DRHOOK- No joke: Eat right, exercise, to lower LDL

LOL. If you don't know what that means, then you probably don't own a smart phone or use Internet social networks. 

Someone told me for a year he thought it meant "Lots of Love." It means "Laughing Out Loud," although honestly, I don't think most people are "ha-ha'ing" when they type LOL. I know I'm not. 

But letting someone know that you're joking or find something amusing can be tricky. Let's face it: you can use only so many LOLs before you look like an idiot.

What does it mean if your doctor text-messages you LDL?

Low Density Lipoprotein (LDL) is the bad-boy cholesterol. Studies have shown higher levels of LDL are associated with cardiovascular disease, like heart attacks. LDL-C is the main type we're interested in. 

What's an ideal LDL? 

That's like asking who's an ideal spouse. It really depends on who you are and what is going on in your life. For example, people with coronary heart disease (CHD) need to have their LDL less than 100, although 70 would be even better. 

Certain other illnesses carry the same risk of a heart attack as folks who already have CHD: diabetes mellitus, those with symptoms from carotid artery disease, peripheral artery disease, abdominal aortic aneurysm (AAA), as well as campers who have multiple risk factors that point towards developing CHD in 10 years (to calculate that would take a separate article).

So an LDL less than 100 is the goal in these groups of people.

Yes, people with diabetes are always amazed to learn that heart disease is the main cause of death in diabetics. Studies might be indicating the 50 million Americans with glucose intolerance (pre-diabetes) are at risk for CHD as well. Furthermore, it appears that chronic kidney disease carries the risk of a heart attack as CHD.

An LDL of 190 or greater is considered high in anyone. For people with one CHD risk factor, an LDL less than 160 is the goal (<130 with two risk factors). 

What are some of these risk factors? Some CHD risk factors can't be controlled, like being a man, having a family history of early CHD (male first-degree relative <55 years old or female first-degree relative <65 years old), and age (men 45 or more, women 55 or more– even if you lie about your age). 

Some CHD risk factors can be modified, like smoking. High blood pressure can be improved with blood pressure medicines, diet, and exercise. HDL, the good cholesterol, when greater than 60 can reduce the risk of CHD. HDL is increased with aerobic exercise, moderate use of alcohol at dinner (not a good idea for those with addictions or liver problems), some medicines, and fish oil. 

Have I mentioned exercise? Personally, I enjoy ice dancing, mountain biking, kayaking, etc. I hate lifting weights, the elliptical rider, and running, but I do it like I do laundry or clean the toilet: it's a necessity. A sedentary life probably is a risk factor for CHD, but still the jury is out. 

If you talk to a cardiologist, she can probably name a million other factors to determine if you could benefit from a cholesterol-lowering medicine. Studies on prevention show for every 10 percent reduction in cholesterol there is a 15 percent reduction in death from heart attack and 11 percent drop in total mortality. 

Diet and exercise really can make a difference in controlling cholesterol, although sometimes it isn't enough because of genetics or whatever. Also, let's face it: it's hard to eat perfectly all the time!

So next time you're texting your loved ones, throw in LDL instead of LOL. It's no laughing matter.

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Dr. Hook cracks a joke or two, but he's a renowned physician with an interesting website, drjohnhong.com. Email him with your questions.

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