You have been diagnosed with high cholesterol levels, and you would like to know the basics about this condition, as well as understand what it means for you? Here, you will be able to find relevant information about your condition, from simple definitions to insights about hypercholesterolemia itself.
What is cholesterol?
Cholesterol is a waxy, fat-like substance that can be found in every cell of the body, of which it is an essential component. It also plays an important role in body functions such as hormone production and digestion. Cholesterol is produced by the liver, and its production is sufficient to cover the body needs. Still, there is another source of cholesterol: animal-based foods like milk, eggs, and meat. To avoid excess cholesterol, experts recommend eating as little dietary cholesterol as possible as part of a healthy diet.1,2
But I heard that there is good cholesterol and bad cholesterol. Is that true?
Yes and no… In fact, cholesterol is just cholesterol, but it travels through the blood on proteins called “lipoproteins”, of which there are two types:
- low-density lipoprotein, or LDL. The LDL cholesterol is sometimes called “bad” cholesterol, and it makes up for most of the body’s cholesterol.
- high-density lipoprotein, or HDL. The HDL cholesterol is called “good” cholesterol, for it “absorbs” cholesterol, which is brought back to the liver, processed, end eliminated.3
I have seen HDL and LDL on my blood results. How should I interpret them?
Cholesterol tests require a blood draw, indeed, but a lipid profile features more than just HDL and LDL. Your test results also show your triglyceride level, and the total cholesterol level.
Triglycerides are a type of fat that is an energy resource for the body, and total cholesterol represents the total amount of cholesterol in blood, entailing HDL, LDL, and triglycerides.
In an adult, desirable cholesterol levels are as follows:
Your results are important, but they should be interpreted by your physician. Depending on your age, gender, family history, your lifestyle, your smoking habits (or lack thereof), and other cardiovascular risk factors, your physician will be able to understand the full picture and determine whether action should be taken or not, if high LDL cholesterol levels should be lowered.4
What are the signs of excess cholesterol? Is it a serious condition?
Excess cholesterol in blood, called HYPERCHOLESTEROLEMIA, usually has no signs or symptoms, hence the importance of a regular check. Especially when considering that, yes, hypercholesterolemia can have serious consequences.4
If HDL cholesterol contributes to the elimination of excess cholesterol, on the opposite, LDL cholesterol can build up on the walls of your blood vessels, creating deposits called “ATHEROMATOUS PLAQUE” (or ATHEROMA). As plaque gets thicker, the inside of the arteries becomes narrower, a process called atherosclerosis. As plaque develops, it impairs the blood flow and can trigger heart disease. Ultimately, when blood flow to the heart is blocked, it can cause chest pain (called angina), a heart attack (myocardial infarction) and even a heart failure.3,5,6
Am I at risk of high cholesterol?
Hypercholesterolemia is a very common condition. In 2008, the World Health Organization published statistics regarding the prevalence of raised total cholesterol among adults worldwide.7
Many risk factors have been identified for high cholesterol.
- Age: The risk for hypercholesterolemia increases with age. Because the body’s capacity to clear cholesterol deteriorates as we get older, cholesterol levels increase, which in turn raises the risk of stroke and heart disease.8
- Gender: Until their mid-50s (or until menopause), women tend to have lower bad cholesterol levels, and at any age higher good cholesterol levels. Still, after menopause (around age 55), LDL cholesterol levels in women increase.8,9
- Family history: some forms of hypercholesterolemia can be due to the overproduction of bad cholesterol by the liver, with a genetic predisposition. In many cases, though, high cholesterol stems from a combination of genetics and diet, for family members often share behaviors and lifestyles.8
- Behaviors and lifestyle choices:
- Since the liver provides enough cholesterol to cover the body needs, dietary cholesterol should be limited. Foods high in saturated fat (meat, dairy products…) or in trans fat (fried foods, baked goods…) may contribute to high cholesterol and related conditions, such as heart disease. Choosing foods low in saturated fat, trans fat, sodium (salt), and added sugars (e.g. lean meat, seafood, fat-free or low-fat dairy products, whole grains, fruits, and vegetables), or high in fiber (e.g. oatmeal and beans) and unsaturated fats (e.g. avocado, olive oil…) may improve your lipid profile.8
- A lack of physical activity can result in gain weight, which can lead to high cholesterol.8
- Smoking is detrimental to blood vessels, making them more likely to accumulate fatty deposits.8
I have cholesterol issues. Are there other conditions I should pay special attention to?
Indeed, other pathologic conditions can interplay with hypercholesterolemia, and cause even further damage. Such comorbid conditions include:
- Type 2 diabetes: Patients with Type 2 diabetes often have lower HDL cholesterol levels and elevated triglyceride and LDL cholesterol levels, which raises the risk for heart disease and stroke.
- Obesity. Obesity is associated with elevated levels of triglycerides and LDL cholesterol, and lower HDL cholesterol levels.8
- CDC. About High Blood Cholesterol. 2019. Available at https://www.cdc.gov/cholesterol/about.htm Accessed on 08 July 2019.
- Cox RA, Garcia-Palmieri MR. Cholesterol, Triglycerides, and Associated Lipoproteins. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Walker HK, Hall WD, Hurst JW, editors. Boston: Butterworths; 1990.
- CDC. LDL & HDL – Good & Bad Cholesterol. 2017. Available at https://www.cdc.gov/cholesterol/ldl_hdl.htm Accessed on 08 July 2019.
- CDC. Getting Your Cholesterol Checked. 2019. Available at https://www.cdc.gov/cholesterol/cholesterol_screening.htm Accessed on 08 July 2019.
- CDC. Coronary Artery Disease – Causes, Diagnosis & Prevention. 2015. Available at https://www.cdc.gov/heartdisease/coronary_ad.htm Accessed on 08 July 2019.
- NHS. Coronary heart disease. 2017. Available at https://www.nhs.uk/conditions/coronary-heart-disease/ Accessed on 08 July 2019.
- WHO. Global Health Observatory – Map Gallery. Available at https://www.who.int/gho/map_gallery/en/ Accessed on 08 July 2019.
- CDC. Knowing Your Risk – High Cholesterol. 2019. Available at https://www.cdc.gov/cholesterol/risk_factors.htm Accessed on 08 July 2019.
- CDC. How and When to Have Your Cholesterol Checked – Features. 2018. Available at https://www.cdc.gov/features/cholesterol-screenings/index.html Accessed on 08 July 2019.