European Stars And Stripes (Newspaper) - May 17, 1988, Darmstadt, Hesse                                Toyo up health testing for More than cholesterol by William Stockton new York times none who is serious about fitness must eventually control Iho at or lipids in his or her blood. An ambitious weekly exercise Elloul aimed at a healthy heart can provide a false sense of Overall fitness ii blood lipids Are out of Miler. Experts in heart disease say it is no enough to be tested for cholesterol the most famous Wood it id. You must also measure the Levels of the other major lipids High density lipoproteins Low density lipoproteins and triglycerides whal s Moie should Ona or More of 1he bleed lipid Levels be outside the optimum Range for your age and set. Ailing to Deal with it can be foolish. Cardiovascular disease even a heart Alia could be the ultimate result despite faithful exorcise. Cardiovascular disease is responsible Lor the deals of 540.000 americans each year. About 5.4 million additional americans have symptoms of the disease and millions More have it but do not know Aboul it Yel. Epidemiologists regard cardiovascular disease As one of the great epidemics in Iho 20th Century in the  nations a legacy of sedentary life styles smoking weight problems and the consumption of too much fat in he Del to a Large extent Iho american enthusiasm for fitness in the last iwo decades reflects a growing realization Hal exercise coupled with Olferts to Slop smoking and lose weight can dramatically lower the risks of heart disease. We Are Aboul to have a cholesterol crusade in America or. Wilt am p. Casl Etli the director of a heart study by the Federal government in Framingham. Mass. Sad in a monograph Tor doctors published last year. Castelli Tike Many other experts on blood lipids and Hearl disease said Hal research is revealing thai Levels of the colder blood lipids besides cholesterol must be measured and their values assessed in conjunction with cholesterol chief among Iheson is High density Lipoprotein or  in the blood control the Deposit of material on the Walls of the arteries a process known As atherosclerosis. Through the years this atherosclerotic plaque builds up enough to clog an artery. Research has shown that Hal is the Good Irmo protein. Ii helps carry cholesterol out of Ine blood Lor excretion from the body. On the other hand Low density Lipoprotein. Or Bdl appears to promote buildup of atherosclerotic plaque it is thus desirable to have Low Levels of Overall cholesterol and Bdl and High Levels of Hal what those actual values should be has been the subject of extensive debate in recent years and nol All cardiologists in the Field agree on every detail. But Many experts on blood lipids believe thai Levels should be under 200 milligrams of cholesterol per Decilier of blood serum Lor people in their Lale 30s and beyond. There is no magic cutoff number and recommended Levels vary by age. Basically the younger a person is the lower the cholesterol Levels should to in addition recent research has shown that someone with High cholesterol values who ordinarily might be in. Danger of Hearl disease is endowed with special Protection ii the Levels of Hal in his mood Are High. Increasingly experts such As Castelli Are recommending that a far better gauge of heart disease risk is the Ralio Between total cholesterol and Hal. To calculate the ratio the total cholesterol value obtained in a blood lest is divided by the Hal value. Thus someone with a cholesterol level of 200 milligrams per Decilier and an Hal level of 40 milligrams per Decilier would have a ratio of 50. The higher the ratio the greater the risk of heart disease. Again there is no magic number Lor the ratio. It varies depending on age and sex. Castelli dealers a value of 4.5. People with a ratio under this number probably do not require treatment. Ii the Ralio is above 4.5, treatment is necessary. Tie Tirol step almost poo to into 4,5 prob Tuy do    i i a always is to reduce cholesterol in Iho diet. Only it thai fails would a doctor consider resorting to a drug. Use of the ratio illustrates How cholesterol values can vary widely bul not be indicative of Iho relative risk. Someone with a High cholesterol level of 250 a danger sign taken by itself bul who also had an Hal value of 60. Would have a satisfactory ratio of1. Likewise someone with a seemingly Safe cholesterol level of 170 bul an unusually Low Hal of 30 would have an unsatisfactory ratio of 5-5. For Many people illness is More than exercise. Ii becomes a Cornit men la an allured life style ii Means weight reduction Antt a More healthy Diel in addition to exercise. For example reducing Tats in the Diel and losing weight can reduce cholesterol Levels weight loss and exercise can increase Hal Levels although researchers still do not understand Why exercise increases Hal. The Bottom line of the Framingham study is that the average person headed for a heart attack should not be a mystery to either himself or his doctors Caffelli said. These Are people who for the most part have a local cholesterol level Between 220 and 260 and who also Lack adequate Hal so that their ratios exceed 4.5 ii you wait until the Chest pain starts to treat these people you waited Loo  predicting risk for heart disease by William Stockton new York times where fitness is concerned we live Inan age o num Jer a we measure our weight the Resh in and exercising pulse ales the caloric intake Al meals and even blood pressure. But in terms of preventing heart disease and possibly living longer through regular exercise such numbers Pale in importance when compared Wilh the four values that reflect the fats found in our blood. They Are the amounts of cholesterol High density lipoproteins Low density lipoproteins and triglycerides. Those who Are serious about illness not Only should have their blood tested for these lipids bul they should also know Hal the values mean in terms of heart disease. Although Many intricacies of the relationships Between the four values still Ore Uncertain a Broad picture is emerging. Assessed together they can reveal much Aboul someone s risk of heart disease and Point toward dietary and exercise changes. Increasingly cardiologists speak of having lha lipids in balance rather than focusing on a single value. It s the Overall balance that matters wrote or. Kenneth h. Cooper director of the aerobics censer in Dallas in his Book controlling  you have to look at All the lipid risk factors in order to gel a comp Tele picture of your atherosclerotic  for example seemingly Low cholesterol values can be misleading if the Levels of High density Lipoprotein or Hal known As the Good Lipoprotein Are also too Low High Levels of Low density Lipoprotein. Or Bdl the bad Lipoprotein and High triglycerides can Point Loward potential trouble even though cholesterol and Hal values Are in line. Assessing the optimal values or the lipids in each person is difficult because of human variability and disagreements among experts about How to interpret research data. The matter is further complicated by such things As smoking weight problems and hereditary factors nevertheless Many cardiologists now believe that the Ralio of local cholesterol to Hal is a significant predictor of the risk of heart disease although they do not always agree Aboul the exact number for the Raio. For example. Or William p. Castelli. Director of Tho Long tuesday May 17,198s term heart disease study conducted by the Federal government in Framingham mass., uses 4.5 As a cutoff for the talk men Over that value Are considered at risk of heart disease his monograph does not address women Cooper uses 4.2 Lor a Man aged 40 to 59, and 30 Lor women in Hal age group. The Ralto is calculated by dividing the total cholesterol value by the Hal value the values Are measured As milligrams of the substance per Decilier of blood some cardiologists favor the ratio of Bdl Loudl. Particularly in patients whose Bdl values arc Between 100 and 140 milligrams per dec tiler. Ii is calculated by dividing the Bdl value by the Kol value. For these patients an Bdl to Hal ratio Over 3 represents above average risk 3 represents average risk and under 3 represents below average  or. Antonio m. Gollo or. Of Baylor collage of Medicine and methodist Hospital in Houston whole in a paper Lor physicians a further complication is Hal in blood lipid tests the value for Bdl is often calculated rather than measured. To determine Iho Bdl level one divides the triglyceride value by five then subtracts thai and the Hal level from the local cholesterol value. In recent years doctors also have begun to include  in their Hearl disease risk assessments. Triglycerides Are another form of fat in the blood that have been implicated in the tarnation of atherosclerotic plaque on artery Walls the cause of angina and heart attacks. For men Normal irl Glycerine Levels Are 100 to 120. Many doctors do nol become concerned about treating High triglycerides until Iho level reaches 200. Such Levels Are known As mild . Some research has shown that women Are at higher risk for heart disease if triglycerides Are High so even lower values Are recommended for them. When triglycerides exceed 200. Concentrations of the Good Lipoprotein. Hal arc often found to be Low. Frequently the Hal Levels will increase if Tho triglycerides Are reduced. Whether mild  increases coronary risk is in dispute whole or. Scott m. Grundy of the University of Texas health science Center in Dallas in a paper Lor physicians. However when High Iri Glyceria Levels Are accompanied by decreased Hal the presumption can be made Hal risk is  cardiologists have Lound that two of Iho Best ways to reduce triglycerides Are to got Down to the Ideal body weight Lor your age and sex and to engage in regular aerobic exercise. The stars and stripes paga17