Firstly What Is Cholesterol
Cholesterol is an essential type of fat that’s carried in the blood.
All cells in the body need cholesterol it’s an essential part of cell walls in our bodies and has important roles, including to produce some hormones, maintain healthy nerve cells and in the synthesis of vitamin D.
Your body needs a small amount of cholesterol to function, but an imbalance between different types of cholesterol in the blood increases the risk of heart disease, one of the leading chronic diseases in Australia today.
About ¾ of the cholesterol in your body is made in the liver and a small amount may come from the food you eat. Various factors affect blood cholesterol levels including your diet and lifestyle, body weight and genes.
Treatments For High Cholesterol Levels
If your doctor determines that your cholesterol levels are borderline or too high, they may start you on a management plan to lower your levels. Ways to manage your cholesterol levels include:
Medication
Your doctor may prescribe cholesterol-lowering medication, like statins, if you are at an increased heart disease risk. Statins are used as a preventive measure because they treat plaque buildup in your arteries.
Diet and lifestyle
According to Erin Michos, M.D., quoted in Johns Hopkins Medicine, diet and lifestyle are very important to maintaining healthy cholesterol levels. Reducing the amount of saturated fats you eat and exercising for at least 30 minutes a day for five days a week can help you lose weight and reduce your cholesterol levels.
Limit smoking and alcohol intake
If you smoke and your cholesterol levels are high, you are at greater risk for artery buildup which can lead to a heart attack or stroke. If you are able to, you should consider a plan to give up smoking. Limiting your alcohol consumption can also help lower your triglycerides and total cholesterol levels.
Are There Any Warning Signs Of High Cholesterol
Most people dont have symptoms when their cholesterol is high. People who have a genetic problem with cholesterol clearance that causes very high cholesterol levels may get xanthomas or corneal arcus . Conditions such as obesity have a link to high cholesterol, and this may prompt a provider to evaluate your cholesterol level.
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Risks Of Untreated High Cholesterol
High cholesterol often has no signs and symptoms but can have devastating health consequences. When there is too much cholesterol in the blood, it builds up in the arteries and can harden. This buildup of plaque narrows the arteries and reduces and slows the blood flow to the heart. If the blood supply to any part of the heart is totally blocked, a heart attack occurs.
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About Your Cholesterol Result
A cholesterol test can measure:
- total cholesterol the overall amount of cholesterol in your blood, including both “good” and “bad” cholesterol
- total cholesterol to HDL cholesterol ratio the level of good cholesterol in your blood compared to your overall cholesterol level
- good cholesterol this makes you less likely to have heart problems or a stroke
- bad cholesterol this makes you more likely to have heart problems or a stroke
- triglycerides a fatty substance similar to bad cholesterol
When you get your result, you may just be told your total cholesterol.
You might be able to get separate results for your good and bad cholesterol, triglycerides, and your total cholesterol to HDL ratio. Ask your doctor or nurse.
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What Do My Test Results Mean
Test results may vary depending on your age, gender, health history, the method used for the test, and other things. Your test results may not mean you have a problem. Ask your healthcare provider what your test results mean for you.
Results are given in milligrams per deciliter . Here are the ranges for total cholesterol in adults:
- Normal: Less than 200 mg/dL
- Borderline high: 200 to 239 mg/dL
- High: At or above 240 mg/dL
These are the adult ranges for LDL cholesterol:
- Optimal: Less than 100 mg/dL
- Near optimal: 100 to 129 mg/dL
- Borderline high: 130 to 159 mg/dL
- High: 160 to 189 mg/dL
- Very high: 190 mg/dL and higher
The above numbers are general guidelines, because actual goals depend on the number of risk factors you have for heart disease.
Your HDL cholesterol levels should be above 40 mg/dL. This type of fat is actually good for you because it lowers your risk of heart disease. The higher the number, the lower your risk. Sixty mg/dL or above is considered the level to protect you against heart disease.
High levels of triglycerides are linked with a higher heart disease risk. Here are the adult ranges:
- Normal: Less than 150 mg/dL
- Borderline high: 150 to 199 mg/dL
- High: 200 to 499 mg/dL
- Very high: Above 500 mg/dL
Depending on your test results, your healthcare provider will decide whether you need lifestyle changes or medicines to lower your cholesterol.
Why Is High Cholesterol A Problem
Too much cholesterol in the bloodstream can harden arteries and promote fatty deposits within these arteries, potentially leading to dangerous blockages and narrowing over time called atherosclerosis.
If the blood vessels leading to your heart become too clogged, blood supply to your heart is reduced, which can lead to symptoms such as angina . If the artery becomes completely blocked, it can lead to a heart attack and stroke, which can be life threatening.
In 2017, the Australian Bureau of Statistics reported 43, 477 deaths in Australia from heart disease. This is approximately 30 per cent of all deaths in Australia, and most deaths are occurring in those aged 65 years and over.
However, heart disease takes years to develop, so you can take steps to reduce your risk.If you discover you have high cholesterol, have family members with high cholesterol, or are not sure if youre at risk, it is advisable you seek your doctors advice.
Other risk factors for heart disease include increased age, ethnicity, family history, inactivity, smoking, high blood pressure, type 2 diabetes and obesity.If these risk factors are present in your life, its even more important to keep your blood cholesterol levels in check and seek your doctors advice.
can help you begin to assess your risk, but we strongly advise you discuss your risk with your GP as this tool does have limitations it doesnt take your family history into account, for example.
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Healthy Cholesterol Levels By Age
The recommended ranges for your cholesterol will vary based on age and gender. As people get older, cholesterol levels rise naturally. For example, people who have gone through menopause may have higher LDL and lower HDL cholesterol levels.
The following table was adapted from the Cleveland Clinic :
| Cholesterol Levels by Age: Normal, Borderline, and High | |
|---|---|
| Age/Sex | |
| Greater than or equal to 239 mg/dL | 160189 mg/dL |
How Can I Reduce My Risk Of Hyperlipidemia
Even children can get their blood checked for high cholesterol, especially if someone in the childs family had a heart attack, stroke or high cholesterol. Children and young adults can get checked every five years.
Once you reach middle age, you should have your cholesterol checked every year or two. Your healthcare provider can help you decide how often you should have a hyperlipidemia screening.
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Cholesterol Levels: What You Need To Know
How do we diagnose high cholesterol?
Lipoprotein panel is a type of blood test that can measure cholesterol levels. Before the test, the patient may need to fast for 9-12 hours. The test gives information about different types of cholesterol:
- otal cholesterol: It shows the total amount of cholesterol in the blood. It includes both low-density lipoprotein cholesterol and high-density lipoprotein cholesterol.
- LDL cholesterol: It transports cholesterol particles throughout the body. LDL cholesterol is often called the bad cholesterol because it builds up in the walls of the arteries, making them hard and narrow.
- HDL cholesterol: It picks up excess cholesterol and takes it back to your liver.
- Non-HDL: This number is total cholesterol minus HDL. Non-HDL includes LDL and other types of cholesterol such as very lowdensity lipoprotein .
- Triglycerides: Another form of fat in the blood that can increase your risk for heart diseases, especially in women, is triglycerides.
Are Test Results Accurate
While no test is always accurate, measurements of blood cholesterol are an effective tool for estimating your risk of cardiovascular disease. Various factors can affect the accuracy of a cholesterol test:
- Direct vs calculated testing: While calculated LDL cholesterol levels are sufficient in most cases, direct testing provides more accurate results in patients with elevated triglyceride levels. Patients who may have elevated triglyceride levels include those diagnosed with type II diabetes or obesity, patients with a history of considerable alcohol intake, and patients taking medication to increase triglycerides.
- Fasting: In most cases, a lipid profile requires fasting. Eating within 8-12 hours before a lipid panel may increase the level of triglycerides in your bloodstream. Because this increased level of triglycerides could affect the accuracy of calculated LDL cholesterol values, your doctor may request that you refrain from eating prior to your blood draw.
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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.
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How Are Triglycerides Different From Cholesterol
Triglycerides and cholesterol are both fatty substances called lipids. But triglycerides are fats cholesterol is not. Cholesterol is a waxy, odorless substance made by the liver. It is used to build cell walls, helps the nervous system and plays an important role in digestion and hormone production.
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Why Cholesterol Affects Women Differently
In general, women have higher levels of HDL cholesterol than men because the female sex hormone estrogen seems to boost this good cholesterol. But, like so much else, everything changes at menopause. At this point, many women experience a change in their cholesterol levels total and LDL cholesterol rise and HDL cholesterol falls. This is why women who had favorable cholesterol values during their childbearing years might end up with elevated cholesterol later in life. Of course, genetics and lifestyle factors can play big roles, too.
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How Can A High Ldl Level Raise My Risk Of Coronary Artery Disease And Other Diseases
If you have a high LDL level, this means that you have too much LDL cholesterol in your blood. This extra LDL, along with other substances, forms plaque. The plaque builds up in your arteries this is a condition called atherosclerosis.
Coronary artery disease happens when the plaque buildup is in the arteries of your heart. It causes the arteries to become hardened and narrowed, which slows down or blocks the blood flow to your heart. Since your blood carries oxygen to your heart, this means that your heart may not be able to get enough oxygen. This can cause angina , or if the blood flow is completely blocked, a heart attack.
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What Affects My Cholesterol Levels
A variety of things can affect cholesterol levels. These are some things you can do to lower your cholesterol levels:
- Diet. Saturated fat and cholesterol in the food you eat make your blood cholesterol level rise. Saturated fat is the main problem, but cholesterol in foods also matters. Reducing the amount of saturated fat in your diet helps lower your blood cholesterol level. Foods that have high levels of saturated fats include some meats, dairy products, chocolate, baked goods, and deep-fried and processed foods.
- Weight. Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol. Losing weight can help lower your LDL cholesterol, total cholesterol, and triglyceride levels. It also raises your HDL cholesterol level.
- Physical Activity. Not being physically active is a risk factor for heart disease. Regular physical activity can help lower LDL cholesterol and raise HDL cholesterol levels. It also helps you lose weight. You should try to be physically active for 30 minutes on most, if not all, days.
- Smoking.Cigarette smoking lowers your HDL cholesterol. HDL helps to remove bad cholesterol from your arteries. So a lower HDL can contribute to a higher level of bad cholesterol.
Things outside of your control that can also affect cholesterol levels include:
Cholesterol Levels In Women
As noted, women with healthy cholesterol levels have slightly higher HDL counts than men. Thatâs because estrogen increases HDL cholesterol and lowers LDL cholesterol, as noted in the Circulation study.
Because of estrogenâs protective effects, women tend to have a lower risk of heart disease before the age of 65. Once women have gone through menopause, their risk of heart attack and stroke is equal to menâs risk.
While men and women have similar targets numbers for total cholesterol, LDL, and triglycerides, women need to aim a little higher when it comes to HDL. The goal is 50 mg/dl or higher.
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How Can I Lower Cholesterol With Diet
Heart-healthy lifestyle changes include a diet to lower your cholesterol. The DASH eating plan is one example. Another is the Therapeutic Lifestyle Changes diet, which recommends that you
Choose healthier fats.You should limit both total fat and saturated fat. No more than 25 to 35% of your daily calories should come from dietary fats, and less than 7% of your daily calories should come from saturated fat. Depending upon how many calories you eat per day, here are the maximum amounts of fats that you should eat:
| Calories per Day | |
|---|---|
| 69-97 grams | 17 grams |
Saturated fat is a bad fat because it raises your LDL level more than anything else in your diet. It is found in some meats, dairy products, chocolate, baked goods, and deep-fried and processed foods.
Trans fat is another bad fat it can raise your LDL and lower you HDL . Trans fat is mostly in foods made with hydrogenated oils and fats, such as stick margarine, crackers, and french fries.
Instead of these bad fats, try healthier fats, such as lean meat, nuts, and unsaturated oils like canola, olive, and safflower oils.
Limit foods with cholesterol. If you are trying to lower your cholesterol, you should have less than 200 mg a day of cholesterol. Cholesterol is in foods of animal origin, such as liver and other organ meats, egg yolks, shrimp, and whole milk dairy products.
Eat plenty of soluble fiber. Foods high in soluble fiber help prevent your digestive tract from absorbing cholesterol. These foods include
Normal Cholesterol Range In Australia
High cholesterol carries no signs or symptoms, and youâll need a blood test to diagnose it. As a guide, health authorities recommend cholesterol levels should be no higher than 5.5 mmol per litre if there are no other risk factors present, or LDL levels less than 2 mmol/l for those who smoke, have high blood pressure or pre-existing heart disease.
According to the Australian Bureau of Statistics, 6.1% of all Australians had high cholesterol in 2017-18, a decline from 7.1% in 2014-15, and we fall into the middle rankings compared to other countries.
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How Often Should I Get My Cholesterol Checked
Your provider will tell you how often you need your cholesterol checked. It depends on your:
- Age: The older you get, the more often you need to have your numbers checked.
- Family history: If you have a close biological family member with a history of heart disease, you face a higher risk of heart problems, too. You may need cholesterol tests more often if your family member has high cholesterol or a history of heart attack or stroke.
- Risk factors for heart disease: If youve been diagnosed with heart disease or have risk factors, youll need cholesterol tests more often.
- Sex assigned at birth: People assigned male at birth need more frequent tests starting at a younger age compared with people assigned female at birth.
Children and teens age 19 and younger should get their first test between ages 9 and 11. Then, they should receive a test every five years. Your childs provider may recommend starting at a younger age based on family history.
Here are general guidelines for adults based on sex and age.
People assigned male at birth
| Age |
|---|
| Every year. |
Who Should Be Tested
Your GP may recommend that you have your blood cholesterol levels tested if you:
- have been diagnosed with coronary heart disease, stroke or mini-stroke , or peripheral arterial disease
- are over the age of 40 people over 40 should have their estimate of CVD risk reviewed regularly
- have a family history of early cardiovascular disease for example, if your father or brother developed heart disease or had a heart attack or stroke before the age of 55, or if your mother or sister had these conditions before the age of 65
- have a close family member who has a cholesterol-related condition, such as familial hypercholesterolaemia
- are overweight or obese
- have high blood pressure or diabetes
- have another medical condition, such as kidney disease, an underactive thyroid, or an inflamed pancreas these conditions can cause increased levels of cholesterol or triglycerides
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