Cardiovascular Disease Dyslipidemia | Non-Pharmacologic Treatment |
Cardiovascular Disease Dyslipidemia: Non-Pharmacologic Treatment Mark C. Houston, M.D., M.S. ABAARM, FACP, FACN, FAHA, FASH INTRODUCTION Cardiovascular disease (CVD) is the number one cause of morbidity and mortality in the United States,1 coronary heart disease (CHD) and myocardial infarction being the leading causes of death.1 The five major risk factors for CHD – hypertension, dyslipidemia, diabetes mellitus, smoking, and obesity – account for 80% of the risk for CHD.1,2 Interventions, both pharmacologic and nonpharmacologic, can improve all of these risk factors and decrease the incidence of CVD and its consequences, such as 3-6 myocardial infarction, angina, congestive heart failure and stroke. Recent guidelines by the National Cholesterol Education Program (NCEP) recommend more aggressive control of serum lipids to reduce the incidence of CHD.7 Nutritional and dietary therapy, weight loss, exercise, and scientifically-proven nutritional supplementation should be used initially in appropriately selected patients to manage dyslipidemia. Hypertriglyceridemia, which is frequently due to obesity, insulin resistance, metabolic syndrome and diabetes mellitus, deserves special attention.7 Pharmacologic therapy should be administered in those cases that are at high or very high-risk for CHD and those who do not respond to non-drug therapy. Many patients prefer non-drug therapies for many reasons including adverse effects of anti-lipid drugs, contraindications or allergic reactions to drugs, perceptions of adverse effects of drugs, or personal preference for natural or alternative therapies. A more aggressive integrative approach to the management of dyslipidemia is recommended to improve CHD outcomes, minimize adverse effects, and reduce health-care costs. NUTRITION AND EXERCISE Optimal nutrition and proper aerobic and resistance exercise form the cornerstone for the management of dyslipidemia.
[Show full text]