High Cholesterol
What is it?
Cholesterol and triglycerides are the two major
fats in the blood. Blood fats are also called
lipids. Your body makes cholesterol (in the liver)
and gets it from food, then uses it to build cell
membranes and hormones. Cholesterol testing is an
analysis of the cholesterol levels in a sample of
your blood. High cholesterol is a total
cholesterol reading over 240. However, a total
cholesterol reading between 200 and 239 is
considered borderline high. High levels of
cholesterol in the bloodstream can block blood
flow and increase your risk of health problems
such as atherosclerosis and coronary artery or
carotid artery disease. These diseases increase
your risk of having a heart attack or stroke.
However, not all cholesterol is bad. To travel
through the bloodstream, cholesterol attaches
itself to certain proteins. The combination of
fats and proteins are called lipoproteins.
Cholesterol is carried by two types of
proteins. A high level of low-density lipoproteins
(LDL) increases the risk of heart disease because
it leaves the fat on the inside walls of the blood
vessels and deposits it in body tissues. You may
have heard LDL referred to as the "bad
cholesterol." The cholesterol carried by
high-density lipoproteins (HDL) lowers your risk
of heart disease, and is often called "good
cholesterol." HDL actually helps your body get rid
of cholesterol. Cholesterol is usually measured as
total serum cholesterol. However, because the
level of HDL cholesterol is so important, many
doctors look at the ratio of the total cholesterol
level to HDL cholesterol level to assess the risk
of heart disease.
Who gets it?
Anyone can develop high cholesterol, but some
people are more likely than others due to disease
or a genetic disorder.
What causes it?
For many people, high cholesterol is caused by
eating a diet that is high in saturated fats and
cholesterol. Some people, however, have an
inherited disorder in which the body cannot
properly metabolize cholesterol. Others have a
disease that causes high cholesterol levels, such
as kidney and liver disease, hypothyroidism, an
overactive pituitary gland, and diabetes mellitus.
What are the symptoms?
There are no symptoms of high cholesterol until
the high levels of cholesterol in the bloodstream
have blocked blood flow. This is signaled by
health problems such as atherosclerosis or
coronary artery disease, which can result in heart
attack or stroke. Narrowed or blocked arteries to
the legs can cause leg pain when walking.
How is it diagnosed?
Your doctor will take a complete medical
history and perform a thorough physical exam. High
cholesterol is diagnosed by a total serum
cholesterol test. A small amount of blood (5
milliliters) is withdrawn from one of your veins
while you are seated. Once the blood is removed,
it will be carefully labeled with information such
as your name, the time and date the blood was
drawn, and your doctor's name. Then, the blood
will be separated in a laboratory so the levels of
cholesterol and HDL, as well as any other
lipoproteins, can be measured. If you are having a
cholesterol test, you should fast for at least 12
hours before the test. This means you may not eat
anything, and may drink only water. Avoid alcohol
for 24 hours before the test. Your doctor may
recommend that you stop taking any medications
that may affect the accuracy of the test results.
However, do not stop taking any regularly
prescribed medications unless your doctor tells
you to. In general, desired test results for
adults are as follows: Total cholesterol (TC):
Below 200 milligrams of cholesterol per deciliter
of blood (mg/dl). HDL cholesterol: Above 40 mg/dl
LDL cholesterol: Below 130 mg/dl TC/HDL ratio:
Below 4.0
What is the treatment?
Treatment of high cholesterol depends upon its
cause. Where high cholesterol is caused by a diet
high in fatty foods, it can be lowered by altering
your diet. Foods to avoid include whole eggs;
shellfish; organ meats such as liver, brain,
heart, kidneys, and sweetbreads; snacks and lunch
meats that are high in saturated fats; fried
foods; and desserts that are high in fats.
Some tips for lowering your fat intake include
removing the fat from meats before cooking them,
using egg whites instead of whole eggs,
substituting applesauce for oil when baking, and
using skim milk and other low fat dairy products.
A diet high in fresh fruits, grains, vegetables,
and beans is important to good health. Read the
labels on the products you buy; sometimes just
reading the ingredients of unhealthy foods is
enough to prevent you from buying them! Some
people, such as those whose high cholesterol is
caused by an inherited disorder, must take
medication to control their cholesterol levels, in
addition to following a healthy diet. Commonly
prescribed medications include cholestyramine,
colestipol, lovastatin, pravastatin, simvastatin,
probucol, gemfibrozil, or niacin. Like most drugs,
these have possible side effects that your doctor
should discuss with you. Where high cholesterol is
caused by disease, treatment is specific to the
underlying disease. Everyone with high cholesterol
also benefits from a doctor-approved exercise
program.
Self-care tips
Most people can control their total serum
cholesterol by following a healthy diet;
maintaining a healthy weight for their age,
height, and body type; not smoking; and
participating in a regular exercise program. A
healthy diet includes the daily recommended
servings of fruits, vegetables, beans, and whole
grains. While you don't need to give up all red
meats and foods containing saturated fats, they
should be eaten in moderation. The key to a
healthy diet is not to deprive yourself of foods
you like, but to balance them with more healthy
foods.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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