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The facts on high cholesterol
Cholesterol is a fatty substance your body needs to rebuild its cells and to make certain hormones. It's carried throughout your body in your bloodstream. Your body only requires a small amount of cholesterol.
When there's too much cholesterol in your bloodstream, you have high cholesterol. This is quite a common condition. Cholesterol levels generally rise with age. High cholesterol can increase your risk of heart disease, stroke, and peripheral vascular disease.
Most of your body's cholesterol (about 80%) is made in your liver. The rest comes from your diet. Dietary cholesterol is found in foods from animal sources, such as eggs, meats, and dairy products. There are two important types of cholesterol you should know about:
- low density lipoprotein (LDL) or "bad" cholesterol
- high density lipoprotein (HDL) or "good" cholesterol
Most of the LDL or "bad" cholesterol circulates in the blood and remains unused. Normally, the liver removes this "extra" cholesterol, but many people have more LDL cholesterol than the liver can handle. LDL cholesterol promotes build-up of harmful plaque (fatty deposits) in the walls of the arteries.
HDL gets its "good" name by picking up LDL cholesterol from the arteries and tissues and carrying it back to the liver, where it can be broken down.
Causes
Many factors determine whether your LDL cholesterol is high or low, including:
- diet
- weight
- level of physical activity
- age (cholesterol levels increase with age)
- gender (men have higher cholesterol)
- alcohol consumption
- heredity
As mentioned in the list above, one cause of high cholesterol is diet - eating foods that are high in saturated fats and cholesterol. Other factors that can increase your cholesterol levels include an inactive lifestyle and being overweight. In some cases, high cholesterol is an inherited genetic condition, called familial hypercholesterolemia. This condition puts you at an increased chance of developing heart disease at an early age.
Some medical conditions, such as diabetes, hypothyroidism, liver disease, and kidney disease, can raise cholesterol levels.
Treating and preventing high cholesterol
Lowering cholesterol levels with treatment reduces the risk of developing coronary artery disease, heart attack, stroke, and other disorders.
A healthy lifestyle is the best defense against high cholesterol. This also helps against other risk factors linked to coronary artery disease. The following lifestyle changes are good first steps in treating high cholesterol:
- follow a diet low in saturated fats and cholesterol
- eat a wide variety of vegetables, whole grains, fruits, nuts, and seeds
- boost your level of physical activity
- maintain a healthy body weight
- moderate alcohol consumption (no more than 2 drinks per day to a maximum of 9 per week for women or 14 per week for men)
If you quit smoking and keep your blood pressure down, it will help lower your risk of developing angina, heart attack, and stroke.
For people who are at a very high risk for coronary artery disease, drug therapy is started immediately, along with lifestyle changes. For those at moderate or low risk for coronary artery disease, medication therapy is started if lifestyle changes don't lower cholesterol to target levels within 3 to 6 months.
Medications used to treat high cholesterol include the "statins" (e.g., atorvastatin, lovastatin, simvastatin), resins (e.g., cholestyramine, colestipol), fibrates (e.g., fenofibrate, gemfibrozil), cholesterol absorption inhibitors (e.g., ezetimibe), and niacin. Medications have been shown to lower the chance of further clogging of the arteries and treat cholesterol problems by lowering levels of LDL (bad) cholesterol or raising the levels of HDL (good) cholesterol.
Some people think that it's too late to change your habits if you've already had a heart attack, but this is not true. It's vital to reduce your cholesterol to help prevent a second heart attack. Some patients with heart disease are now treated with a "statin" even if their cholesterol is normal. Your body is constantly producing cholesterol, so you must take your medication and follow lifestyle changes as recommended by your doctor to prevent levels from rising.
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