Symptoms Of High Cholesterol
High cholesterol doesnât have symptoms. So you can be unaware that your levels are getting too high. Thatâs why itâs important to find out what your cholesterol numbers are. If they’re too high, lowering them will lessen your risk for getting heart disease. And if you already have heart disease, lowering cholesterol can reduce your odds of a heart attack or of dying from heart disease.
The Tlc Program To Lower High Cholesterol
The National Heart, Lung, and Blood Institute created the TLC Program, short for Therapeutic Lifestyle Changes, for people who want to control their cholesterol. Even if you take medications to lower your cholesterol, you may want to consider the possible benefits of this program.
It has three parts: diet, exercise, and weight control. The goal: Reduce your risk of heart disease. This is not a fad diet. Itâs considered a âbalancedâ plan, and the idea is to change your habits for the long run.
This plan focuses on foods that are low in natural cholesterol and saturated fat but high in the âgood fats.â One class of these good fats is monounsaturated fats. You also get a lot of fiber in this diet.
When you follow the program, you shoot for 2 key numbers every day:
You do this to lower your LDL level. You can always talk to your doctor or dietician in more detail about how to measure how much fat and dietary cholesterol youâre taking in.
The first step is to manage dietary fats
When you follow the TLC Program, all the fat you eat in one day should not go over 35% of total calories. Try to avoid saturated fats. They can be found in things like:
- Whole milk dairy products
Trans fats can also raise cholesterol. Avoid them when you can. They are found in products such as:
- Fried foods
- Stick margarine
Some sources include:
Hdl Cholesterol: ‘good’ Cholesterol
Not all cholesterol is bad. High-density lipoprotein cholesterol is considered “good” cholesterol because it actually works to keep the LDL, or “bad” cholesterol from building up in your arteries. The higher the HDL, the better. HDL levels of 60 mg/dL and higher can help reduce your risk for heart disease. Conversely, HDL levels of 40 mg/dL and lower are considered a high risk-factor for developing heart disease.
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Why High Cholesterol Matters
High cholesterol puts you at risk for heart disease and stroke, leading causes of death in the U.S. High levels of LDL cholesterol can contribute to plaque buildup on the walls of the arteries, narrowing the arteries and restricting blood flow. If some of this plaque breaks off and gets stuck in a narrowed artery, it can block the artery and cut off blood supply to the heart or brain, resulting in heart attack or stroke.
Cholesterol Levels For Children
By comparison, acceptable levels of total cholesterol and LDL cholesterol in children are different.
- An acceptable range of total cholesterol for a child is less than 170 mg/dL. Borderline high total cholesterol for a child ranges from 170 to 199 mg/dL. Any reading of total cholesterol over 200 in a child is too high.
- A childs LDL cholesterol levels should also be lower than an adults. The optimal range of LDL cholesterol for a child is less than 110 mg/dL. Borderline high is from 110 to 129 mg/dL while high is over 130 mg/dL.
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Safe Blood Cholesterol Levels
Health authorities recommend that cholesterol levels should be no higher than 5.5 mmol per litre if there are no other risk factors present. If there are other cardiovascular risk factors such as smoking and high blood pressure or pre-existing cardiovascular disease, then the aim for the LDL levels would be less than 2 mmol/l. Approximately half of all adult Australians have a blood cholesterol level above 5 mmol/l. This makes high blood cholesterol a major health concern in Australia.
High Cholesterol Causes And Risk Factors
Lots of things can raise — or lower — your cholesterol levels. They include:
Saturated fats and simple carbohydrates. Reducing the amount of saturated fat, simple carbohydrates, and cholesterol in your diet can help lower your blood cholesterol.
Trans fats. Avoid artificial trans fats, which can raise your cholesterol. Check labels on baked goods, snack foods, frozen pizza, margarine, coffee creamer, vegetable shortenings, and refrigerated dough . Keep in mind that items that say they have “0 g trans fat” can actually have a tiny bit of trans fat in each serving, which adds up. So check the ingredients list. “Partially hydrogenated” means it has trans fat in it.
Good fats. Unsaturated fats don’t raise cholesterol levels. You can find unsaturated fats in foods like nuts, fish, vegetable oil, olive oil, canola and sunflower oils, and avocados. Limit saturated fats, which you find in animal products, and don’t eat processed meats.
Sugar. Eating and drinking too much sugar raises your triglyceride levels. High levels of triglycerides make heart disease more likely. Check food and drink labels to see how much sugar has been added, apart from sugars that are naturally part of a food. The average woman should get no more than 5 teaspoons per day from added sugars, and men shouldn’t get more than 9 teaspoons per day calories, according to the American Heart Association.
Heredity. High blood cholesterol can run in families.
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How Is High Cholesterol Diagnosed
A cholesterol blood test gives important information about the amount and types of fats in the bloodstream. Types of fats include cholesterol and triglycerides.
Triglycerides are the most common form of fat in your body. Triglycerides are produced by your body and also come from the food you eat. When you eat, your body converts unused calories into triglycerides. The triglycerides are stored in your fat cells and are released for energy in between meals.
If you regularly eat more calories than you burn, this may lead to high levels of triglycerides. If the levels of triglycerides in your blood are too high, they can affect your blood cholesterol levels.
Risk Assessment Of Individuals With Diabetes
A detailed overview of risk assessment to guide decisions in whom to use statin therapy is provided in the Cardiovascular Protection in People with Diabetes chapter, p. S162. Principles of risk assessment also are discussed in the 2016 Canadian Cardiovascular Society Guidelines for the Management of Dyslipidemia , and efforts were made to ensure consistency between the guidelines. Accordingly, actual risk calculation is not required in most cases as people with diabetes > 40 years of age, or > 30 years of age and duration of diabetes > 15 years or with concomitant microvascular or cardiovascular disease warrant therapy .
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Why It Is Done
Cholesterol and triglyceride testing is done:
- As part of a routine physical examination to screen for a lipid disorder.
- To check your response to medicines used to treat lipid disorders.
- To help determine your chances of having of heart disease, especially if you have other risk factors for heart disease or symptoms that suggest heart disease is present.
- If you have unusual symptoms, such as yellow fatty deposits in the skin , which may be caused by a rare genetic disease that causes very high cholesterol levels.
Cholesterol Levels In Canadians
Between 2009 and 2011, unhealthy total cholesterol levels were present in 39% of Canadians aged 6 to 79 years old according to results from the Canadian Health Measures Survey . Among the different age groups, the percentage of Canadians with unhealthy levels of total cholesterol varied significantly, from 35% or less in people under 40 years old, but increasing to 57% and 44% in 40 to 59 year olds and 60 to 79 year olds, respectively. Among people aged 12 and over who had unhealthy total cholesterol levels, only 25% reported having been diagnosed with high cholesterol by a health professional .
The number of Canadians with unhealthy LDL cholesterol levels increased significantly with age, with less than 6% of 6 to 19 year olds having unhealthy LDL cholesterol levels, compared to 12% of 20 to 39 year olds, and 40% of 40 to 59 year olds. However, this number decreased in older adults where 26% of 60 to 79 year olds had unhealthy LDL cholesterol levels. In contrast, no significant difference between age groups was found for unhealthy levels of HDL cholesterol .
The percentage of Canadians with an unhealthy ratio of total cholesterol to HDL cholesterol also varied with age, ranging from 1% for 6 to 11 year olds to 23% for the 40 to 59 .
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Where Does Cholesterol Come From
Most of it is manufactured in your liver: Your body produces all the cholesterol it needs. In healthy people, about 80 per cent of the cholesterol that’s in the body is produced by the body. The rest comes from what you eat.
If you eat a high-fat diet especially a diet high in saturated fats chances are you will have elevated levels of bad cholesterol in your blood. Saturated fats raise levels of LDL cholesterol in your blood more than anything else in your diet. Trans fats are also a major culprit, as are foods that come from animal sources such as eggs, meat and some dairy products. Egg yolks and organ meat such as liver are considered very high in cholesterol.
High levels of bad cholesterol can also be hereditary.
Ratio And Risk For Women
Because women often have higher levels of good cholesterol, their cholesterol ratio risk categories differ. According to the same study, a 4.4 ratio indicates average risk for heart disease in women. Heart disease risk for women doubles if their ratio is 7, while a ratio of 3.3 signifies roughly half the average risk.
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What To Know About Triglycerides
In addition to cholesterol, you might hear about your triglycerides, another kind of fat found in the bloodstream. Women should pay particular attention to this. A high level of triglycerides seems to predict an even greater risk for heart disease in women compared with men, says Michos.
When you take in more calories than you need, your body converts the extra calories into triglycerides, which are then stored in fat cells. Triglycerides are used by the body for energy, but people with excess triglycerides have higher risk of medical problems, including cardiovascular disease. Drinking a lot of alcohol and eating foods containing simple carbohydrates , saturated fats and trans fats contributes to high triglycerides. High levels may also be caused by health conditions such as diabetes, an underactive thyroid, obesity, polycystic ovary syndrome or kidney disease.
Triglycerides also circulate in the bloodstream on particles that may contribute to plaque formation. Many people with high triglycerides have other risk factors for atherosclerosis, including high LDL levels or low HDL levels, or abnormal blood sugar levels. Genetic studies have also shown some association between triglycerides and cardiovascular disease.
High Cholesterol: Prevention, Treatment and Research
How Do I Minimize My Risk Of Developing High Levels Of Bad Cholesterol
Health Canada advises that you maintain a healthy weight, get at least 30 minutes of exercise a day and stay away from cigarettes. It also recommends reducing the total fat in your diet by:
- Choosing leaner meats, poultry and fish.
- Reducing meat portions to the size of a deck of cards.
- Eating no more than one egg yolk a week.
- Choosing skim dairy products such as skim milk, cottage cheese with 1 per cent M.F. on the label and yogurt with less than 1 per cent M.F. on the label.
- Choosing cheeses with less than 15% M.F. on the label.
- Cooking with little or no fat.
- Using vegetable oils such as olive, canola, corn, sunflower, safflower, and peanut oil in small quantities.
- Avoiding store-bought baked goods such as croissants, muffins and doughnuts.
Health Canada also recommends you eat more vegetables, fruit, whole grains such as oats or barley, and legumes such as dried peas, dried beans and lentils.
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Medications To Lower High Cholesterol
The goal of cholesterol treatment is to help you prevent a heart attack or stroke. So the drugs your doctor prescribes also depend on your chances for heart disease.
The higher your risk, the more important it is to get your levels down. Your doctor will look at all of your risk factors and decide which medications will help you the most.
Cholesterol-lowering drugs include:
Cholesterol-lowering drugs work best when combined with a low-cholesterol diet and an exercise program.
Statins block the production of cholesterol in the liver. They lower LDL and triglycerides and can slightly raise HDL. These drugs are the first treatment for most people with high cholesterol. If you already have heart disease, statins reduce the chances of heart attacks. Side effects can include diabetes, liver damage, and, in a few people, muscle tenderness or weakness. If your doctor prescribes statins, you should ask them the percentage by which you should lower your cholesterol. Generally, it will be between 30% and 50%. Commonly used statins include:
Bile acid sequestrants
These drugs work inside the intestine, where they bind to bile and prevent your circulatory system from reabsorbing it. Bile is made largely from cholesterol, so these drugs work by reducing the body’s supply of cholesterol. That then lowers both total and LDL cholesterol. The most common side effects are constipation, gas, and upset stomach. Commonly used bile acid sequestrants include:
Same Numbers Different Ratio
Two people with the same total cholesterol number can have different cholesterol ratios. The ratios indicate different levels of heart disease risk. Harvard Medical School cites the following example: If your total cholesterol is 200 and your HDL is 60, your cholesterol ratio would be 3.3. Thats near the AHAs ideal level. However, if your HDL is 35 below the recommended level of 40 for men and 50 for women your cholesterol ratio would be 5.7. This ratio places you in a higher risk category.
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When Should You Contact Your Healthcare Provider About Your Cholesterol Levels
In truth, your healthcare provider will probably talk to you about your numbers first. As always, contact your provider if you have any new or worsening pain or other uncomfortable feelings. Make sure you know what medications you take and what they are expected to do. Call the provider if you have a reaction to the medicine.
Before you go to the office, and after you have had a cholesterol test, it helps to have a list of questions prepared about your test results and any proposed treatment.
A note from Cleveland Clinic
When considering cholesterol numbers, its important to remember that you really have the ability to make those numbers go in your favor. What you choose to eat, how much you are able to move and how you deal with lifes ups and downs are things that you can influence.
Last reviewed by a Cleveland Clinic medical professional on 07/31/2020.
Cholesterol Chart For Adults
According to the 2018 guidelines on the management of blood cholesterol published in the Journal of the American College of Cardiology , these are the acceptable, borderline, and high measurements for adults.
All values are in mg/dL and are based on fasting measurements.
Your doctor may recommend a plan of treatment for high cholesterol that includes lifestyle modifications and potentially medication. This will vary based on factors like other medications you may be taking, your age, sex, and general health.
Here are some medications more commonly prescribed for high cholesterol:
Medications can also be used to treat contributing factors to cholesterol like triglycerides. These may be used in addition to some of the medications above.
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How Is High Cholesterol Treated
There are several ways to lower high blood cholesterol , including lifestyle changes or medication, or both. Your healthcare provider will work with you to determine which therapy is best for you.
Healthcare providers like to start with the least invasive treatments when possible, such as lifestyle changes. Youll be advised to:
- Avoid tobacco. If you do smoke, quit. Smoking is bad for you in many ways, and reducing your level of good cholesterol is one of them.
- Change the way you eat. Limit the amount of trans fats and saturated fat. Eat heart-healthy foods like fruits, vegetables, poultry, fish and whole grains. Limit red meat, sugary products and dairy products made with whole milk.
- Get more exercise. Try to get about 150 minutes of physical activity every week, or about 30 minutes per day for most days of the week.
- Keep a healthy weight. If you need to lose weight, talk to your healthcare provider about safe ways to do this. Youll see results even before you reach your ideal weight. Losing even 10% of your body weight makes a difference in your cholesterol levels.
- Reduce the effect of negative emotions. Learn healthy ways to deal with anger, stress or other negative emotions.
- Control blood sugar and blood pressure. Make sure you follow your healthcare providers instructions for blood sugar levels, especially if you have diabetes, and for keeping blood pressure in the healthy range.
- Atorvastatin .
- Simvastatin .
- Pitavastatin .
Additional Lipid Markers Of Cvd Risk
The TC/HDL-C ratio is an index of CVD risk and is considered to be a traditional determinant or risk marker when considering the need for lipid-lowering therapy. An elevated TC/HDL-C ratio is usually associated with a low HDL-C and/or elevated TG, both of which are commonly seen in individuals with diabetes and often in individuals without diabetes, even in the face of an optimal LDL-C . The elevated TC/HDL-C ratio is considered to represent a marker of lipid-derived, residual risk in treated patients, but it is not considered a target of therapy. Even so, this dyslipidemia is relatively responsive to healthy behaviour interventions and improvements in glycemic control, interventions that should be considered in all instances anyway.
Evidence suggests that fibrate therapy may help reduce the microvascular complications associated with diabetes , and it appears as if these beneficial effects are not solely due to the lipid changes induced by this drug class . For example, the Fenofibrate Intervention and Event Lowering in Diabetes study found that long-term treatment with fenofibrate reduced albuminuria and slowed estimated glomerular filtration rate loss over 5 years, despite initially and reversibly increasing plasma creatinine . Furthermore, if residual hyper-TG is high enough to impart a risk of pancreatitis, fibrates may be warranted.
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