Cholesterol is a type of fat which is made by your body and it is essential for good and proper health. It is an ingredient of every cell in your body and it plays a crucial part in your body. Though cholesterol is not only good for you, but necessary, that doesn't mean it is always a good thing.
In fact, a high cholesterol level, which is more than the normal amount of cholesterol your body is meant to have, in the blood which is called hypercholesterolemia and is associated with an increased risk of getting many different various problems. The most common of these problems are coronary heart disease and stroke.
So, what else do you need to know about high cholesterol levels, also called hypercholesterolemia?
What is cholesterol?
Cholesterol is a soft and waxy fat particle that circulates through blood, the most common steroid in the body. Cholesterol is a building block of cell membranes and essential in the formation of bile, which aids in the digestion of fats, vitamin D, and other steroids and hormones. The liver produces most of the cholesterol the body needs, but many popular foods contain cholesterol and substances used by the liver to produce cholesterol. A high intake of these foods can increase the level of cholesterol in the blood leading to condition called hypercholesterolemia.
What is hypercholesterolemia?
High cholesterol levels, or hypercholesterolemia, can cause the formation and accumulation of plaque deposits in the arteries. Plaque is composed of cholesterol, other fatty substances, fibrous tissue, and calcium, so when it builds up in the arteries, it results in atherosclerosis, or coronary heart disease. Atherosclerosis can lead to plaque ruptures and blockages in the arteries, which increase the risk of serious conditions, such as heart attacks, stroke circulation problems, and death. The development of plaques and blockages in the arteries involves several steps, but it begins when the innermost lining of the arteries (endothelium) is damaged. Then cholesterol particles deposit into the damaged wall and form plaques. After this, more cholesterol and other substances incorporate into the plaque and it grows, narrowing the artery. The problem is, plaque deposits can grow large enough to interfere with the blood flow through the artery, which results in blockage.
When coronary arteries (the arteries supplying the heart with blood) are blocked, chest pain such as angina may occur. When arteries in the legs are blocked, leg pain or cramping may occur, and when arteries supplying the brain with blood are blocked, a stroke may occur. If a plaque ruptures or tears, a blood clot may develop on top of it.
Types of cholesterol
Measurement unit for cholesterol are milligrams per deciliter of blood, and doctors are able to measure several different types of blood cholesterol. High levels of some types are worse or better than high levels of other types of cholesterol. Types include total blood cholesterol, HDL or high-density lipoprotein cholesterol (“good cholesterol”), then LDL or low-density lipoprotein cholesterol (“bad cholesterol”), and triglycerides, which are the backbone of many types of fat.
Total blood cholesterol is the most common cholesterol measurement, which measures the concentration of fat in the bloodstream, including cholesterol and triglyceride molecules contained in LDL, HDL, and other. Total blood cholesterol levels can help determine if LDL and triglyceride levels are likely to be normal or elevated. If total cholesterol levels are elevated, a lipid profile might determine which lipid level is too high.
HDL, or “good cholesterol” helps protect against atherosclerosis by preventing cholesterol from depositing on arterial walls as it circulates in the bloodstream. Low HDL levels occur because of genetic predisposition, lack of exercise, smoking, or obesity. Some physicians believe it is important to assess the ratio between total blood cholesterol and HDL cholesterol during diagnostic procedures. The ratio calculation works by dividing the HDL number into the total cholesterol number.
LDL or low-density lipoprotein taks up about 70% of total cholesterol in the body. This is mostly fat and not much protein, and causes cholesterol deposits in the arteries. High levels of LDL are associated with an increased risk of heart disease so this one is referred to as “bad cholesterol”.
Triglycerides are a different type of fat, which mostly come from fats in food, so the calories that we eat and do not use immediately convert into triglycerides, and are transported to fat cells for storage. Although most triglycerides are stored in fat tissue, low levels are also in the blood. The problem is that raised level of blood triglycerides together with high LDL can increase the risk of heart disease.
Why is high cholesterol a problem?
The main risk associated with high cholesterol is coronary heart disease and stroke. This is because blood vessels become narrow with fatty deposits called plaques, to which cholesterol contributes. The narrowed blood vessels reduce blood flow to the heart, which might result in angina or, if the vessel blocks completely, a heart attack. High cholesterol can also increase the risk of other conditions, depending on which blood vessels narrow or block. There is also a risk of peripheral vascular disease with problem of hypercholesterolemia. This problem commonly results in leg pain, ulcers, infections, and eventually gangrene.
What causes high cholesterol?
Several factors may contribute to high blood cholesterol, and most common is a diet high in saturated fats and, less so, high in cholesterol. The cause could also be a lack of exercise, which may increase LDL (“bad” cholesterol) and decrease HDL (“good” cholesterol). Family history could predispose some people to have a higher risk of high cholesterol, especially if they have a direct male relative aged under 55 or a female relative aged under 65 affected by coronary heart disease. Being overweight may increase LDL cholesterol and decrease HDL cholesterol as well. We should also consider age and sex, since cholesterol generally rises slightly with increasing age, and men are more likely to develop hypercholesterolemia than women are. Drinking alcohol excessively also contributes to this problem.
Rarely, high cholesterol levels develop because of a condition that runs in the family called a lipid disorder, or familial hypercholesterolemia. Some other health conditions such as poorly controlled diabetes, certain kidney and liver diseases, and an under-active thyroid gland may also cause cholesterol levels to rise. Some medicines such as beta-blockers, steroids or thiazides may also affect blood lipid levels and cause hypercholesterolemia.
How does diet affect blood cholesterol?
Only about 20% of cholesterol comes directly from the diet, while the other 80% is produced by the liver. However, a diet high in saturated fats and cholesterol can cause the liver to produce more LDL cholesterol. The amount of diet-based influence on cholesterol levels varies from person to person, and is probably an inherited characteristic. Some people who eat high-fat diets have high cholesterol levels. At the same time, others may have normal or low cholesterol levels.
Who should have a cholesterol test?
Anyone who has any cardiovascular disease, such as coronary heart disease, peripheral vascular disease, or stroke, should have his or her cholesterol measured by a doctor. Anyone, even children, with a family history of familial hypercholesterolemia should have cholesterol measured. Anyone aged 35 or over should consider having their cholesterol measured if they have some risk factors for CHD, or coronary heart disease. These risk factors are family history of early heart disease, diabetes, high blood pressure, or smoking.
Diagnosis of hypercholesterolemia
Having a high cholesterol level does not cause symptoms, so most people find out they have high cholesterol when they have their blood cholesterol measured as part of a medical check-up. Alternatively, a doctor could identify hypercholesterolemia after diagnosing other health problems, such as heart disease.
Treatment of hypercholesterolemia
The main aim of lowering cholesterol is to reduce the risk of heart disease and other problems hypercholesterolemia might provoke. The type of treatment depends on the overall risk of heart disease, but there are two ways to treat high cholesterol. The first is with simple lifestyle changes, including a diet change. You should also consider managing weight and increasing exercise. The second is to combine lifestyle changes with cholesterol-lowering medicines the doctor should prescribe.
Dieting and healthy eating can reduce cholesterol, so make sure that your diet is low in saturated fats in particular, and low in fat overall. Biscuits, cakes, pastries, red meat, hard cheese, butter and foods containing coconut or palm oil all tend to be high in saturated fats, so try to avoid them. Large amounts of cholesterol are contained in a few food types, including eggs and offal such as liver and kidneys. Although dietary cholesterol does not usually contribute much to blood cholesterol, still it is advisable to limit these foods to three servings a week if you have hypercholesterolemia. It is also important to eat plenty of fiber, especially soluble, which is able to lower cholesterol. You can get it from fruits and vegetables, beans and oats. You should aim to eat at least five portions of fruit and vegetables each day.
Medicines for cholesterol lowering should be prescribed to people who already have CHD. The doctor could also prescribe medicines for people who are at high risk of getting it because they have other risk factors. The main medicines for lowering cholesterol are statins, such as Zocor and Lipitor.