High Cholesterol

High cholesterol refers to several disorders that can result in too much fat (lipids) in the blood. These lipids can enter the walls of the arteries and increase the risk for developing hardening of the arteries (atherosclerosis). When this occurs, the crucial blood flow to the rest of your body is affected. If not enough blood is flowing to your heart or brain, a heart attack or stroke can occur.

Types of High Cholesterol

  • Total cholesterol: A measure of the total amount of cholesterol in your blood. It includes the two types: low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol.
    • Low-density lipoprotein (LDL) cholesterol: The “bad cholesterol.” This type is the main source of cholesterol buildup and blockage in the arteries.
    • HDL (good) cholesterol: This “good cholesterol.” This type carries cholesterol from other parts of your body back to the liver. Your liver then processes the cholesterol out of your body.
  • Triglycerides: The most common type of fat in the body. Triglycerides are not a type of cholesterol but are a part of a lipoprotein panel (test that measures cholesterol levels). A high triglyceride level combined with low HDL or high LDL is linked with fatty buildups in the artery walls.

Causes of High Cholesterol

High cholesterol is most commonly associated with high-fat diets, a sedentary lifestyle, obesity and diabetes. However, other conditions, traits or habits may also raise your risk for the disease. These conditions are known as risk factors and include:

Non-modifiable risk factors: These factors are irreversible and cannot be changed. The more of these risk factors you have, the greater your chance of developing high cholesterol.

  • Family history/Genetics
  • Occurs at any age
  • Gender

Modifiable risk factors: These factors can be modified, treated or controlled through medications or lifestyle changes.

  • Excessive alcohol consumption over many years.
  • Eating too much saturated fat, trans fat and cholesterol such as red meats, whole milk, egg yolks, butter, cheese, fried foods, and packaged foods.
  • Smoking

Other conditions that contribute to developing high cholesterol

  • Thyroid disease: a condition that is caused by the over or under function of the thyroid gland. The thyroid gland is an essential organ for producing thyroid hormones, which maintains the body’s metabolism.
  • Liver cirrhosis: a serious degenerative disease that occurs when healthy cells in the liver are damaged and replaced by scar tissue, usually as a result of alcohol abuse or chronic hepatitis.
  • Nonalcoholic fatty liver disease: a group of liver conditions affecting people who drink little to no alcohol.

Symptoms of High Cholesterol

Elevated blood lipid levels alone do not cause symptoms, except with pancreatitis (a painful inflammation of the pancreas). However, if symptoms do appear, they usually present themselves as serious medical emergencies:

Diagnosis of High Cholesterol

A blood test that analyzes lipid levels is called a lipid panel. This test is traditionally performed after an overnight fast. The period of fasting is usually 9 to 12 hours. Your test report will show your cholesterol level in milligrams per deciliter of blood (mg/dL). Desirable test ranges are as follow:

  • Low-density lipoprotein (LDL) cholesterol
    • A normal range is less than 130mg/dL
  • Very-low density lipoprotein (VLDL) cholesterol
    • A normal range is less than 31mg/dL

LDL and VLDL cholesterol are the so-called "bad" cholesterols which increase the risk for atherosclerosis.

  • High-density lipoprotein (HDL) cholesterol
    • A normal range is less than 40 mg/dL
  • Total cholesterol
    • A normal range is less than 200mg/dL
      • With all of the non-HDL cholesterol being less than 130mg/dL
  • Triglycerides
    • A normal range is less than 150mg/dL

Treatment of High Cholesterol

Treatment usually begins with some lifestyle changes; however, in most cases, other options may be needed. Treatment options include:

Lifestyle changes

  • Avoid smoking
  • Eat a heart-healthy diet, especially low-fat diet.
  • Exercise under the directions of your doctor.
  • If you’re overweight, talk to your doctor about weight-loss options.
  • If applicable, ask your doctor more information on diabetes management.
  • Make and keep appointments to see your doctor for routine check-ups and follow-up tests.

Medications

  • Statins will help lower your LDL “bad” cholesterol.
  • Bile acid binding resins will help lower your LDL “bad” cholesterol.
  • Cholesterol absorption inhibitors will help lower your LDL “bad” cholesterol.

If you also have high triglycerides, your doctor may prescribe:

  • Fibrates will help lower blood triglyceride levels.
  • Niacin will help lower your cholesterol and triglyceride levels.
  • Omega-3 fatty acid supplements will help lower your cholesterol and triglyceride levels.
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