What Age Should I Get Screened For High Blood Cholesterol
About 1 in 5 adolescents have an unhealthy cholesterol reading,1 and nearly 93 million U.S. adults age 20 or older have high cholesterol.2 But since high cholesterol doesnt have symptoms, many people dont know their levels are high.
Cholesterol should be checked starting early in lifeeven children and adolescents should have their cholesterol checked.
Cholesterol testing should be done
- Every 5 years for people age 20 or older who are at low risk for cardiovascular disease.3
- More frequently than every 5 years for people with cardiovascular disease risk factors.3
The 2018 ACC/AHA Guidelines recommend that cholesterol management be based on a persons lifetime cardiovascular risk.1
If your family has a history of early heart attacks or heart disease, or if a child has obesity or diabetes, doctors may recommend screening for high cholesterol more often.
Ways To Prevent High Cholesterol
You can prevent high cholesterol the same way you can help lower itby living a healthy lifestyle focused on a heart-healthy diet and exercise. Other strategies that can help prevent high cholesterol include:
- Quitting smoking
- Getting enough good quality sleep
- Limit alcohol intake
However, if you have familial hypercholesterolemia, you may not be able to prevent it. You can work with your doctor to detect it early and manage it to prevent complications.
Signs And Symptoms Of High Cholesterol
High cholesterol on its own doesn’t usually cause symptoms. People often don’t realize they have high cholesterol until they get tested. However, the complications that high cholesterol causes do. As arteries and other blood vessels narrow and blood flow is slowed or stopped, every part of your body can be affected.
Uncontrolled high cholesterol can lead to the following complications:
- Atherosclerosis, which is a buildup of fatty deposits in your blood vessels
- Carotid artery disease, which is narrowing of the blood vessels in the neck that carry blood from the heart to the brain
- Coronary heart disease, which is damage or disease in the heart’s major blood vessels
- Heart attack
- Peripheral artery disease, which is narrowing or blockage of the vessels that carry blood from the heart to the legs
- Stroke
Symptoms of these complications can include:
- Dizziness
- Fatty deposits of cholesterol visible from under the skin called xanthelasmas
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What Is High Cholesterol
Cholesterol is a fatty molecule that your cells need to function. Your liver makes it, but you can also get cholesterol from the foods you eat.
The term high cholesterol usually refers to the amount of cholesterol being carried in the blood by low-density lipoprotein, or LDL . High-density lipoprotein, or HDL, cholesterol increases your risk of atherosclerosis, where deposits of cholesterol, calcium and white blood cells produce plaques in the walls of arteries. These plaques can reduce blood flow to vital organs like the heart and brain, and produce serious complications like heart attack and stroke.
There can be many reasons why your cholesterol is high:
Getting A Cholesterol Test
A blood sample is taken that will be used to determine the amount of bad cholesterol , good cholesterol and other fatty substances in your blood.
You may be asked not to eat for 10-12 hours before the cholesterol test, usually including when you’re asleep at night. This ensures that all food is completely digested and won’t affect the outcome of the test.
Your GP or practice nurse can carry out the cholesterol test and will take a blood sample, either using a needle and a syringe or by pricking your finger.
A newer type of test that measures non-high-density lipoprotein is now sometimes used because it’s thought to be a more accurate way of estimating cardiovascular disease risk than LDL.
Non-HDL cholesterol is total cholesterol minus HDL cholesterol. It’s also not necessary to fast before the test, so it is more convenient.
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How Can I Keep Healthy Blood Cholesterol Levels
Talk to your doctor about your numbers. Your risk of disease depends on other factors, too, in combination with high cholesterol. To keep your cholesterol managed, you should do the following:
- Choose healthy foods. Limit foods that are high in saturated or trans fats, sugar, and sodium . Choose foods high in fiber, such as fresh fruits and veggies, and in unsaturated fats, such as avocados and nuts. Learn more about healthy eatingexternal icon.
- Stay physically active. You should get at least 2 hours and 30 minutes of moderate exercise, such as biking or brisk walking, every week.6Learn more about physical activityexternal icon.
- Dont smoke. Smoking damages the blood vessels and greatly increases the risk for heart disease and stroke. If you dont smoke, dont start. If you smoke, learn how to quit.
- Take medicine if necessary. A healthy diet and physical activity can help many people reach healthy cholesterol levels, but some people may need medicines to lower their cholesterol. Always take your medicine as prescribed.
Learn more about ways to prevent high cholesterol.
Are There Any Treatments For High Cholesterol Levels Caused By Genetics
Usually, the first line of treatment for high cholesterol is lifestyle modification, but if you have FH youll need more advanced treatment. Its always important to eat a low-fat diet, exercise and control your weight. Having a healthy lifestyle is crucial for heart health and for overall health, says Martin. However, people with FH could eat an extremely low-fat diet and still not be able to control their cholesterol because theyre genetically unable to handle it. For them, cholesterol is going to build up in the bloodstream regardless of what they eat.
Fortunately, there are medications that can substantially lower LDL cholesterol levels. The most common treatment for FH is statin drug therapy. Statin drugs work by blocking an enzyme that produces cholesterol in the liver and increases your bodys ability to remove cholesterol from the blood. They can lower your LDL cholesterol levels by 50 percent or more. Statins have been safely used to reduce the risk of heart disease for 30 years and continue to be the number one option when it comes to helping people with FH.
Other treatment options include medications that block cholesterol from being absorbed from your intestines into your bloodstream, or drugs that block an enzyme called PCSK9, which reduces the amount of LDL cholesterol in your blood.
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Complications Of High Cholesterol
Since high cholesterol alone typically doesnt cause any symptoms, people only experience complications when their high cholesterol contributes to the development of severe heart disease, often in the form of heart attack or stroke. Over the long term, high cholesterol can cause plaque to form in your arteries, which can then narrow and lead to a cardiovascular emergency.
Medicines To Lower Cholesterol
For some people, making lifestyle changes alone does not their lower cholesterol enough. They may also need to take medicines. There are several types of cholesterol-lowering drugs available. They work in different ways and can have different side effects. Talk to your health care provider about which medicine is right for you.
Even if you take medicines to lower your cholesterol, you still need to continue with lifestyle changes.
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Consider Plant Sterols And Stanols
Multiple types of supplements show promise for managing cholesterol.
Plant stanols and sterols are plant versions of cholesterol. Because they resemble cholesterol, they are absorbed from the diet like cholesterol.
However, because parts of their chemistry are different from human cholesterol, they do not contribute to clogged arteries.
Instead, they reduce cholesterol levels by competing with human cholesterol. When plant sterols are absorbed from the diet, this replaces the absorption of cholesterol.
Small amounts of plant stanols and sterols are naturally found in vegetable oils and are added to certain oils and butter substitutes.
A research review reported that clinical studies show that taking 1.53 grams of plant sterols/stanols daily can reduce LDL concentration by 7.512%. Researchers said taking it with a main meal twice per day allows for optimal cholesterol-lowering .
Although research has established the cholesterol-lowering benefit of plant stanols and sterols, it has not yet proved that they decrease the risk of heart disease. Numerous clinical trials have suggested that plant sterols supplements and enriched foods may lower heart disease risk, but hard data is still lacking .
summary
Plant stanols and sterols in vegetable oil or margarines compete with cholesterol absorption and reduce LDL by up to 20%. They are not proven to reduce heart disease.
Symptoms Of High Cholesterol
Often, there are no specific symptoms of high cholesterol. You could have high cholesterol and not know it.
If you have high cholesterol, your body may store the extra cholesterol in your arteries. These are blood vessels that carry blood from your heart to the rest of your body. A buildup of cholesterol in your arteries is known as plaque. Over time, plaque can become hard and make your arteries narrow. Large deposits of plaque can completely block an artery. Cholesterol plaques can also break apart, leading to formation of a blood clot that blocks the flow of blood.
A blocked artery to the heart can cause a heart attack. A blocked artery to your brain can cause a stroke.
Many people dont discover that they have high cholesterol until they suffer one of these life-threatening events. Some people find out through routine check-ups that include blood tests.
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How To Know If You Need Treatment
Everyone with high cholesterol should start with heart-healthy lifestyle changes like diet, exercise, quitting smoking, and weight loss. But if your cardiac risk is high, you may need treatment with medications, too.
Your doctor can use a formula to calculate a score that shows your risk of a heart attack in the next 10 to even 30 years.
Your cardiac risk is based on a combination of these things:
- Smoking habit or past smoking habit
- Diabetes
- Heart disease or family history of early heart disease
You may not need to treat high cholesterol with medications like statins now if you are:
- 19 or younger and donât have FH
- 20-39, with no family history of early heart disease, and your LDL is below 160 mg/dL
- 40-75, and your cardiac risk is low
- 40-75, and your cardiac risk is borderline
- 40-75, and your cardiac risk is intermediate
- 75 or older
- Have advanced liver disease
If your cardiac risk score is borderline or intermediate: Your doctor may talk with you about the risks and benefits of cholesterol-lowering drugs, including possible side effects.
Ask yourself if youâre ready to stick with a healthy diet, weight loss, and exercise. If youâre not, you may want to treat high cholesterol with medication.
If your cardiac risk is intermediate or unclear, but youâre not sure if you want to take medication to treat your high cholesterol, your doctor may suggest one of these heart disease screening tests:
Coronary calcium scan
High-sensitivity CRP
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How Do I Lower My Cholesterol Your 5 Top Questions Answered
High cholesterol could be caused by things we can control like lifestyle habits, or things we cant like age and family history. Keeping on top of the things you can control with simple changes can help to lower your risk of heart and circulatory disease. We answer your questions with simple tips to help you start making changes today.
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How Is High Cholesterol Diagnosed
You cant tell if you have high cholesterol without having it checked. A simple blood test will reveal your cholesterol level.
Men 35 years of age and older and women 45 years of age and older should have their cholesterol checked. Men and women 20 years of age and older who have risk factors for heart disease should have their cholesterol checked. Teens may need to be checked if they are taking certain medicines or have a strong family history of high cholesterol. Ask your doctor how often you should have your cholesterol checked.
Risk factors for heart disease include:
- Cigarette smoking.
- Having an immediate family member who has had heart disease.
- Being overweight or obese.
- Inactivity.
Heredity Can Play A Role
Some people inherit genes from their mother, father or even grandparents that cause them to have too much cholesterol. This is called familial hypercholesterolemia . The severity of FH is related to the duration and degree of LDL cholesterol in the blood. FH is dangerous because it can cause premature atherosclerotic heart disease.
If you have a family history of FH or problems related to high cholesterol, get your levels checked.
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Hdl Vs Ldl Cholesterol
HDL cholesterol contains a higher proportion of protein and is made up of substances that dont lead to plaque buildup in your arteries. High-density cholesterol also carries LDL cholesterol away from the arteries back to the liver, where its broken down and eliminated from the body.
On the other hand, LDL cholesterol has a higher cholesterol and lower protein composition. When theres an excess of LDL cholesterol from consuming a diet high in calories and fat, excess LDL cholesterol seeps through artery walls and oxidizes .
When oxidation occurs, macrophages consume the oxidized LDL cholesterol in the artery wall and die, leading to inflammation in the artery walls. The body is then triggered to block the increasing macrophage by creating tissue in the artery walls called plaque, resulting in atherosclerosis.
What Are The Signs And Symptoms Of High Cholesterol
High cholesterol generally doesnt have obvious symptoms, but it can increase the risk of serious health conditions if left untreated. Thats why its important to get a blood test and regular check-ups. If you are 45 or older , see your doctor for a cholesterol test as part of a Heart Health Check. If you have a family history of high cholesterol, speak to your GP about your heart disease risk.
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Common Misconceptions About Foods And Cholesterol
Just because a food contains cholesterol does not mean it will raise cholesterol levels. In fact, the latest Dietary Guidelines for Americans of 2015-2020 removed the recommendation to limit dietary cholesterol to 300 mg per day, stating that adequate evidence was not available. Extensive research does not show that eating foods that contain cholesterol causes heart disease.
However, many foods remain feared for the belief that they increase the risk for heart disease or harm overall health. Some of these foods are highlighted below:
In addition to these foods, there has been concern over the recently trending ketogenic diet and its role in cholesterol levels. This style of eating limits nearly all sources of carbohydrates and instead gets a majority of calories and other nutrients from high-fat foods and protein. This diet includes eating large amounts of meat, eggs, cheese, and other high cholesterol, high saturated fat foods.
While it may seem as though this style of eating would be harmful to cholesterol levels, current research does not support this so far.
Baked Goods And Sweets
Cookies, cakes and doughnuts usually contain butter or shortening, making them high in saturated fat and cholesterol.
They also tend to be full of sugar, which can lead to high levels of blood triglycerides, an unhealthy blood fat that can be a risk factor for coronary heart disease.
Instead, make your desserts at home, choosing recipes that dont need shortening or lots of butter. This also allows you to modify recipes and cut down the amount of sugar used, to half or three-quarters the recommended amount. You can also enjoy baked fruit as a dessert, or substitute applesauce for eggs or butter in your baking.
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Treating Cholesterol With Medication
There are medications, such as statins, that can lower HDL cholesterol. But not everyone with LDL over 100 needs to take them. Whether you need medications depends on your cholesterol levels and other risks.
- Candidates for cholesterol-lowering medication include people who know they have plaque buildup in the arteries of their heart, neck, or legs, and those who have had a heart attack or stroke. It does not matter what the LDL cholesterol level is.
- Other high-risk individuals include those ages 4075 years old with diabetes and an LDL level of 70 mg/dL or higher.
- In general, for people with an LDL level of 190 mg/dL or higher, the goal is to reduce LDL levels by at least 50% with a combination of medications and lifestyle changes.
- People who have an elevated overall 10-year risk of developing plaque in their arteries or risk of heart attack or stroke are also advised to take medications. This 10-year risk is based on a number of risk factors. In general, people with 20% or greater 10-year risk of these conditions benefit from medication. However, these decisions should always be made with your doctor.
- In people with lower levels of risk, additional tests may be done to try to figure out if you will be helped by taking medications along with making lifestyle changes.
What Foods Will Lower My Cholesterol
The best way to eat a better diet is to swap your saturated fats with foods that are high in unsaturated fat like vegetable oils , nuts seeds and avocado and oily fish.
A few small swaps can make a big difference to your cholesterol level. Many people say they dont notice the difference. Try:
- swapping butter to vegetable oil spreads like sunflower, olive or rapeseed oil spreads
- switching whole milk to skimmed milk
- using natural yogurt instead of sour cream or double cream
- replacing regular mince with leaner, lower fat options
- swapping red or processed meat for fish, turkey or chicken without the skin, or plant-based proteins such as lentils, soya or Quorn
- switch your crisps for unsalted nuts
- having reduced fat cheese instead of regular cheese
- ordering less takeaways. Instead try our healthy comfort foods for delicious heart-healthy options.
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