Hypercholesterolemia: prevention, detection and management.

High serum cholesterol, leading to atherosclerosis, heart attack and stroke, is a major health problem in the United States and other Western countries. Hypercholesterolemia is amenable to dietary and other lifestyle changes that are brought about through education and supportive counseling. Dietary modification includes weight control, lowered intake of fats and cholesterol, and increased ingestion of water-soluble fiber. This article explores cholesterol metabolism and the mechanisms of factors lowering serum cholesterol in the body. The actions of chylomicrons, very low density lipoproteins, low density lipoproteins and high density lipoproteins are reviewed. Detection and evaluation of serum total and low density lipoproteins, and pharmacological therapy for hypercholesterolemia are discussed. Specific techniques for the health care provider to use in educating and counseling clients are emphasized.