BACKGROUND: Although cholesterol itself isn't bad, having too much of it or an improper balance of "good" and "bad" cholesterol is bad news. "Good" cholesterol is called high-density lipoprotein and makes up one-fourth to one-third of blood cholesterol, says the American Heart Association. Low-density lipoprotein is also known as "bad" cholesterol.

If too much LDL circulates in the blood, it can build up on the inner walls of the arteries that feed the heart and brain. This can eventually form plaque that narrows that arteries and leaves a person at high risk for heart attack or stroke.

A GENETIC PROBLEM: When most people hear the term "high cholesterol," they immediately think of an unhealthy lifestyle, but some people are born with the problem. Inherited bad cholesterol characterized by high levels of LDL is called familial hypercholesterolemia, and it effects about one in every 500 people. About one in 1 million people inherit a defective LDL receptor gene, causing them to have cholesterol levels of between 700 and 1,200. The American Heart Association says optimal levels of LDL are less than 100.

TREATMENTS: Proper diet, exercise and some medications can bring LDL levels down to safer levels for people with familial hypercholesterolemia and others forms of high cholesterol. The National Institutes of Health recommends reducing fat intake by eating less beef, pork and lamb; choosing low-fat dairy products; and avoiding coconut and palm oil.

It also helps to reduce cholesterol intake by avoiding egg yolks, organ meats and sources of animal-derived saturated fat. Although diet adjustments like these and stain drugs may improve LDL levels in people with the less severe form of familial hypercholesterolemia, those with the more severe form of the disease may need help beyond that.

DIALYSIS FOR BAD CHOLESTEROL: For people with high cholesterol who won't respond to medication, hope comes in the form of a system called Heparin-induced Extracorporeal Lipoprotein Precipitation, or HELP.

Treatment with HELP involves a machine that literally filters bad cholesterol out of the blood. After blood is drawn from the patient, it's separated into red cells and plasma and the plasma runs through the machine. Material in the HELP machine grabs on to bad cholesterol particles and removes them from the blood. The plasma is then put back together with red blood cells and returned to the body. The entire process is known as LDL apheresis and takes an hour and a half to two hours for the patient.

Although uncommon, possible side effects of LDL apheresis include increased bleeding after the procedure, too much or too little fluid in the bloodstream, air in the bloodstream and low blood pressure (Source: Mayo Clinic).

FOR MORE INFORMATION, PLEASE CONTACT:
Judy Martin
Media Relations
Washington University School of Medicine
St. Louis, MO
(314) 286-0105