for LDL cholesterol. Note, however, that LDL cholesterol remains the primary target of therapy. The Framingham risk score gives estimates for myocardial infarction and coronary death.
A Framingham Risk Score below 10% is considered to be low risk; between 10-20% is considered to be intermediate risk and above 20% is considered to be high risk. This score does not mean that you WILL develop heart disease; it only means that you are at higher risk. This score gives you and your health care provider a standard on which to base your treatment. However, it is only one factor among many others. For instance, if you have high blood pressure and/or diabetes, your risk of developing heart disease is increase regardless of what your Framingham Risk Score is.
The sixth step in treating your lipids is to change your lifestyle. Change the glycemic load of your diet; change the fat content of your diet; change the calorie density of your diet; increase the soluble fiber content of your diet. In addition, get moving; get off the couch and start walking and exercising. Lift small weights and stretch. Stop smoking and if you drink alcohol, limit yourself to one-half ounce of 90 proof liquor or one-half can of beer a day. Stopping alcohol totally is a better option.
The seventh step in treating your lipids is medication and/or supplements. There are excellent, safe and effective medications available for you to use in treating your lipids along with the above measures. In addition, Omega-3 Fish oil is very important in the treatment of triglycerides. there are other nutraceuticals -- substances which are not made by pharmaceutical companies and which are not regulated by the FDA -- which can be beneficial to you in controlling your lipids.
The eighth step in treating your lipids is really the first -- learn. Education is critically important. The more you know about lipids, the more likely you are to take them seriously. Through the weekly Your Life Your Health series in the Examiner; through SETMA's website and through education materials given to you in the clinic, SETMA is committed to sharing any and all valid and relevant information with you. We believe as a member of your own healthcare team, you should be knowledgeable in order to actively participate in your care.
Come and join SETMA's Metabolism Clinic and Cholesterol clinic, you are the only missing member of the team. |
