SURGERY, DRUGS, LIFE-STYLE, AND HYPERLIPIDEMIA

Heart disease is the number-one cause of death in the United States, a nd more money is spent on its treatment each year than for any other c ondition. Both epidemiologic and experimental data clearly show that e levated plasma cholesterol levels increase the risk of death from coro nary heart disease. Genetic insufficiencies can cause high blood chole sterol, but most people with high cholesterol do not have genetic abno rmalities; rather, they have Lifestyles that include high-fat diets an d little exercise. Cholesterol can be managed aggressively with corona ry artery bypass surgery, percutaneous transluminal coronary angioplas ty, partial deal bypass, and even liver transplant. Antihyperlipidemic drugs include bile-acid-binding resins, nicotinic acid, fibric acid d erivatives, hydroxymethylglutaryl coenzyme A-reductase inhibitors, and the antioxidant probucol. Strict programs of low-fat diets and exerci se are also effective for reducing cholesterol, lowering blood pressur e, and preventing heart disease without the side effects associated wi th surgery and drug therapy. Such lifestyle changes are critical to re ducing the incidence of heart disease iu this country.