Reshi Gano

What Is Cholesterol?

To understand high blood cholesterol (ko-LES-ter-ol), it is important to know more about cholesterol.
Cholesterol is a waxy, fat-like substance that is found in all cells of the body. Your body needs some cholesterol to work the right way. Your body makes all the cholesterol it needs.
Cholesterol is also found in some of the foods you eat.
Your body uses cholesterol to make hormones, vitamin D, and substances that help you digest foods.
Blood is watery, and cholesterol is fatty. Just like oil and water, the two do not mix. To travel in the bloodstream, cholesterol is carried in small packages called lipoproteins (lip-o-PRO-teens). The small packages are made of fat (lipid) on the inside and proteins on the outside. Two kinds of lipoproteins carry cholesterol throughout your body. It is important to have healthy levels of both:
Low-density lipoprotein (LDL) cholesterol is sometimes called bad cholesterol.
High LDL cholesterol leads to a buildup of cholesterol in arteries. The higher the LDL level in your blood, the greater chance you have of getting heart disease.
High-density lipoprotein (HDL) cholesterol is sometimes called good cholesterol.
HDL good cholesterol carries cholesterol from other parts of your body back to your liver. The liver removes the cholesterol from your body. The higher your HDL good cholesterol level, the lower your chance of getting heart disease.

What Is High Blood Cholesterol?
Too much cholesterol in the blood, or high blood cholesterol, can be serious. People with high blood cholesterol have a greater chance of getting heart disease. High blood cholesterol on its own does not cause symptoms, so many people are unaware that their cholesterol level is too high.
Cholesterol can build up in the walls of your arteries (blood vessels that carry blood from the heart to other parts of the body). This buildup of cholesterol is called plaque (plak). Over time, plaque can cause narrowing of the arteries. This is called atherosclerosis (ath-er-o-skler-O-sis), or hardening of the arteries.
Special arteries, called coronary arteries, bring blood to the heart. Narrowing of your coronary arteries due to plaque can stop or slow down the flow of blood to your heart. When the arteries narrow, the amount of oxygen-rich blood is decreased. This is called coronary heart disease (CHD). Large plaque areas can lead to chest pain called angina (an-JI-nuh or AN-juh-nuh). Angina happens when the heart does not receive enough oxygen-rich blood. Angina is a common symptom of CHD.
Some plaques have a thin covering and can burst (rupture), releasing cholesterol and fat into the bloodstream. The release of cholesterol and fat may cause your blood to clot. A clot can block the flow of blood. This blockage can cause angina or a heart attack.
Lowering your cholesterol level decreases your chance for having a plaque burst and cause a heart attack. Lowering cholesterol may also slow down, reduce, or even stop plaque from building up.
Plaque and resulting health problems can also occur in arteries elsewhere in the body.

Why Is Cholesterol Important?
Your blood cholesterol level has a lot to do with your chances of getting heart disease. High blood cholesterol is one of the major risk factors for heart disease. A risk factor is a condition that increases your chance of getting a disease. In fact, the higher your blood cholesterol level, the greater your risk for developing heart disease or having a heart attack. Heart disease is the number one killer of women and men in the United States. Each year, more than a million Americans have heart attacks, and about a half million people die from heart disease.

How Does Cholesterol Cause Heart Disease?
When there is too much cholesterol (a fat-like substance) 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.
High blood cholesterol itself does not cause symptoms; so many people are unaware that their cholesterol level is too high. It is important to find out what your cholesterol numbers are because lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack or dying of heart disease, even if you already have it. Cholesterol lowering is important for everyone-younger, middle age, and older adults; women and men; and people with or without heart disease.

What Do Your Cholesterol Numbers Mean?
Everyone age 20 and older should have their cholesterol measured at least once every 5 years. It is best to have
a blood test called a “lipoprotein profile” to find out your cholesterol numbers. This blood test is done after a 9 to 12 hour fast and gives information about your:
Total cholesterol
LDL, or bad cholesterol – the main source of cholesterol buildup and blockage in the arteries
HDL, or good cholesterol – helps keep cholesterol from building up in the arteries
Triglycerides – another form of fat in your blood

If it is not possible to get a lipoprotein profile done, knowing your total cholesterol and HDL good cholesterol can give you a general idea about your cholesterol levels. If your total cholesterol is 200 mg/dL* or more or if your HDL good cholesterol is less than 40 mg/dL, you will need to have a lipoprotein profile done.

See how your cholesterol numbers compare to the tables below.
Total Cholesterol Level Category
Less than 200 mg/dL Desirable
200-239 mg/dL Borderline high
240 mg/dL and above High
LDL Cholesterol Level LDL Cholesterol Category
Less than 100 mg/dL Optimal
100-129 mg/dL Near optimal/above optimal
130-159 mg/dL Borderline high
160-189 mg/dL High
190 mg/dL and above Very high

HDL good cholesterol, protects against heart disease, so for HDL good cholesterol, higher numbers are better.
A level less than 40 mg/dL is low and is considered a major risk factor because it increases your risk for developing heart disease. HDL good cholesterol levels of 60 mg/dL or more help to lower your risk for heart disease.

Triglycerides can also raise heart disease risk. Levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more) may need treatment in some people.

What Affects Cholesterol Levels?
A variety of things can affect cholesterol levels. These are things you can do something about:

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.

Weight
Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol.
Losing weight can help lower your LDL and total cholesterol levels, as well as raise your HDL good cholesterol and lower your triglyceride levels.

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.

Things you cannot do anything about also can affect cholesterol levels. These include:

Age and Gender
As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women’s LDL levels tend to rise.

Heredity
Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.

Lowering Cholesterol With Therapeutic Lifestyle Changes (TLC) TLC is a set of things you can do to help lower your LDL cholesterol. The main parts of TLC are:
The TLC Diet
This is a low saturated-fat, low-cholesterol eating plan that calls for less than 7 percent of calories from saturated fat and less than 200 mg of dietary cholesterol per day. The TLC diet recommends only enough calories to maintain a desirable weight and avoid weight gain. If your LDL is not lowered enough by reducing saturated fat and cholesterol intakes, the amount of soluble fiber in your diet can be increased. Certain food products that contain plant stanols or plant sterols (for example, cholesterol lowering margarines) can also be added to the TLC diet to boost its LDL-lowering power.

Weight Management
Losing weight if you are overweight can help lower LDL and is especially important for those with a cluster of risk factors that includes high triglyceride and/or low HDL good cholesterol levels and being overweight with a large waist measurement (more than 40 inches for men and more than 35 inches for women).

Physical Activity
Regular physical activity (30 minutes on most, if not all, days) is recommended for everyone.
It can help raise HDL good cholesterol and lower LDL and is especially important for those with high triglyceride and/or low HDL good cholesterol levels who are overweight with a large waist measurement.

Drug Treatment
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 good cholesterol. Fibric acids lower LDL somewhat but are used mainly to treat high triglyceride and low HDL good cholesterol 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 good cholesterol level, if present. The treatment includes losing weight if needed, increasing physical activity, quitting smoking, and possibly taking a drug.

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