Management of High Cholesterol in Older Adults
Key Highlights
- High blood cholesterol is common in older adults and usually does not cause any signs or symptoms.
- Most people come to know of their high cholesterol levels only during a routine health checkup.
- There can be several causes for high cholesterol in older adults, including unhealthy diet, lack of physical activity, obesity, and other health conditions and medications.
- The treatment for high cholesterol in older adults is usually a combination of lifestyle changes and medications.
Have you ever thought that something you believe to be a villain could actually be a hero in disguise? Well, that's precisely the case with cholesterol - the fatty substance that we often think of as a bad guy. While it's true that high levels of cholesterol in the blood can be detrimental to our health, did you know that it's also an essential component that helps keep our cells healthy?
Unfortunately, as we age, cholesterol levels tend to increase, putting older adults at a higher risk for heart conditions like heart attacks and stroke. Total cholesterol levels increase steadily from age 20 to 65, following which they decrease in men but plateau in women.
So, let's delve into the impact of high blood cholesterol on older adults and explore the best ways to manage it!
What is cholesterol?
One can check their blood cholesterol levels with a routine blood test. To interpret the result, we must understand that there are a few parameters that are evaluated:
- High-Density Lipoprotein (HDL): Also called ‘good’ cholesterol
- Low-Density Lipoprotein (LDL): Also called ‘bad’ cholesterol
- Triglycerides: A type of fat present in the blood
Until a few years ago, total cholesterol was the primary focus.
However, according to current guidelines:
- High low-density lipoprotein (LDL) levels are associated with a greater risk for cardiovascular disease, stroke, and other related conditions.
- Triglycerides also increase the risk of heart and vascular conditions.
What are the symptoms of high cholesterol
High blood cholesterol is a silent condition that causes no signs or symptoms. Most older adults only learn about their high blood cholesterol levels via routine blood tests during annual health checkups.
The National Heart, Lung, and Blood Institute (NHLBI) recommends that people over 65 years should undergo cholesterol tests annually.
The frequency may be higher if the individual has a family history of high cholesterol, heart disease, diabetes, or high blood pressure.
Causes or risk factors of high cholesterol in older adults
Several factors can increase blood cholesterol in older adults, including:
- Obesity
- Lack of physical activity
- Eating an unhealthy diet
- Medical conditions
- Diabetes
- Chronic kidney disease
- Hypothyroidism
- HIV/AIDS
- Lupus
- Medications that an individual may be taking for the following conditions:
- Acne
- High blood pressure
- Cancer
- HIV/AIDS
- Irregular heart rhythms
- Genetics
- Family history
Treatment and Management of High Cholesterol in Older Adults
When it comes to managing high cholesterol in older adults, there is no one-size-fits-all. Physicians must thoroughly evaluate the individual’s health, medical condition and drug history to identify the cause of high blood cholesterol and determine the best way to manage it.
Despite the high prevalence of cardiovascular diseases in the elderly, there aren’t sufficient studies or guidelines for the correct management of hypercholesterolemia for this age group. This makes the management of hypercholesterolemia a challenge in older adults.
Managing high cholesterol in older adults involves making lifestyle changes, medications or usually a combination of both. The best approach is personalised for each individual after determining the cause of their high blood cholesterol levels, risk factors, medications and lifestyle habits.
Lifestyle changes
Individuals with high LDL cholesterol must make certain lifestyle changes in their daily routines. A few of these include:
- Reduce the amount of fat in your diet
- Lose weight and maintain it within an optimal range
- Get regular exercise (include aerobic workouts)
- Eat a high-fibre diet by including fresh fruits and vegetables (A plant-based diet is effective in lowering LDL)
- Quit smoking and alcohol consumption.
The benefits of lifestyle changes become evident within 6 to 12 months. However, the effects may vary depending on other factors that influence cholesterol levels in an individual.
Medications
With advancements in medicine and pharmaceuticals, several medications are available to lower cholesterol levels, especially LDL. These medications vary in how they work, their effectiveness and their cost.
The physician determines a medication that is apt for each individual. The most commonly used medications for managing high blood cholesterol are statins.
Statins for cholesterol management
Statins are most commonly used to lower LDL levels and effectively prevent heart attack, stroke, and coronary artery disease, among others. Two of the most commonly used statins are atorvastatin and rosuvastatin.
Statins work by decreasing the body’s cholesterol production and increasing cholesterol removal by the liver. This way, they effectively reduce LDL cholesterol levels by as much as 25% to 55%.
Besides lowering LDL levels, statins also reduce triglycerides and inflammation and prevent stroke and heart attacks due to these effects.
Side effects of statins
Though statins are usually well-tolerated by older adults, some may experience side effects like muscle pain, aches and weakness.
Studies have shown that using statins also increases an individual’s risk of developing diabetes if they are already in the prediabetes stage. However, the benefit of reducing heart conditions and stroke is far greater.
It is important to follow the physician’s prescription when taking statins, as some should be taken before bedtime, while others with a meal.
Additionally, foods like grapefruit can often increase side effects due to statins and, therefore, should be avoided.
Older adults with high cholesterol or triglyceride levels must understand that treating these conditions is a lifelong process. Though medications may lower your cholesterol levels quickly, it may take longer to experience the benefits of lifestyle modifications.
Once the treatment plan is effective, seniors must stay committed to their plan and visit their doctor regularly to monitor their cholesterol and triglyceride levels. Discontinuing treatment abruptly or without asking your doctor can cause the blood cholesterol levels to rise, increasing the risk for heart attacks, strokes and other cardiovascular conditions.
How can older adults prevent an increase in cholesterol levels
There are several ways for older adults to prevent an increase in cholesterol levels:
1. Maintaining a Healthy Diet
Older adults should focus on consuming a healthy, balanced diet that is low in saturated fats, trans fats, and cholesterol. Foods high in fibre, such as fresh fruits and vegetables, whole grains, and legumes, can help lower cholesterol levels.
2. Exercising Regularly
Regular exercise is essential for maintaining a healthy weight and reducing the risk of cardiovascular disease. Older adults should aim for at least 30 minutes of moderate-intensity exercise, such as brisk walking, every day.
3. Managing Stress
Chronic stress can raise cholesterol levels. Older adults should try to manage stress through relaxation techniques like deep breathing, meditation, and yoga.
4. Quit Smoking
Smoking is a major risk factor for cardiovascular disease and can increase cholesterol levels. Older adults who smoke should consider quitting.
5. Limiting Alcohol Intake
Drinking too much alcohol can raise cholesterol levels. Older adults should limit their alcohol intake.
6. Taking Medications as Prescribed
Older adults with high cholesterol may need to take medications like statins to lower their cholesterol levels. It is important to take these medications as prescribed by a doctor and to follow up regularly to ensure they are working effectively.
Conclusion
Managing high cholesterol levels is crucial for older adults to maintain their overall health and reduce the risk of cardiovascular disease.
Older adults can work with their healthcare providers to develop a comprehensive plan that includes lifestyle modifications such as a healthy diet, regular exercise, stress management techniques, quitting smoking, avoiding alcohol intake, and taking medications as prescribed.
It is essential to regularly monitor cholesterol levels and make adjustments to the management plan as needed. With proper management, older adults can improve their cholesterol levels and lead a healthy and active life.
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- Cholesterol and Cardiovascular Disease in the Elderly. Facts and Gaps
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Our team of experts frequently monitors developments in the health and wellness field, and we update our articles when new information becomes available.
Current Version
Dec, 02 2023
Written By
Dr. Pulyk Nataliya Omelanivna
Fact checked By
Dr. Stefanenko Irina Borisovna
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