The Providence Lipid Clinic helps patients manage their cholesterol to reduce the risk of heart disease. At the request of the attending physician, patients with lipid disorders will be enrolled in the Lipid Clinic. The process will include patient assessment, patient and family teaching, referral to other disciplines such as the clinical dietitian as needed, ongoing monitoring of patient compliance and follow-up lab work.
The Lipid Clinic nurse will meet with the patient. Topics to be addressed at the initial interview will be identification of the particular dyslipidemia, risk factors, assessment of current diet and exercise, and lipid lowering medications the patient is currently taking. If an initial lipid profile has been done the patient will be given the results as a baseline and goals for all lipid values will be set.
Patient teaching will be done by the Lipid Clinic nurse directed to the age and specific learning needs of the patient. Where possible family members will be included in the education process. The nurse may utilize videos, pamphlets from the American Heart Association and other sources, and medication teaching sheets specific to the patient dyslipidemia and treatment plan. Patients will be referred to the dietitian and cardiac rehab as needed.
A written plan for the achievement of Clinic goals will be provided to the patient following the initial enrollment visit. Lipid profiles, liver profiles and other lab work will be performed per physician order. Medication changes may be made per physician order as well. The patient will be notified of lab results and treatment changes by telephone or office visit.
Patient follow-up for lab work will be monitored and patients notified by telephone or letter. Patients will be discharged from the Lipid Clinic upon reaching clinic goals or by physician's order. All Lipid Clinic records will be maintained by Providence Medical Records Department upon discharge from the Lipid Clinic.
Lipids is the scientific name for fatty substances. Cholesterol and triglycerides are two kinds of lipids carried through the blood. In order for cholesterol to move easily throughout the body, it is packaged with a protein. These protein packages are called lipoproteins. Two different kinds of lipoproteins – low density and high density – are used to assess your risk of heart disease.
Low-density lipoproteins (LDLs) contain most of the cholesterol in the blood. They carry cholesterol to body tissues, including the coronary arteries. The cholesterol found in LDL is considered most responsible for the formation of plaque, a fatty substance that builds up on the walls of the arteries. The plaque formation eventually can lead to a heart attack or atherosclerosis. This is why the cholesterol in these particles is often called "bad" cholesterol. High levels of LDL increase the risk of heart disease.
HDL cholesterol (the good cholesterol) helps to prevent arteries from becoming blocked due to LDL (the bad cholesterol). It does this by "hauling" away the excess cholesterol lining the walls of our blood vessels, then bringing it back to the liver for reprocessing. This in turn helps to keep arteries clear. And, if levels of HDL are high enough (a level of 40 and above in males, 50 and above in females), it can also decrease risk for a heart attack. For every one-point increase in HDL, there is a 3 percent decrease in a person's risk of suffering a fatal heart attack.
Triglyceride is another type of fat. Fat is an important source of energy and provides essential nutrients for health. Some of the triglycerides in your body come from the fat you eat. Your body also makes triglycerides when you consume more calories than you need from carbohydrates, proteins, and alcohol. The same lipoproteins that transport cholesterol also move triglycerides to cells where they are needed. High triglycerides are associated with an increased risk for heart disease, especially when HDL levels are low.
- Exercise – Just 20-30 minutes of aerobic exercise on most days of the week can jump-start your HDL in the right direction
- Break the tobacco habit – Quitting smoking can raise your HDL levels significantly.
- Lose weight – Losing just 10 pounds can increase your HDL. Aim for a weight loss goal to achieve a body mass index (BMI) of 25 or below
- Choose the better fat – Minimize the saturated and trans fats in your diet. These substances increase the bad cholesterol while decreasing your good cholesterol. Instead, switch to products containing unsaturated fats (olive, canola, flaxseed, etc.). These may raise your HDL levels. However, this is not a free fatty-pass, because we still have to watch the calories!
- Cut back on simple carbohydrates – Cakes, cookies and highly processed cereals and breads are high-glycemic foods that can lower your HDL and raise the levels of another fat in your blood stream, triglycerides.
- Drink alcohol in moderation, with a caveat – Alcohol should not be considered medicine—if you don't drink, don't start—but some studies have found mild alcohol consumption (one drink per day for women, two for men) can raise HDL by up to four points. Important caveat: Alcohol may be harmful to those with liver or addiction problems. In these cases, the risks certainly outweigh the benefits.
- Feast on cold-water fish – Eating salmon, mackerel or other fish from icy waters several times a week can have a very positive effect on your HDL levels. They contain omega-3 fatty acids, which may help to explain their health benefits.
- Add fiber – The soluble fiber found in fruits, vegetables, nuts and grains might boost your HDL.
- Avoid anabolic steroids – These decrease your HDL levels, in addition to all their other potential health dangers.