Ask The Doctor: Can Hdl Cholesterol Be Too High
Q.I know I need to keep my LDL cholesterol low and my HDL cholesterol high, but can HDL ever be too high?
A. For high-density lipoprotein levels, it does appear that the higher, the betterat least to a point. But you should also think about how you achieve that level. HDL is known as the “good” cholesterol particle because it functions to clear cholesterol from the arteries and deliver it back to the liver. Higher HDL levels are associated with a lower risk of heart disease. HDL levels lower than 40 milligrams per deciliter are considered worrisome, and levels higher than 60 mg/dL are considered excellent.
One recent study that examined high levels of HDL reported the benefits extended until 90 mg/dL in men, but then leveled off, which suggests no further benefit even with higher levels. A man’s HDL level is predominantly determined by genetics, or inherited factors. Moderate-intensity exercise, three to four times a week, is an important mechanism to raise HDL with the bonus of other health benefits. Other methods to raise HDL are not so healthy. For instance, medications or supplements, like niacin, have shown disappointing results in controlled studies. Alcohol intake is known to increase HDL, but consuming more than two standard drinks a day can raise your risk of high blood pressure, heart attack, and stroke.
–William Kormos, MD
What Can Affect My Ldl Level
Things that can affect your LDL level include
- Diet. Saturated fat and cholesterol in the food you eat make your blood cholesterol level rise
- Weight. Being overweight tends to raise your LDL level, lower your HDL level, and increase your total cholesterol level
- Physical Activity. A lack of physical activity can lead to weight gain, which can raise your LDL level
- Smoking.Cigarette smoking lowers your HDL cholesterol. Since HDL helps to remove LDL from your arteries, if you have less HDL, that can contribute to you having a higher LDL level.
- Age and Sex. As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women’s LDL levels tend to rise.
- Genetics. Your genes partly determine how much cholesterol your body makes. High cholesterol can run in families. For example, familial hypercholesterolemia is an inherited form of high blood cholesterol.
- Medicines. Certain medicines, including steroids, some blood pressure medicines, and HIV/AIDS medicines, can raise your LDL level.
- Other medical conditions. Diseases such as chronic kidney disease, diabetes, and HIV/AIDS can cause a higher LDL level.
- Race. Certain races may have an increased risk of high blood cholesterol. For example, African Americans typically have higher HDL and LDL cholesterol levels than whites.
What Numbers Should I Look For
Some recommend that everyone over age 20 should get their cholesterol levels measured at least once every 5 years. The test that is performed is a blood test called a lipoprotein profile. That includes:
- Total cholesterol level
What Affects Cholesterol Levels?
A variety of factors can affect your cholesterol levels. They include:
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Myth: Women Dont Need To Worry About Heart Disease
In fact, more women die from heart disease every year than from breast cancer.
Mentend to develop coronary artery disease and have heart attacks at younger agesthan women. But after menopause, the risk for heart attack levels out andis the same for women and men.
Thegood news is that the chance that a woman will survive heart attack hasincreased by 56% due to earlier recognition and management of heart disease,says Dr. Gillinov.
Onereason women arent always diagnosed with heart disease is that many use theirOb/Gyn for primary care and never get a heart examination. Women should have acomplete head-to-toe checkup with baseline heart exams in early adulthood, henotes. This allows for risk factors to be identified and discussed before theyimpact the heart.
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.
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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.
How Can I Lower My Cholesterol Level
The first step in reducing your cholesterol is to maintain a healthy, balanced diet. It’s important to keep your diet low in fatty food.
You can swap food containing saturated fat for fruit, vegetables and wholegrain cereals. This will also help prevent high cholesterol returning.
If these measures don’t reduce your cholesterol and you continue to have a high risk of developing heart disease, your GP may prescribe a cholesterol-lowering medication, such as statins.
Your GP will take into account the risk of any side effects from statins. The benefit of lowering your cholesterol must outweigh any risks.
Read more about how high cholesterol is treated
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How Can I Lower My Cholesterol Naturally
For many people, revamping everyday habits can go a long way toward lowering cholesterol without medication. There are a number of lifestyle changes that can be made, and they fall under the categories of diet and exercise, says Dr. Khandwalla.
Eating heart-healthy foods is a great place to start. This means reducing your intake of red meat and full-fat dairy products, both of which contain saturated fats that raise cholesterol. Instead, focus on eating lean proteins chicken, turkey, seafood and adding more soluble fiber to your diet from fruits, vegetables, and oatmeal, according to the National Heart, Lung and Blood Institute . Getting aerobic exercise most days of the week can also help lower cholesterol.
What Is Dangerously High Cholesterol
You may be diagnosed with borderline-high or high cholesterol if your blood test results show:
- Total cholesterol higher than 200 milligrams per deciliter
- LDL cholesterol higher than 100 mg/dL
- Triglycerides over 150 mg/dL
- HDL cholesterol lower than 40 mg/dL
But what do these numbers really mean for your health?
While having high cholesterol isnt something youll notice day to day, it does mean youre at risk for or may already have heart disease, the leading cause of death for both women and men in the United States.
Want to know more? Here are answers to 11 frequently asked questions about high cholesterol.
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How Does High Cholesterol Cause Heart Disease
When there is too much cholesterol in your blood, it builds up in the walls of your arteries, causing a process called atherosclerosis, a form of heart disease. The arteries become narrowed and blood flow to the heart muscle is slowed down or blocked. The blood carries oxygen to the heart, and if not enough blood and oxygen reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack.
There are two forms of cholesterol that many people are familiar with: Low-density lipoprotein and high-density lipoprotein These are the forms in which cholesterol travels in the blood.
LDL is the main source of artery-clogging plaque. HDL actually works to clear cholesterol from the blood.
How Can I Lower My Ldl Level
There are two main ways to lower your LDL cholesterol:
- Therapeutic lifestyle changes . TLC includes three parts:
- Heart-healthy eating. A heart-healthy eating plan limits the amount of saturated and trans fats that you eat. Examples of eating plans that can lower your cholesterol include the Therapeutic Lifestyle Changes diet and the DASH eating plan.
- Weight Management. If you are overweight, losing weight can help lower your LDL cholesterol.
- Physical Activity. Everyone should get regular physical activity .
- Drug Treatment. If lifestyle changes alone do not lower your cholesterol enough, you may also need to take medicines. There are several types of cholesterol-lowering drugs available, including statins. The medicines work in different ways and can have different side effects. Talk to your health care provider about which one is right for you. While you are taking medicines to lower your cholesterol, you still should continue with the lifestyle changes.
Some people with familial hypercholesterolemia may receive a treatment called lipoprotein apheresis. This treatment uses a filtering machine to remove LDL cholesterol from the blood. Then the machine returns the rest of the blood back to the person.
NIH: National Heart, Lung, and Blood Institute
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How Is High Cholesterol Treated
The main goals in treating high cholesterol are to lower your LDL levels and lower your risk of cardiovascular disease. To lower cholesterol, eat a heart-healthy diet, exercise regularly, and maintain a healthy weight. Some may also need to take cholesterol-lowering drugs.
Doctors determine your “goals” for lowering LDL based on the number of risk factors you have for heart disease.Ã Based on your risk, your doctor will determine the intensity of LDL reduction you need, and prescribe a medication accordingly.
Foods Labeled ‘low Cholesterol’
When you’re shopping and you see an item that says it’s low in cholesterol, you still need to check the nutrition label. If it’s high in saturated fat, it can raise your LDL cholesterol. Also check the serving size. It might be smaller than you think, and if you eat too much, you’ll get more cholesterol than you realized.
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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.
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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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.
Aortic Aneurysm And Cholesterol
Aneurysm is defined as enlarging the diameter of artery, local or diffuse, by 50% or more relative to normal. According to localization, it is divided into thoracic and abdominal. Aortic aneurysms are 80% in abdominal location . It is a chronic disease associated with inflammation of the aortic wall. It is suggested that the vessel is formed as a result of elasticity and power loss of the aortic wall after occlusion of vasa vasorum.
In the population with abdominal aortic aneurysm, association with other atherosclerotic cardiovascular diseases was frequently observed. The presence of abdominal aortic aneurysm was frequently associated with other atherosclerotic cardiovascular diseases. Smoking, age, and male sex increases the risk of aortic aneurysm. While intimal atheroma and thrombosis process are present in both diseases, elastin fragmentation and adventitial chronic inflammation are limited to aortic aneurysms .
In the tromsø study, there was a relation between the intima media thickness and the incidence of coronary artery disease and abdominal aortic aneurysm, but no correlation with aortic diameter . The relationship between lipid level and aortic aneurysm has not been clearly elucidated . The data for the studies are based on the similarity of risk factors for atherosclerosis and aortic aneurysm risk factors.
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Almond Milk: No Cholesterol No Saturated Fat
Almonds are heart-healthy, says cardiologist Dr. Day, who recommends almond milk to his heart patients. Unsweetened almond milk contains between 30 and 40 calories per 1-cup serving and has no saturated fat. And because it’s a plant-based milk, it also contains no cholesterol. Fortified versions contain the same amount of vitamin D as skim cows milk, and some brands even contain up to 50 percent more calcium. Almond milk also contains polyunsaturated fatty acids, which may lower LDL cholesterol, reduce inflammation, and improve cognition , according to research out of the University of Maryland Medical Center in Baltimore. Unfortunately, almond milk is also low in protein compared with cow’s milk and other milk alternatives, making it a less ideal choice.
To maintain a healthy heart, Day says, be sure to drink unsweetened almond milk. The biggest issue with alternative milks is that most of them are sweetened, he says. Added sugar in any form can be dangerous to your heart.
Lower Extremity Peripheral Artery Diseases And Cholesterol
A common cause of lower extremity peripheral artery disease is atherosclerosis. It is common in men who have cigarette use at a young age. Diabetes and smoking are the most common causes of amputation in peripheral artery diseases. In the atherosclerotic process, progressive narrowing of the vessel wall occurs. Clinical signs are observed in the later stages of the disease. Clinical disease severity is determined by Fontaine and Rutherford classifications. There are studies that argue that the ankle brachial index used in lower extremity diseases should be used as a risk factor for coronary artery disease. When ABI is above 0.9, it is considered normal but below 0.40 is considered as serious disease.
The 2017 ESC guidelines for peripheral arterial disease recommended LDL cholesterol lowering to 70 mg/dL or 50% reduction in LDL levels in patients with an initial LDL level of 70135 mg/dL. Studies in lower extremity arterial disease patients have shown that statin therapy decreases all-cause mortality and cardiovascular mortality.
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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.
What Are Ldl And Hdl
LDL and HDL are two types of lipoproteins. They are a combination of fat and protein. The lipids need to be attached to the proteins so they can move through the blood. LDL and HDL have different purposes:
- LDL stands for low-density lipoproteins. It is sometimes called the “bad” cholesterol because a high LDL level leads to a buildup of cholesterol in your arteries.
- HDL stands for high-density lipoproteins. It is sometimes called the “good” cholesterol because it carries cholesterol from other parts of your body back to your liver. Your liver then removes the cholesterol from your body.
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