Middle-aged men face new health challenges

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As men get older, they tend to face many new health problems in a short period of time, says HCMC’s Dr. Bryan Nelson. Dr. Nelson is a family medicine physician at HCMC’s Golden Valley Clinic, as well as the Medical Director for the BeWell Clinic downtown and the St. Anthony Village Clinic. In a Healthy Matters podcast, he discussed the types of issues men face around the time they hit “middle-age” and what can be done to prevent and treat these problems. One such problem he focused on in the podcast was cholesterol.

“Cholesterol is important for our bodies,” says Dr. Nelson. “The problem is our liver doesn’t usually discriminate on what type of cholesterol gets made. And it tends to be either a genetic issue—or sometimes an age issue—where our liver starts making different types of cholesterol.”

The “good” cholesterol is called high-density lipoprotein (HDL), while the “bad” cholesterol is known as low-density lipoprotein (LDL).

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Dr. Bryan Nelson

“When you get a cholesterol check, oftentimes you also get a level called a triglyceride,” Dr. Nelson explains. “Triglycerides are kind of a marker for how much fat is in your system. So, basically what happens is that your LDL cholesterol plus your triglycerides tend to form atherosclerotic plaques. And atherosclerotic plaques, as time goes on, can break off and cause heart attacks, blockages, memory issues, circulatory problems, and erectile dysfunction.”

So, what can we do about it? “There are medicines—and there are some other things you can do besides medicines—to really help change the balance from the good and bad cholesterol,” says Dr. Nelson.

Most cholesterol medications, called statins, work fairly well. However, according to Dr. Nelson, “they have a tendency to cause muscle aches and you have to watch liver enzymes.” Other types of cholesterol medicines are called resins, and there are some herbal remedies out there as well. Both carry similar risks of side effects, though, and herbal remedies are generally untested. Niacin has also been used in the past, but, according to Dr. Nelson, it is not as good as other treatments that are out there.

To hear the entire podcast from May 31, 2015 go to the podcast on WCCO Radio’s site. Healthy Matters with host Dr. David Hilden airs Sunday mornings at 7:30 a.m. on WCCO Radio 830 AM.

Will more Americans benefit from cholesterol-lowering therapy?

In Nov 2013, the American College of Cardiology and the American Heart Association (ACC/AHA) introduced new guidelines to reduce heart attack and stroke through lifestyle changes and selective use of cholesterol-lowering  medications.

The ACC/AHA proposed changes to the guidelines for prescribing cholesterol-lowering medications called statins in accordance with the latest clinical study data available on the use of these drugs to reduce heart attack and strokes, due to the high prevalence of heart attack and stroke associated with high blood cholesterol.

Dr. Woubeshet Ayenew
Dr. Woubeshet Ayenew

“For years, the LDL or ‘bad’ cholesterol level was the basis for the initiation and follow up of statin therapy,” cardiologist Dr. Woubeshet Ayenew at Hennepin County Medical Center explains. “But the new guidelines de-emphasized the value attached to following the LDL level and instead recommended that the intensity of statin therapy match the risk of stroke and heart attack in an individual. For example, high-intensity cholesterol reduction is now recommended for those who have had prior heart attack or stroke, since the recurrence of such events is highest for those individuals.” Continue reading “Will more Americans benefit from cholesterol-lowering therapy?”