Cholesterol is a fatty chemical, known as lipid.
Our body cells make some cholesterol that is required for normal functioning, for e.g. making hormones and vitamin D. Additionally, cholesterol is also present in many food we eat for e.g. egg yolk, fatty part of the meat and cheese & butter. Some level of cholesterol is good for our body but too much cholesterol can deposit in the arteries called plaques. Overtime, these plaques restrict the blood flow in the arteries resulting in heart diseases and stroke.
Cholesterol is carried through blood supply to all parts of the body in the form of particles called lipoproteins. There are two main types of lipoproteins that carry cholesterol.
High density lipoproteins (HDL): HDL brings the cholesterol from cells back to liver. The liver helps in removing the cholesterol from the body. HDL helps in preventing plaque formation and therefore are considered as good cholesterol.
Low-density lipoproteins (LDL): LDL carries the cholesterol to the cells and when there is too much LDL, it starts to deposit in arteries which can lead to plaque formation and eventually heart disease and stroke. LDL is much more in quantity than HDL. High level of LDL encourages plaque formation. LDL is therefore considered as bad cholesterol.
Triglycerides are one other form of fats present in our bodies. They are used to produce energy.
Combination of HDL, LDL and triglycerides levels are assessed to determine the risk of heart disease and stroke.
There are no symptoms associated with high cholesterol.
If it becomes high enough, complications can occur. The only way to know if the person has high cholesterol is to have blood testing done. Everyone should have their cholesterol levels checked at age 20 and then once every five years to keep a close eye on it. If readings were high, more frequent testing may be needed.
There are not specific causes when it comes to high cholesterol.
In most cases, a set of risk factors is what leads to someone developing this condition. Most risk factors that can cause high cholesterol are things that can be controlled.
Familial hypercholesterolaemia is an inherited condition in which LDL levels remain high even the person eat healthy diet. In some other cases liver simply creates too much cholesterol.
High cholesterol in combination with other risk factors can increase the chance of heart disease and stroke.
• Smoking: Cigarette smoking damages blood vessel walls. This makes them more vulnerable to plaque buildup.
• Unhealthy diet: Diet containing too much fats especially saturated fats (most fried food) and cholesterol can lead to plaque formation.
• Low HDL levels: Having HDL levels less than 40 mg/dL (for men) and 50 mg/dL (for women)
• Having high blood pressure: When blood pressure is high, more plaques can build up because the artery walls become damaged.
• Family history: If someone in family who developed heart disease earlier than age 55, the risk of developing heart disease is higher if the persons has high cholesterol.
• Being obese: People who have body mass index 30 or higher have greater chance of having high cholesterol
• Not exercising: People who do not exercise regularly, have a higher risk of high bad cholesterol and low good cholesterol.
• Having diabetes: High blood sugar damages artery lining and it increases the risk of high bad cholesterol and low good cholesterol.
The only way to accurately diagnose high cholesterol is to perform blood testing. When a doctor measures cholesterol, they will look at the total cholesterol, triglycerides, LDL cholesterol and HDL cholesterol. Patients will typically need to fast for about 12 hours before the test to ensure the results are accurate.
The following represents cholesterol levels and how to know that they are high or healthy.
Reducing LDL (bad cholesterol) is very important in addition to increasing HDL (good cholesterol) levels. Healthy lifestyle include eating healthy diet and regular exercise can decrease the LDL and increase HDL levels.
In addition to adopting healthy lifestyle, there are a number of cholesterol-lowering medications doctor may prescribe.
These medications may include:
• Statins: These help the liver to get cholesterol out of your blood.
• Cholesterol absorption inhibitors: These limit how much cholesterol is absorbed in the small intestine.
• Bile-acid-binding resins: These help the liver to get more cholesterol out of the blood.
• Statin and cholesterol absorption inhibitor combination drugs: These work to reduce cholesterol absorption and help the liver to get cholesterol out of the blood.
If the triglycerides are high, there are certain medications doctor may prescribe, including:
• Fibrates: These increase the removal of triglycerides and decrease VLDL production.
• Omega-3 fatty acids: This may help to lower triglyceride levels.
• Niacin: This helps to reduce how well the liver can create VLDL and LDL cholesterol.
There are a few complications patient can experience if cholesterol is high and risk for complications gets higher as long as high cholesterol levels are left untreated. When the plaque buildup is not taken care of, it can lead to a condition called atherosclerosis. This condition means that on the artery walls, the plaques build up and can narrow or block the arteries.
If this happens, the following complications are possible:
• Heart attack: If any of the plaques rupture or tear, a clot can form and this blocks blood flow. When a part of the heart is not getting the blood it needs, a heart attack can happen.
• Chest pain: Chest pain is possible when the coronary arteries are narrowed or blocked.
• Stroke: A stroke happens when there is something blocking blood from getting to the brain.
The one positive thing about high cholesterol is that there are a lot of things patient can do at home to help improve cholesterol levels and lower the risk of complications.
The following lifestyle changes are important when someone have high cholesterol:
• Lose excess weight
• Do not eat high LDL cholesterol containing/ fatty diet
• Eat more healthy fats (unsalted nuts e.g. peanuts, almonds, walnuts, sunflower seeds etc)
• Exercise regularly
• Eat whole grains
• Eat more fish
• Eat plenty of fresh vegetables and fruits
• Quit smoking