Research For Your Health
The NHLBI is part of the U.S. Department of Health and Human Services National Institutes of Health the Nations biomedical research agency that makes important scientific discoveries to improve health and save lives. We are committed to advancing science and translating discoveries into clinical practice to promote the prevention and treatment of heart, lung, blood, and sleep disorders, including high blood cholesterol. Learn about current and future NHLBI efforts to improve health through research and scientific discovery.
Does High Cholesterol Cause Heart Disease
In our guide on saturated fat and heart disease we introduced the three steps that lead to the cholesterol theory of heart disease:
1) Saturated fat in the diet increases the amount of bad cholesterol in the blood2) Higher levels of bad cholesterol clog the arteries and lead to heart disease.
3) Saturated fat increases the risk of heart disease.
We discussed how the evidence supporting this third claim seemed very weak. In this guide well be looking at the second claim: Do higher blood cholesterol levels cause heart disease?
Symptoms Of Familial Hypercholesterolaemia
High blood cholesterol can be asymptomatic, which means the person may not even realise they have it. Some of the signs and symptoms of familial hypercholesterolaemia can include:
- family history of the disorder
- family history of heart attacks at an early age
- high LDL cholesterol levels that resist treatment in one or both parents
- cholesterol deposits on the knees, elbows and buttocks
- high blood cholesterol levels
- chest pain caused by narrowed coronary arteries
- heart attack early in life.
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Ways To Lower Cholesterol
Check your own cholesterol level and if it’s high, ask to have your kids’ levels checked.
Here are 5 ways to help keep your family’s cholesterol in control:
It’s important to make healthy living a family effort. The steps you take to improve your family’s lifestyle will have a positive effect on your family’s health now and far into the future.
What Is The Point Of Lowering My Cholesterol
Evidence strongly suggests that high cholesterol can increase the risk of:
- Artery narrowing
- Transient ischemic attack also known as a mini stroke
This is due to the fact that cholesterol can accumulate in the artery wall, restricting blood flow to your heart, brain, and the rest of your body. It also increases your chances of developing a blood clot somewhere in your body.
As your blood cholesterol level rises, so does your risk of developing coronary heart disease. During times of stress or physical activity, this can cause pain in your chest or arm .
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Why Is Cholesterol Important
Too much cholesterol can build up in your blood vessels. This build up can narrow the vessels and lead to a blockage, preventing blood from getting to a certain area of your body. When this occurs in your heart vessels, it is called coronary heart disease and can cause a heart attack or stroke.
In people with chronic kidney disease , heart and blood vessel disease is very common. It is suggested that people with CKD have cholesterol labs drawn at least yearly. Your doctor may want to do them more frequently if something has changed with your health.
What You Should Worry About
Should you actually worry about cholesterol in food? The greater danger for everyone is in foods that are high in trans fats.
Those often appear on food labels as hydrogenated oils or partially hydrogenated vegetable oil, he says. Those types of fats do tend to raise cholesterol and do tend to increase the risk of heart disease.
All in all, look for trans fat and saturated fat on labels at the grocery store. The American Heart Association recommends;limiting dietary saturated;fat intake and focusing more on eating fruits, veggies, whole grains, lean animal protein or plant protein sources.
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What’s The First Step In Treating High Cholesterol
Guidelines for treating problems with cholesterol emphasize lifestyle changes. These are:
- Increase physical activity to 30 minutes every day at a moderate level
- Obtain and maintain a healthy weight
- Talk to your doctor and dietitian about how to improve your food choices
- Do not smoke
- Do not drink alcohol excessively
Trans Fats And Saturated Fats
Trans fats raise your LDL cholesterol and lower your HDL cholesterol. Both of these changes are associated with increased risk of heart disease, according to the American Heart Association. Trans fats also offer no nutritional value.
Partially hydrogenated oils are the main source of trans fat in our diets. Theyre found in many types of processed foods.
In 2018, the U.S. Food and Drug Administration made a final determination that PHOs arent safe for human consumption. Theyre now being phased out of our food supply. In the meantime, try to avoid food that lists PHOs or trans fats on the label.
Saturated fats are another source of LDL cholesterol and should be consumed sparingly. Foods containing saturated fats include:
- sweet treats and pastries such as donuts, cakes, and cookies
- red meat, fatty meat, and highly processed meat
- shortening, lard, tallow
- many fried foods
- whole-fat dairy products such as milk, butter, cheese, and cream
These high-cholesterol foods, along with processed and fast foods, can contribute to weight gain and obesity. Being overweight or obese raises your risk of heart disease as well as other health conditions.
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Cholesterol And Chronic Heart Failure
Heart disease may lead to a weakening of the heart muscle. A weak heart means that less blood and therefore less oxygen is delivered to the arteries. To compensate for the decreased power, the heart beat goes up, but in severe heart failure this is not sufficient. Patients with severe heart failure become short of breath because too little oxygen is delivered to the tissues, the pressure in their veins increases because the heart cannot deliver the blood away from the heart with sufficient power, and they become edematous, meaning that fluid accumulates in the legs and in serious cases also in the lungs and other parts of the body. This condition is called congestive or chronic heart failure.
There are many indications that bacteria or other microorganisms play an important role in chronic heart failure. For instance, patients with severe chronic heart failure have high levels of endotoxin and various types of cytokines in their blood. Endotoxin, also named lipopolysaccharide, is the most toxic substance produced by Gram-negative bacteria such as Escherichia coli, Klebsiella, Salmonella, Serratia and Pseudomonas. Cytokines are hormones secreted by white blood cells in their battle with microorganisms; high levels of cytokines in the blood indicate that inflammatory processes are going on somewhere in the body.
What Do The Studies Say
“For decades, the mainstream view has been that an elevated level of total cholesterol is a primary cause of atherosclerosis and cardiovascular disease . There are several contradictions to this view, however. No study of unselected people has found an association between TC and degree of atherosclerosis”.
“Moreover, in most of the Japanese epidemiological studies, high TC is not a risk factor for stroke, and further, there is an inverse association between TC and all-cause mortality, irrespective of age and sex”.
“It is well known that total cholesterol becomes less of a risk factor or not at all for all-cause and cardiovascular mortality with increasing age, but as little is known as to whether low-density lipoprotein cholesterol , one component of total cholesterol, is associated with mortality in the elderly…” the study published in the British Medical journal decided to study this further.
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Living With High Cholesterol
If you have high cholesterol, you are twice as likely to develop heart disease. That is why it is important to have your cholesterol levels checked, especially if you have a family history of heart disease. Reducing your LDL bad cholesterol through good diet, exercise, and medicine can make a positive impact on your overall health.
Why Does It Matter
You might be asking yourself, why does it matter what causes heart disease? Is it that important to know whether its bad LDL cholesterol or something else?
The reason we believe this is so important is because understanding the cause of a disease is the first step to preventing it. If you know the risk factors, youre likely to change the actions you do every day to lower your risk. However, if we get these risk factors wrong, we might actually be doing more harm than good.
So, whats the answer? Should we be worried about eating foods with saturated fat? Should everyone be taking drugs to reduce cholesterol levels?
Or is there a better way?
Our current view is that high levels of bad LDL cholesterol in the blood are not the main cause of heart disease. Instead, we believe theres another hypothesis that provides a good explanation for all the known risk factors for heart disease.
But before we get into this, lets understand a bit more about heart disease and the current widely held hypotheses.
- Its important to know whether LDL cholesterol causes heart disease because understanding the cause of a disease is the first step to preventing it.
- Currently, the evidence suggesting LDL cholesterol is to blame for heart disease seems weak.
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What Is The Difference Between Good Cholesterol And Bad Cholesterol
Good cholesterol is known as high-density lipoprotein . It removes cholesterol from the bloodstream. Low-density lipoprotein is the bad cholesterol.
If your total cholesterol level is high because of a high LDL level, you may be at higher risk of heart disease or stroke. But, if your total cholesterol level is high only because of a high HDL level, youre probably not at higher risk.
Triglycerides are another type of fat in your blood. When you eat more calories than your body can use, it turns the extra calories into triglycerides.
Changing your lifestyle can improve your cholesterol levels, lower LDL and triglycerides, and raise HDL.
Your ideal cholesterol level will depend on your risk for heart disease.
- Total cholesterol level; less than 200 is best, but it depends on your HDL and LDL levels.
- LDL cholesterol levels; less than 130 is best, but this depends on your risk for heart disease.
- HDL cholesterol levels; 60 or higher reduces your risk for heart disease.
- Triglycerides; less than 150 milligrams per deciliter is best.
Myth: I Would Be Able To Feel It If I Had High Cholesterol
Fact:;High cholesterol usually has no signs or symptoms. You may not know you have unhealthy cholesterol levels until it is too latewhen you have a heart attack or stroke. Thats why its so important to get your cholesterol levels checked at least every 5 years.1,2 Learn more about getting your cholesterol checked.
Occasionally, some people develop yellowish growths on their skin called;xanthomas, which are cholesterol-rich deposits. People with xanthomas may have high cholesterol levels.
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Know Your Numbers And What To Do About Them
When it comes to cholesterol, it’s important to know your numbers. Hyperlipidemia means your blood has too many lipids , such as cholesterol and triglycerides. One type of hyperlipidemia, hypercholesterolemia, means you have too much non-HDL cholesterol and LDL; cholesterol in your blood. This condition increases fatty deposits in arteries and the risk of blockages.
Another way your cholesterol numbers can be out of balance is when your HDL cholesterol level is too low. With less HDL to remove cholesterol from your arteries, your risk of atherosclerotic plaque and blockages increases.
If youre diagnosed with hyperlipidemia, your overall health and other risks such as smoking or high blood pressure;will help guide treatment. These factors can combine with high LDL cholesterol or low HDL cholesterol levels to affect your cardiovascular health. Your doctor may use the ASCVD Risk Calculator to assess your risk of a coronary event in the next 10 years.
The good news is, high cholesterol can be lowered, reducing risk of heart disease and stroke. If youre 20 years or older, have your cholesterol tested and work with your doctor to adjust your cholesterol levels as needed.
Often, changing behaviors can help bring your numbers into line. If lifestyle changes alone dont improve your cholesterol levels, medication;may be prescribed. Lifestyle changes include:
Is High Cholesterol Dangerous
High cholesterol is just one of several risk factors for coronary heart disease. A health-care professional will consider a person’s overall risk when assessing their cholesterol levels and discussing treatment options.
Risk factors are conditions that increase a person’s risk for developing heart disease. Some risk factors can be changed and others cannot. In general, the more risk factors a person has, the greater the chance of developing coronary heart disease. Some risk factors can be controlled; however, some cannot be controlled.
Risk factors that cannot be controlled include:
- Family history of early heart disease
Risk factors that can be controlled include:
- High blood cholesterol
- Low HDL cholesterol
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Ldl Cholesterol Or Bad Cholesterol
Low-density lipoprotein is often called bad cholesterol. It carries cholesterol to your arteries. If your levels of LDL cholesterol are too high, it can build up on the walls of your arteries.
The buildup is also known as cholesterol plaque. This plaque can narrow your arteries, limit your blood flow, and raise your risk of blood clots. If a blood clot blocks an artery in your heart or brain, it can cause a heart attack or stroke.
According to the
What Causes High Cholesterol
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Cholesterol is both good and bad. At normal levels, it is an essential substance for the body. However, if concentrations in the blood get too high, it becomes a silent danger that puts people at risk of heart attack.
Cholesterol is present in every cell of the body and has important natural functions when it comes to digesting foods, producing hormones, and generating vitamin D. The body produces it, but people also consume it in food. It is waxy and fat-like in appearance.
There are two types of cholesterol:
- low-density lipoproteins , or bad cholesterol
- high-density lipoproteins , or good cholesterol
In this article, we will explain the role of cholesterol. We will also discuss the causes of high cholesterol, and its symptoms, treatment, and prevention.
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High Cholesterol Protects Against Infection
Many studies have found that low cholesterol is in certain respects worse than high cholesterol. For instance, in 19 large studies of more than 68,000 deaths, reviewed by Professor David R. Jacobs and his co-workers from the Division of Epidemiology at the University of Minnesota, low cholesterol predicted an increased risk of dying from gastrointestinal and respiratory diseases.3
Most gastrointestinal and respiratory diseases have an infectious origin. Therefore, a relevant question is whether it is the infection that lowers cholesterol or the low cholesterol that predisposes to infection? To answer this question Professor Jacobs and his group, together with Dr. Carlos Iribarren, followed more than 100,000 healthy individuals in the San Francisco area for fifteen years. At the end of the study those who had low cholesterol at the start of the study had more often been admitted to the hospital because of an infectious disease.4,5 This finding cannot be explained away with the argument that the infection had caused cholesterol to go down, because how could low cholesterol, recorded when these people were without any evidence of infection, be caused by a disease they had not yet encountered? Isn´t it more likely that low cholesterol in some way made them more vulnerable to infection, or that high cholesterol protected those who did not become infected? Much evidence exists to support that interpretation.
Myth: All Cholesterol Is Bad For You
Fact:;Some types of cholesterol are essential for good health. Your body needs cholesterol to perform important jobs, such as making hormones and building cells. Cholesterol travels through the blood on proteins called;lipoproteins. Two types of lipoproteins carry cholesterol throughout the body:
- LDL ,;sometimes called bad;cholesterol,;makes up most of your bodys cholesterol. High levels of LDL cholesterol raise your risk for heart disease and stroke.
- HDL ,;or good;cholesterol,;carries cholesterol back to the liver. The liver then flushes it from the body. High levels of HDL cholesterol can lower your risk for heart disease and stroke.
When your body has too much LDL cholesterol, it can build up in the walls of your blood vessels. This buildup is called;plaque. As your blood vessels build up plaque over time, the insides of the vessels narrow. This narrowing can restrict and eventually block blood flow to and from your heart and other organs. When blood flow to the heart is blocked, it can cause angina or a heart attack.
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