(LifeWire) - There are many cholesterol lowering drugs on the market to treat high cholesterol, but they may not be enough - lifestyle changes are important, too.
Heart disease is a complex puzzle, with cholesterol as just one of many contributing risk factors. The importance of managing cholesterol levels and maintaining cardiovascular health with medication, exercise and a low-fat diet cannot be underestimated. But high blood pressure, diabetes, smoking and obesity should not be ignored either.
The best way to protect against heart disease is to lower all of these risk factors.
Some conditions, such as a family history of heart disease and type 1 diabetes, cannot be eliminated, and these factors automatically raise an individual's risk of heart attack and stroke. For people with these inherent factors, it's even more important to pay close attention to the other pieces of the cardiovascular puzzle and minimize their risk as much as possible.
Risks are Interconnected
Nearly every risk factor for heart disease is affected by the other factors. For example, smoking raises blood pressure, increases "bad cholesterol" (LDL) and triglyceride levels and lowers "good cholesterol" (HDL) levels. Smoking also causes blood vessels to be more prone to having cholesterol molecules become adherent, which form plaque that blocks the flow of blood.
When arteries become clogged, a condition known as atherosclerosis, the flow of blood and oxygen to the heart and brain can be completely cut off, causing a heart attack or stroke. Therefore, while medications may help to lower cholesterol levels in the blood, smoking will continue to add plaque to the arterial walls.
Similarly, the wrong diet can have disastrous effects on other risk factors, no matter how much medication is taken to treat cholesterol, diabetes and high blood pressure.
A high-fat diet will continue to provide the body with raw materials that manufacture the "bad cholesterol." Diets high in fat and calories may also lead to excess weight and obesity, which in turn can raise blood pressure. A diet high in carbohydrates, which the body converts to sugar, and eventually fat if the sugar is not used for energy, will make it nearly impossible to control type 1 or type 2 diabetes.
Type 2 diabetes is especially tricky. In type 2 diabetes, the body has become resistant to insulin, the hormone that helps cells absorb sugar for energy. So blood sugar levels remain high, and so does the amount of insulin, because it hasn't been used up to process the sugar. At the same time, the body produces even more insulin to try to metabolize the extra sugar. This results in too much insulin, which in turn raises "bad cholesterol" and triglyceride levels in the blood, despite cholesterol-lowering medications.
Diet and Exercise
Good food choices include fresh vegetables, whole grains, fish and lean poultry. Avoid oil and butter, refined grains such as white rice, white bread, and pasta, and foods high in sugar, which should all be replaced with healthier choices. Fresh fruit, which can be high in sugar and calories, may not be the best choice if you are diabetic or trying to lose weight.
For many people, exercise provides the only way to attain high levels of "good cholesterol," which helps the body remove the "bad cholesterol" from the blood and arteries. Although some cholesterol medications promote the "good cholesterol," they may not be enough to protect a sedentary person against cardiovascular disease. Similarly, the negative effects of smoking and high blood sugar on the "good cholesterol" levels may negate the effects of any medication.
Aerobic, or "cardio" exercise -- such as walking, jogging, cycling or swimming -- burns fat, increases the flow of oxygen throughout the body and helps stimulate the "good cholesterol."
One large study found that people who have two of three major risk factors -- such as high blood pressure, high cholesterol and cigarette smoking -- have more than five times the chance of developing heart disease and three times the risk of dying than people without those conditions. So even if blood cholesterol levels are low, each of the other risk factors that remain untreated increase the odds of a heart attack or stroke.
Sources:
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