High Cholesterol

All of us are familiar with that confusing print-out you get from your doctor about your blood work and then your doctor says your cholesterol total is too high. This can be very confusing and even alarming at the same time. Unfortunately, that total number does not tell you exactly what is going on with your cholesterol. Many factors come into play when determining if you are at risk or not.

Cholesterol is a natural fat found in your body and is necessary for producing certain hormones and for building cell walls. Of course, you have heard that “high cholesterol” is very dangerous and can ultimately lead to heart disease. However, you should know exactly what your good cholesterol (HDL) and your bad cholesterol (LDL) levels are. Just because your total is 200 or slightly above does not mean you have a cholesterol problem. There are other factors to consider:

  • Heredity
  • Nutrition
  • Exercise
  • Body Weight

Exercise raises the “good” cholesterol in your body, while eating a heart healthy diet can lower your “bad” cholesterol; therefore, your total numbers could be effected.

The guidelines you should follow are:

LDL (Bad)
HDL (Good)
Average Above 100 Less than 40 - Above 240
Optimal Below 70 Less than 60 Above 149 200


If you look at the chart and you want your results to be average or desirable but your chart reads in the med-high range, you need to make some changes in your lifestyle.

Here are a few things you might want to do:

  • Start a more intense work out program-increasing your cardiovascular work out helps to raise the HDL’s and lowers your body weight
  • Reduce the fat in your meals by eliminating butter, high-fat processed meats like sausage and bacon, cheese, whole milk and oils
  • Limit your packaged products
  • Reduce cholesterol causing foods like egg yolks, pre-made cakes, cookies, muffins, and fried foods.




High Blood Pressure

Everybody has blood pressure. When your heart beats, it pumps blood through your body. As the blood moves through the arteries, it pushes against the inside walls of the arteries. This force is called blood pressure. A normal blood pressure means that the heart is pumping the blood through the arteries with the right amount of force. Think of your arteries as a garden hose. When anything clogs up the hose or makes the space inside the hose smaller, the water comes out at a higher pressure. The same thing happens in your body. Anything that clogs up the blood vessels (like cholesterol), causes them to become smaller (like nicotine), or fills them with too much fluid (as salt does), will cause blood pressure to rise.

High blood pressure or hypertension is referred to as the "silent killer." Since most people with high blood pressure don't have noticeable symptoms, and since it's not clear who will get it or when, it is important to have your blood pressure checked regularly. To confirm a diagnosis of hypertension, readings from two or more visits are needed. Having high blood pressure for a long time can harm some of your most important organs. The brain, kidneys, eyes, and heart get oxygen and nutrients from very small blood vessels. When the pressure in these vessels rises, the organ may become damaged due to lack of blood flow and less oxygen to the organ.

Left untreated, high blood pressure can cause:

  • Strokes
  • Heart Attack
  • Renal (Kidney) Failure
  • Vision Problems

The guidelines you should follow are:

Less than 130
210 or Higher
Less than 85-89
120 or Higher


Here are some tips for reducing high blood pressure and cardiovascular risks:

  • Lose weight. Being overweight increases your risk of developing high blood pressure. Weight loss in even modest amounts can lower and help control blood pressure, blood cholesterol, triglyceride, and blood sugar levels. Of all the non-drug methods of hypertension control, weight loss is by far the most effective.
  • Exercise regularly. Regular aerobic exercise such as walking, running, bicycling, or swimming laps can prevent and reduce high blood pressure. More activity can also help reduce weight and stress. Many experts recommend 30 to 45 minutes of aerobic exercise 3 to 5 times a week.
  • Control salt in your diet. Not everyone is sensitive to the blood pressure-raising effects of too much sodium, but there is no simple way to find out whether you have such sensitivity. Since the amount of salt in the average American diet raises blood pressure for about half of those with high blood pressure and interferes with some blood pressure-lowering drugs, cutting down on salt is recommended for anyone with high blood pressure. Limit salt to less than 2,300 mg per day by not adding it to your food and by limiting processed, convenience, and fast foods, which are traditionally high in sodium.
  • Limit alcohol. Drinking too much alcohol can raise blood pressure, add weight, and make it harder to control high blood pressure. Avoid alcohol or do not have more than 2 drinks a day. A drink is defined as 12 ounces of beer, 4 ounces of wine, or 1.5 ounces of 80-proof liquor.
  • Quit smoking. Smoking cigarettes does not cause high blood pressure, but smoking is a major risk factor for cardiovascular disease. That is why everyone who smokes - especially people with high blood pressure - should quit.
  • Eat less fat. Some evidence shows that a low-fat diet may reduce blood pressure and lower blood cholesterol. Eating less fat will also aid in weight loss.




Diabetes occurs when the body cannot properly use or produce insulin, a hormone that helps the body absorb glucose (sugar made from carbohydrates) for energy. Insulin is made in the pancreas and brings glucose from the blood into the cells, where it is used for energy. When insulin isn't available or the body doesn't use it properly, blood glucose levels rise. Uncontrolled high blood glucose levels can cause serious health problems, including heart disease, kidney disease, blindness, or nerve damage. Keeping your blood glucose level as close as possible to normal (70 to 115 mg/dl before a meal) is key to being healthier and more energetic.

Although there are different types of diabetes, the cause—the body's inability to use food properly—is the same. The major types of diabetes are type 1 (insulin-dependent), type 2 (non-insulin-dependent), and gestational diabetes.

Call your health care provider if you have any of the following symptoms:

  • Extreme thirst
  • Unusual tiredness
  • Excessive appetite
  • Frequent urination
  • Tingling or numbness in legs or feet
  • Cuts or bruises that heal slowly
  • Blurred vision or any change in vision

Types of Diabetes:

  • Type 1 (Insulin-Dependent) Diabetes:
    This type of diabetes may develop at any age, but occurs most often in children, teenagers, and young adults. Symptoms include being very thirsty, hungry, and tired, and needing to urinate often. Children with type 1 diabetes rarely have these symptoms for longer than a few weeks before it is diagnosed.

    With type 1 diabetes, the pancreas stops producing enough insulin. To make up for this lack of insulin, people with type 1 diabetes control their blood sugar level through diet and exercise, and by giving themselves insulin injections.
  • Type 2 (Non-Insulin-Dependent) Diabetes:
    The most common form of diabetes, type 2 diabetes usually develops gradually with few, if any, symptoms. It most commonly occurs in people over the age of 40 and in those who are overweight. The pancreas keeps making insulin, but the body does not use it effectively. This leads to a buildup of glucose in the blood. Type 2 diabetes is often diagnosed by tracking a gradual increase in blood glucose levels. It can usually be controlled by diet and exercise, but sometimes oral medication is necessary as well.

Here are some self-care steps for diabetes:

  • Nutrition-A good diet is important for everyone, especially people who have diabetes. Planning meals and watching the total amount of carbohydrates you eat are key to maintaining a blood glucose level that is as normal as possible. Your meal plans should be suited to your lifestyle and nutritional needs.
  • Blood Glucose Monitoring-Whether you have type 1, type 2, or gestational diabetes, it is important to check blood glucose levels and keep them as close to normal as possible. Closely controlling your blood glucose helps you feel better and reduces the risk of problems associated with diabetes. Glucose levels are monitored by pricking a finger and testing a drop of blood using chemically treated plastic strips that indicate the glucose level in the blood. Color charts or small calculator-sized machines are used to analyze the blood glucose test strips. Your health care provider can teach you how to monitor your blood glucose correctly. Many people with diabetes monitor their blood glucose up to 6 times daily, especially those taking insulin to help control type 1 or type 2 diabetes. Others who have type 2 diabetes and are not taking insulin may need to monitor their blood glucose only 2 or 3 days a week if the level remains within normal range, or close to it.
  • Exercise-People with diabetes enjoy the same benefits from exercise as everyone else: improved heart and lung efficiency, reduced body fat, increased muscle tone, and improved fitness. But people who have diabetes get more benefits; exercise combined with fewer calories will often control type 2 diabetes without the need for medication. Exercise can lower blood glucose levels by making body cells more sensitive to insulin and improving their ability to use and store glucose. Your health care provider can help you determine the benefits of exercise and the type of exercise program that is best for you.
  • Regular Medical Care-People with diabetes are at higher risk for several illnesses. Although keeping your diabetes under control decreases your likelihood of developing complications, you still face the possibility of diabetic retinopathy, kidney damage, cataracts, and circulatory problems. Diabetic retinopathy is a condition in which the retina (a part of the eye) and the blood vessels nourishing it are damaged. This condition can lead to blindness. If you have diabetes, it's important to have your eyes checked for retinopathy every year, because it is more easily treated if caught early. Also, talk with your provider about foot care and how to detect circulatory problems. Foot wounds in people with diabetes can develop into gangrene, but if you know how to care for your feet properly you should be able to prevent this from happening.





Topic Overview

What is a stroke?

A stroke occurs when a blood vessel in the brain is blocked or bursts . Without blood and the oxygen it carries, part of the brain starts to die. The part of the body controlled by the damaged area of the brain can't work properly.

Brain damage can begin within minutes, so it is important to know the symptoms of stroke and act fast. Quick treatment can help limit damage to the brain and increase the chance of a full recovery.

What are the symptoms?

Symptoms of a stroke happen quickly. A stroke may cause sudden:

  • Numbness, weakness, or paralysis of the face, arm, or leg, especially on one side of the body.
  • Trouble seeing in one or both eyes. You may have double vision, or things may look dim or blurry.
  • Confusion or trouble understanding.
  • Slurred or garbled speech.
  • Trouble walking. You may feel unsteady, dizzy, or clumsy.
  • Severe headache.

If you have any of these symptoms, call 911 or other emergency services right away.
See your doctor if you have symptoms that seem like a stroke, even if they go away quickly. You may have had a transient ischemic attack (TIA), sometimes called a mini-stroke. A TIA is a warning that a stroke may happen soon. Getting early treatment for a TIA can help prevent a stroke.

What causes a stroke?

There are two types of stroke:

  • An ischemic stroke develops when a blood clot blocks a blood vessel in the brain. The clot may form in the blood vessel or travel from somewhere else in the blood system. About 8 out of 10 strokes are ischemic (say “iss-KEE-mick”) strokes. They are the most common type of stroke in older adults.
  • A hemorrhagic stroke develops when an artery in the brain leaks or bursts. This causes bleeding inside the brain or near the surface of the brain. Hemorrhagic (say “heh-muh-RAH-jick”) strokes are less common but more deadly than ischemic strokes.

How is a stroke diagnosed?

Seeing a doctor right away is very important. If a stroke is diagnosed quickly—within the first 3 hours of when symptoms start—doctors may be able to use medicines that can lead to a better recovery.

The first thing the doctor needs to find out is what kind of stroke it is: ischemic or hemorrhagic. This is important because the medicine given to treat a stroke caused by a blood clot could be deadly if used for a stroke caused by bleeding in the brain.

To find out what kind of stroke it is, the doctor will do a type of X-ray called a CT scan of the brain, which can show if there is bleeding. The doctor may order other tests to find the location of the clot or bleeding, check for the amount of brain damage, and check for other conditions that can cause symptoms similar to a stroke.

How is it treated?

For an ischemic stroke, treatment focuses on restoring blood flow to the brain. If less than 3 hours have passed since your symptoms began, doctors may use a medicine that dissolves blood clots. Research shows that this medicine can improve recovery from a stroke, especially if given within 90 minutes of the first symptoms.1 Other medicines may be given to prevent blood clots and control symptoms.

A hemorrhagic stroke can be hard to treat. Doctors may do surgery or other treatments to stop bleeding or reduce pressure on the brain. Medicines may be used to control blood pressure, brain swelling, and other problems.

After your condition is stable, treatment shifts to preventing other problems and future strokes. You may need to take a number of medicines to control conditions that put you at risk for stroke, such as high blood pressure, high cholesterol, and diabetes. Some people need to have a surgery to remove plaque buildup from the blood vessels that supply the brain (carotid arteries).

The best way to get better after a stroke is to start stroke rehab. The goal of stroke rehab is to help you regain skills you lost or to make the most of your remaining abilities. Stroke rehab can also help you take steps to prevent future strokes. You have the greatest chance of regaining abilities during the first few months after a stroke. So it is important to start rehab soon after a stroke and do a little every day.

Can you prevent a stroke?

After you have had a stroke, you are at risk for having another one. You can make some important lifestyle changes that can reduce your risk of stroke and improve your overall health.

  • Don't smoke. Smoking can more than double your risk of stroke.2 Avoid secondhand smoke too.
  • Eat a heart-healthy diet that includes plenty of fish, fruits, vegetables, beans, high-fiber grains and breads, and olive oil. Eat less salt too.
  • Get exercise on most, preferably all, days of the week. Your doctor can suggest a safe level of exercise for you.
  • Stay at a healthy weight.
  • Control your cholesterol and blood pressure.
  • If you have diabetes, keep your blood sugar as close to normal as possible.
  • Limit alcohol. Having more than 2 drinks a day increases the risk of stroke.
  • Take a daily aspirin or other medicines if your doctor advises it.
  • Avoid getting sick from the flu. Get a flu shot every year.

Work closely with your doctor. Go to all your appointments, and take your medicines just the way your doctor says to.

Author: Robin Parks, MS Last Updated March 6, 2007
Medical Review: Anne C. Poinier, MD - Internal Medicine
Richard D. Zorowitz, MD - Physical Medicine and Rehabilitation