Cholesterol, like fat, cannot move around the bloodstream on its own because it does not mix with water. The bloodstream carries cholesterol in particles called lipoproteins that are like blood-borne cargo trucks delivering cholesterol to various body tissues to be used, stored or excreted. But too much of this circulating cholesterol can injure arteries, especially the coronary ones that supply the heart. This leads to accumulation of cholesterol-laden “plaque” in vessel linings, a condition called atherosclerosis.
When blood flow to the heart is impeded, the heart muscle becomes starved for oxygen, causing chest pain (angina). If a blood clot completely obstructs a coronary artery affected by atherosclerosis, a heart attack (myocardial infarction) or death can occur.
When there is too much cholesterol in your blood, it builds up in the walls of your arteries. Over time, this buildup causes "hardening of the arteries" so that arteries become narrowed and blood flow to the heart is slowed down or blocked. The blood carries oxygen to the heart, and if enough blood and oxygen cannot reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack.
Many people have multiple risk factors for heart disease and the level of risk increases with the number of risk factors. By reducing these risk factors you can largely prevent the onset of cardiovascular disease. On its own elevated blood cholesterol is not necessarily a problem, but coupled with one or more other risk factors for heart disease, it is often the straw that breaks the camel’s back.
It is, therefore, very important to know what your cholesterol levels are and to keep them at a healthy level before you have any problems.
High risk cholesterol:
If your total cholesterol level is 240 or more, it’s definitely high. You have a higher risk of heart attack and stroke. In fact, you should have your LDL and HDL cholesterol balanced.
People whose total cholesterol is 200 to 239 mg/dL have borderline-high cholesterol. In fact, people who have a total cholesterol of 240 mg/dL have twice the risk of coronary heart disease as people whose cholesterol level is 200 mg/dL.
Heredity – High cholesterol often runs in families. Even though specific genetic causes have been identified in only a minority of cases, genes still play a role in influencing blood cholesterol levels. If your parents have high cholesterol, you need to be tested to see if your cholesterol levels are also elevated.
Age and gender – Before menopause, women tend to have total cholesterol levels lower than men at the same age. Cholesterol levels naturally rise as men and women age. Menopause is often associated with increases in LDL cholesterol in women.
Stress – Studies have not shown stress to be directly linked to cholesterol levels. But experts say that because people sometimes eat fatty foods to console themselves when under stress, this can cause higher blood cholesterol.
Physical Activity - Not being physically active is a risk factor for heart disease. Regular physical activity can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also helps you lose weight. You should try to be physically active for 30 minutes on most, if not all, days.
Excess weight – Being overweight tends to increase blood cholesterol levels. Losing weight has been shown to help lower levels. A greater risk of increased cholesterol levels occurs when that extra weight is centered in the abdominal region, as opposed to the legs or buttocks.
Diet - Saturated fat and cholesterol in the food you eat make your blood cholesterol level go up. Saturated fat is the main culprit, but cholesterol in foods also matters. Reducing the amount of saturated fat and cholesterol in your diet helps lower your blood cholesterol level.
Cholesterol consists of two ingredients: High-Density Lipoproteins - HDL cholesterol (the good cholesterol) and Low-Density Lipoproteins - LDL cholesterol (the bad cholesterol).
The main goal of cholesterol-lowering treatment is to lower your LDL level enough to reduce your risk of developing heart disease or having a heart attack. There are two main ways to lower your cholesterol
TLC is a set of things you can do to help lower your LDL cholesterol. The main parts of TLC are:
Even if you begin drug treatment to lower your cholesterol, you will need to continue your treatment with lifestyle changes. This will keep the dose of medicine as low as possible, and lower your risk in other ways as well. There are several types of drugs available for cholesterol lowering including statins, bile acid sequestrants, nicotinic acid, fibric acids, and cholesterol absorption inhibitors. Your doctor can help decide which type of drug is best for you.
The statin drugs are very effective in lowering LDL levels and are safe for most people. Bile acid sequestrants also lower LDL and can be used alone or in combination with statin drugs. Nicotinic acid lowers LDL and triglycerides and raises HDL. Fibric acids lower LDL somewhat but are used mainly to treat high triglyceride and low HDL levels. Cholesterol absorption inhibitors lower LDL and can be used alone or in combination with statin drugs.
Once your LDL goal has been reached, your doctor may prescribe treatment for high triglycerides and/or a low HDL level, if present. The treatment includes losing weight if needed, increasing physical activity, quitting smoking, and possibly taking a drug.