If you’ve been diagnosed with high cholesterol, you may have taken steps to retool your daily routines to make them healthier, by eating a healthy diet, exercising, and, if your doctor prescribed cholesterol-lowering medications, taking them consistently.
But could there be something you’ve missed that could be sabotaging your success as you work to reduce your risk of cardiovascular disease? Here are 8 things that may be working against your efforts to reduce cholesterol and some ideas for smart steps to get you back on track.
错误1：你没注意你的饮食中糖和酒精。
当你有高胆固醇的诊断，这是可以理解 - 和正确的 - 你会专注于你的饮食限制饱和和反式脂肪。但同样重要的是看糖和你喝酒的量，这也有助于高胆固醇, says艾琳·唐纳利MICHOS，MD，医学医学院的约翰霍普金斯大学的副教授，妇女心血管健康的主任约翰霍普金斯Ciccarone中心心血管疾病的预防，在巴尔的摩。
那是因为你的身体变成糖和酒精多余的热量为胆固醇和甘油三酯，这将有助于不健康胆固醇水平在你的血液。“人们没有意识到，这就是为什么他们的人数没有好转，即使他们减少脂肪和锻炼，” MICHOS博士说。
To help improve your cholesterol levels, cut down on all sources of sugar, including sweetened drinks, alcohol, and refined carbohydrates, such as white bread and pasta, and opt for whole grains rich in cholesterol-lowering fiber.
Mistake 2: You’re only focusing on LDL cholesterol levels.
虽然很高兴知道你所谓的“坏”LDL (low-density lipoprotein) cholesterol number is, that doesn’t give you the complete picture, and numbers alone do not tell the story. Doctors order ablood test看看你的血脂面板，其中包括你的高密度脂蛋白（HDL，或“好”胆固醇），LDL cholesterol, triglycerides, and total blood (or serum) cholesterol (calculated by adding your HDL, LDL, and 20 percent of your triglycerides).
To evaluate your risk for cardiovascular disease, doctors will also consider other risk factors, such as your age, family history, and whether you have other health conditions related to heart disease, such as diabetes and high blood pressure, according to the美国心脏协会（AHA）。
误区3：你忘了把你的药 - 或已完全停止。
药物治疗高胆固醇，包括statins，对胆固醇水平都有一个成熟的影响，并可能预防心脏发作在人与冠状动脉心脏疾病。但根据文章在杂志上发表2018年5月Vascular Health and Risk Management，规定未服用他汀类药物是有联系的心血管问题甚至死亡显著较高的风险。
文章引用的评论显示全球服药依从性问题：
- One Italian study examining the effectiveness of statins found that only 61 percent were still taking their meds as prescribed after 3 months.
- A Canadian study found that as many as 60 percent of patients who had experienced acute coronary syndrome, such as a heart attack, stopped taking their statin within 2 years of hospitalization.
- 他汀类药物停止估计增加了惊人的$ 44十亿到医疗保健费用在美国
根据这一点Vascular Health and Risk Managementarticle, researchers theorize that noncompliance may be due to a combination of factors, including cost, infrequent visits with cardiologists, concerns about side effects, and forgetting to take the medication. They also note that statins may be discontinued at a higher rate than other medications because high cholesterol is a symptomless condition with infrequent tests compared with something like diabetes, which requires constant monitoring of blood sugar levels.
文章提出了一些解决方案，可能会增加坚持他汀类药物治疗，如更好的耐心教育和沟通与医生，改善医疗保健服务，家访，和智能手机应用程序提醒的是信号时，它的时间服药。
Whatever your barrier is to taking statins as directed, it’s important to identify the problem and address it. Statins cannot work effectively if you don’t take them as prescribed, and stopping your medication without your doctor’s guidance can have serious health consequences, especially if you have a history of stroke. A研究发表在2017年8月在美国心脏协会杂志发现谁后停药3〜6个月的他汀治疗的人ischemic stroke在被停药后有一年内再度中风的风险较高。
If you’re experiencing any problems taking your statins, be sure to talk with your doctor so you can address the issue and continue therapy to manage your cholesterol.
误区4：你吃任何你想要的。
Taking statins doesn’t mean you can ignore advice about a cholesterol-lowering diet, Michos stresses. Many people wrongly believe their medication will undo any cholesterol overload, regardless of what they eat.
即使你服用药物降低胆固醇，你仍然需要看你的热量摄入，减少饱和脂肪和碳水化合物的量，这可能是导致不健康的胆固醇水平。相反，吃cholesterol-lowering foods，如豆类，富含纤维的水果，蔬菜和全谷物。
误区5：你已经从你的饮食中切出所有的脂肪。
While it’s true that you should cut out trans fats and saturated fats — often found in baked goods, such as crackers and cookies — not all fats need to be avoided, says Michos. In fact, you should be eating heart-healthy monounsaturated and polyunsaturated fats — the kind found in olive oil, olives, and nuts — as well as foods rich in omega-3 fatty acids, such as salmon, tuna, and mackerel. But, she says, you should still watch the number of calories you eat, which can add up quickly, even with healthy fats.
Mistake 6: You’re not exercising enough.
“饮食本身往往是不够的。应该配合运动，” MICHOS说。当谈到锻炼，公式很简单：久坐等于HDL水平较低，根据啊哈. You can lower both cholesterol and high blood pressure by doing at least 150 minutes of moderate-intensity exercise, such as walking, bicycling, swimming, or even doing yard work, each week.
甚至更多的好消息：一个review published in November 2018 in the journal生物医学研究国际found that both low- and中等强度的有氧运动led to a significant reduction in total cholesterol, including LDL.
误区7：您从事溜溜球节食。
你的饮食跳，从一个饮食承诺帮助你降低胆固醇，减肥另一回事？据MICHOS，这似乎是最适合改善心脏健康和减少胆固醇的饮食不一定是新的。
She recommends aMediterranean diet的尝试和真正的吃，强调水果，蔬菜，五谷杂粮，健康的脂肪和鱼的计划。这是高ω-3脂肪酸，与心血管疾病的风险降低有关，并削减回来的路上foods high in saturated fat, such as meat.
Mistake 8: You Take Statins With Grapefruit Juice
也许你想获得一个健康的开始新的一天，并把你的他汀类药物与早餐。但是如果你的早餐包括葡萄柚汁，你可能想先与你的医生检查。根据Cleveland Clinic，柚子汁中含有一种化学物质，可以与你的身体分解某些他汀类药物的能力。
Additional reporting by Katherine Lee
