What Is Bad Cholesterol
Cholesterol moves in the body combined with proteins. This combination of cholesterol and proteins is called lipoproteins. The low-density lipoprotein or LDL cholesterol is called bad cholesterol. High levels of this cholesterol increase risk for heart diseases and stroke.
When you have high levels of LDL cholesterol in the body, the LDL cholesterol can accumulate on the walls of the blood vessels forming a plaque. The continuous cholesterol build-up or a plaque narrows the inside of the blood vessels with time. The narrowed blood vessel hampers the blood supply to the concerned organ. Thus, when the plaque is present in the heart, it can cause angina or a heart attack. Plaque build-up in the brain can cause a stroke.
Another type of cholesterol is HDL cholesterol. It is also called good cholesterol as it absorbs cholesterol and carries it back to the liver. The liver then removes the cholesterol from the body. HDL cholesterol, thus, can lower your risk for heart diseases and stroke.
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
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:
Niacin
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 bodys 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:
What Other Tests Might I Have Along With This Test
Your healthcare provider may also order other tests to look at how well your heart is working. These tests may include:
- Electrocardiogram, or ECG, which tests your heart’s electrical impulses to see if it is beating normally
- Stress test, in which you may have to exercise while being monitored by ECG
- Echocardiogram, which uses sound waves to make pictures of your heart
- Cardiac catheterization. For this test, a healthcare provider puts a tube into your blood vessels and injects dye. X-rays are then done to look for clogs in the arteries of the heart
Your provider may also order tests for high blood pressure or blood sugar, or glucose.
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Complications Of High Cholesterol
According to the National Heart, Lung, and Blood Institute , there are no visible signs and symptoms of high cholesterol levels. When your cholesterol levels remain high for an extended period, your blood vessels are at an increased risk of being clogged with fat deposits. A sudden break/rupture in these deposits can result in a stroke or heart attack.
The following are some health complications that may occur due to high cholesterol:
How Often Should I Get A Cholesterol Test
When and how often you should get a cholesterol test depends on your age, risk factors, and family history. The general recommendations are:
For people who are age 19 or younger::
- The first test should be between ages 9 to 11
- Children should have the test again every 5 years
- Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke
For people who are age 20 or older::
- Younger adults should have the test every 5 years
- Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years
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If Cholesterol Is Necessary Why Do We Have To Worry About How Much We Have
Having enough cholesterol to meet your needs is important. Having too much cholesterol can cause problems. If your cholesterol levels are high, the condition is called hyperlipidemia. If your cholesterol levels are low, the condition is called hypolipidemia. It is not common to have cholesterol levels that are too low, but it can happen.
Questions To Ask Your Doctor
If testing shows you have high cholesterol, you may want to ask your doctor these questions at your next visit.
1. What are the dangers of having high cholesterol? Can other problems develop?
2. What could have caused my cholesterol to be too high? Is it inherited?
3. Are there things I can do at home or in my life to reduce my cholesterol?
4. Is medicine necessary? Are there alternative treatments?
5. If medicine is needed, how does the medicine work?
6. How long can I take medicine? What are the side effects? Is long-term use harmful?
7. How can exercise help to lower my cholesterol?
8. Where can I learn more about how to live with high cholesterol?
9. What changes should I make to the way I eat?
10. How often do I need to get my cholesterol level checked?
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Cholesterol Food And Eating For Your Body
Your liver produces enough cholesterol for it to complete its vital jobs around your body.
Although high LDL levels are associated with coronary artery disease as weve seen above, the previous notion that dietary cholesterol which is the amount of cholesterol that we get from food has a great effect on the risk of heart disease is now considered controversial.
Researchers have found that while dietary cholesterol consumption can lead to higher serum cholesterol levels, its not clear how much this affects the risk of cardiovascular disease because studies have arrived at conflicting conclusions.
Nevertheless, heart-healthy diets, such as the Mediterranean or DASH diets, inherently have relatively low cholesterol.
While restricting the amount of cholesterol in your diet may not be the most important goal, eating a healthy diet is key to lowering your risk of cardiovascular disease.
Normal Cholesterol Levels For Men By Age
Normal values of different types of cholesterol vary according to age and gender. Your cholesterol level is measured in milligrams per deciliter .
The following table represents recommended cholesterol levels for men younger and older than 20 years old:
The following table also represents borderline and high cholesterol levels for men according to their age. These values can help you maintain optimal cholesterol levels.
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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 .
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.
Effects Of High Cholesterol Levels
The liver is the main processing centre for cholesterol and dietary fat. When we eat animal fats, the liver transports the fat, together with cholesterol in the form of lipoproteins, into our bloodstream.
Too much cholesterol circulating within LDL in our bloodstream leads to fatty deposits developing in the arteries. This causes the vessels to narrow and they can eventually become blocked. This can lead to heart disease and stroke.
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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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Cholesterol Levels For Men And Women
HDL levels differ for men and women
Women naturally have higher HDL cholesterol levels than men due to differences in the genes. Women should aim for an HDL cholesterol level above 1.2mmol/L while men should aim for above 1mmol/L.
Cholesterol levels can rise during pregnancy
During pregnancy, both cholesterol and triglyceride levels can significantly rise. We don’t recommend getting a cholesterol test during pregnancy because your results won’t be accurate. Our advice is to wait until at least 6-8 weeks after your baby is born or after you stop breastfeeding to get a cholesterol test. This means you don’t need to worry unnecessarily.
Cholesterol levels rise during the menopause
Women may also find their cholesterol levels rise during the menopause.
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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 dont 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 dont 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 shouldnt 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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Plant Sterols Can Lower Cholesterol Levels
Plant sterols are found naturally in plant foods including sunflower and canola seeds, vegetable oils and in nuts, legumes, cereals, fruit and vegetables. Some margarine and milks have concentrated plant sterols added to them. Margarines enriched with plant sterolslower LDL cholesterol in most people if the correct amount is eaten .
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Another Type Of Fat Found In The Blood Mainly From The Food We Eat
Whats healthy? Less than 1.7 mmol/L ideally on a fasting sample, or less than 2.3 mmol/L on a non-fasting sample.
What should I do? Very high triglyceride levels can cause a painful condition called pancreatitis. People can have raised levels for many reasons, but the most common reasons are lifestyle-related:
- Being apple-shaped .
- Developing or having type 2 diabetes.
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Excessive alcohol consumption.
You can keep your triglyceride levels low by losing weight, being more active and eating sensibly, especially by cutting back on alcohol, sugary foods and saturated fats, and eating more fruits, vegetables, pulses and wholegrains.
When To See A Doctor
Since high cholesterol has no apparent symptoms, regular monitoring of your cholesterol levels is very crucial.
Men over 20 years are recommended to get their cholesterol levels tested every 4 to 6 years. However, you should go for more frequent screening tests and visits to your doctor if:
- Your cholesterol levels go back to borderline or high levels even after treatment.
- You have a family history of high cholesterol.
- Youre obese.
- You have high blood pressure.
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How To Lower Cholesterol: Know Your Fats
The American Heart Association recommends that just 25% to 35% of your daily calories come from fats such as those found in fish, nuts, and vegetable oils. For healthy people, saturated fat should comprise no more than 7% of your total calories. On a 2,000 calorie-a-day diet, thats about 140 calories worth of saturated fat. If you need to lower your LDL cholesterol, limit saturated fat to 5% to 6% of calories, or about 11 to 13 grams of saturated fat on a 2,000-calorie diet. Reduce trans fats to less than 1% of your total daily calories. This means avoiding fried foods and many junk foods.
Do You Need To Lower Your Cholesterol And Triglycerides
If you have high cholesterol, high triglycerides or an unhealthy balance of blood fats, your doctor will probably recommend bringing these levels down with lifestyle changes and sometimes treatments.
They should look at your results in relation to any other risk factors for heart disease such as high blood pressure, being overweight, smoking, and other health conditions such as diabetes.
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The Total Amount Of Cholesterol In Your Blood
Whats healthy? Government advice has moved away from giving absolute figures, but ideally your cholesterol should be be 5 mmol/L or less, or 4 mmol/L if youre at high risk of CVD, or you have high blood pressure, diabetes or have had a cardiovascular event.
What should I do? If your TC level is too high, you can help bring it down by making some simple diet and lifestyle changes, such as:
- Being more active.
- Cutting down on foods rich in saturated fats, such as butter, lard and full-fat dairy.
- Swapping fatty meats for lean meats, such as chicken.
- Eating more foods with healthy fats, such as olive oil, nuts, seeds and oily fish.
- Having meat-free days – try Quorn® or soya products instead.
- Eating more fruits, vegetables and wholegrains, especially oats and barley.
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Including more foods fortified with plant sterols or stanols in your diet.
Your doctor or nurse will tell you when you need to be tested again.
How To Measure Cholesterol Levels
Every adult whos at least 20 years old should have their cholesterol levels measured at least once every five years, recommends the National Heart, Lung, and Blood Institute. People with a strong family history of very high cholesterol should consider testing earlier.
Ideally, your doctor will gather a full lipoprotein profile, which is a blood test conducted after nine to 12 hours of fasting. This test provides insight into your:
- Total cholesterol
- Triglycerides
This information can help you and your physician make informed decisions.
Blood lipids give you an understanding of your risk of heart disease, says Sujatha Rajaram, Ph.D., professor at the Loma Linda University School of Public Health and the scientific committee chair of the International Congress on Vegetarian Nutrition. Having an idea of what those numbers look like early on gives you an opportunity to make some lifestyle changes. lf levels are healthy, healthy habits will help keep them that way if levels are elevated, you can do something about it before medications need to be used to intervene.
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You Dont Need To Avoid Eggs And Seafood
Some foods are high in cholesterol but are fine to eat in moderation, as long as your overall diet is low in saturated fats. For example:
- Egg yolks a single egg yolk contains 200250 mg of cholesterol, which is almost the uppermost recommended daily intake . However, reducing egg intake is probably not important for healthy people with normal blood cholesterol levels.
- Seafood prawns and seafood contain some cholesterol, but they are low in saturated fat and also contain healthy omega-3 fatty acids. Seafood is a healthy food and should not be avoided just because it contains cholesterol. However, avoid fried and battered seafood.
Other Factors That Affect Blood Cholesterol
The CDC point outs that some health conditions and lifestyle factors can raise cholesterol levels. It says that type 2 diabetes, for example, raises LDL cholesterol levels, as does familial hypercholesterolemia.
The CDC also states that having a diet high in saturated fats and getting low levels of exercise may contribute to high cholesterol levels.In addition, it acknowledges that having family members with high cholesterol increases a persons risk.
The NIH recommends consulting a healthcare professional before starting a new exercise plan, but overall, it advises a person to get at least 30 minutes of exercise a day.
Having a healthy diet and getting plenty of exercise can also bring down high cholesterol levels in children.
Generally, the earlier a person starts making these changes, the better for their cholesterol levels, as cholesterol builds up over time.
High cholesterol at any age increases the risk of heart disease, heart attack, and stroke. These risks only increase over time.
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