SA JOURNAL OF DIABETES & VASCULAR DISEASE
VOLUME 8 NUMBER 4 • NOVEMBER 2011
165
Keep and Copy Series
Patient
information
leaflet
TAKING CONTROL OF YOUR
CHOLESTEROL LEVELS
S Afr J Diabetes Vasc Dis
2011:
8
:
165–166.
T
he first time your doctor/clinic sister tells
you that you have high cholesterol levels, it
can come as quite a shock, particularly if
you are otherwise healthy. Raised cholesterol levels
result in a greater risk of heart disease and you will
want to avoid this severe complication and hazard
to life.
High cholesterol can occur for a number of rea-
sons. Eating foods high in saturated fats, exercising
too little, being overweight or obese, smoking and
regularly drinking too much alcohol are all lifestyle
factors that can cause raised cholesterol.
Some medical conditions are also known to cause
high cholesterol. These include diabetes, hyperten-
sion, liver or kidney disease and an under-active thy-
roid gland. These are all treatable conditions.
Medicines prescribed for other reasons may also
result in high cholesterol as a side effect. Some of
these are birth-control pills, beta-blockers, some
diuretics and some antidepressants.
Risk factors for raised cholesterol levels that can-
not be treated include a family history of coronary
heart disease, stroke, hypercholesterolaemia or hy-
perlipidaemia. Men have a greater chance of having
higher blood cholesterol levels than women. Aging
and experiencing an early menopause also increase
the risk. Some ethnic groups may be more suscepti-
ble to high cholesterol levels than others.
SO WHAT CAN YOU DO TO IMPROVE THE
SITUATION?
The first important aspect is to realise that by chang-
ing your lifestyle, losing weight, exercising and us-
ing natural remedies such as plant stenols (special
margarines and natural over-the-counter products
such as Phytocor), you can lower your total choles-
terol level by some 2–3%. This may be enough, and
for most of us, this is a better solution than taking
medication! So, try this approach for the first three
months. Then visit your doctor/sister again and ask
that he/she redo your lipid test using the same test
as before.
Since lifestyle factors are just one of the reasons
for high cholesterol levels, sometimes changing your
lifestyle is not enough to lower these levels. If your
cholesterol levels are still raised, the doctor will ex-
plain that medication is essential. You then need to
say: ‘Tell me what my lipid levels are’. These include
total cholesterol, low-density lipoprotein cholesterol
(LDL-C); high-density lipoprotein cholesterol (HDL-C)
and triglycerides (TG).
The general idea is that your total cholesterol
must be below 5 mmol/l, the LDL-cholesterol be-
low 2.5 mmol/l, the HDL-C (the good cholesterol)
at or above 1 mmol/l and the triglycerides below 2
mmol/l. If you have had a heart attack, stroke or have
diabetes, your doctor might want to go even lower
on your LDL-C and triglycerides. Make sure he/she
explains why he/she wants to do this.
The medication he/she prescribes will consist of
one or more drugs. Most commonly the first medi-
cine will be a statin but it may also be drugs that
interfere with cholesterol uptake, such as ezetimibe
or a fibrate. You may even be given one tablet that
combines two different classes of drugs.
STATIN THERAPY
The dose of statin (a drug that blocks the enzymatic
production of cholesterol in the body) prescribed
by your doctor will depend on your cholesterol
