Lower Your Cholesterol - Preventing Stroke: Stroke

Content provided by the Faculty of the Harvard Medical School

Lower your cholesterol

High levels of low-density lipoproteins (LDL), the "bad" cholesterol, help lay the foundation for atherosclerotic plaque, so it's not surprising that lowering LDL can help prevent atherosclerosis and reduce the risk of stroke. The National Cholesterol Education Program has issued guidelines for total cholesterol levels as well as for LDL, HDL (high-density lipoproteins, the "good" cholesterol), and triglycerides (see Table 3).

The safest and cheapest way to treat high cholesterol is to change your diet, increase physical activity, and, if necessary, lose weight (see "Watch your weight"). A diet with proven benefits for cardiovascular health consists of plenty of fruits and vegetables, as well as fish and other foods that contain "good fats" instead of "bad fats." The good fats help increase HDL, the form of cholesterol that enhances the health of your heart and blood vessels. The good fats are polyunsaturated fats (found in vegetable oils, nuts, and fish) and monounsaturated fats (found in olive and canola oils). The bad fats, which raise LDL, are saturated fats (found in meat and dairy products) and trans fats (found mainly in partially hydrogenated vegetable oils).

In 2002, the Health Professionals Follow-up Study, an ongoing study of thousands of men, found that men who ate fish as little as once a month were 43% less likely to have ischemic strokes than men who ate seafood less frequently. The Nurses' Health Study, an ongoing study of thousands of women, found similar results. Data from two long-term studies, the Framingham Heart Study and the Nurses' Health Study, also suggest that people who eat the most fruits and vegetables are less likely to have strokes than those who eat the least.

However, a low-fat diet does not reduce stroke risk, according to findings from the National Institutes of Health's Women's Health Initiative, an 8-year study of 48,835 women published in the Journal of the American Medical Association in 2006. The incidence of stroke was the same for women ages 50 to 79 whose daily calories consisted of less than 30% fat as it was for women whose daily calories from fat were 35%.

You may be able to reach your target cholesterol and triglyceride levels through lifestyle changes alone. Medication is an option if you are unable to lower your cholesterol and triglycerides to your target levels after three months, if your LDL cholesterol is 190 mg/dL or higher, or if you have one or more risk factors for stroke, including cardiovascular disease, diabetes, and high triglycerides (200 mg/dL or higher) and low HDL cholesterol (less than 40 mg/dL). Several clinical trials have found that statins, a class of lipid-lowering drugs, reduce the risk of stroke in people with cardiovascular disease. But there are other medications for reducing LDL and triglyceride levels and raising HDL. Talk with your doctor about which one is best for you.

Last updated:	September 05, 2008