High cholesterol is a condition where there are high levels of cholesterol in the blood. Cholesterol is a waxy, fat-like substance that is found in all cells of the body and is needed for various bodily functions.
However, having too much cholesterol circulating in the blood can lead to plaque buildup in the arteries and increase the risk of heart disease and stroke. Therefore, it is important to understand how to properly diagnose and treat high cholesterol.
High Cholesterol And Its Effects On The Body
Cholesterol travels through the bloodstream attached to lipoproteins, which are particles made of fat and protein. There are two main types of lipoproteins that carry cholesterol – low-density lipoprotein (LDL) and high-density lipoprotein (HDL).
LDL cholesterol is often referred to as “bad” cholesterol because it carries cholesterol to tissues and can build up in the arteries. HDL cholesterol, on the other hand, is known as “good” cholesterol because it removes excess cholesterol and carries it to the liver for elimination.
When there is too much LDL cholesterol circulating in the blood, it starts to accumulate in the walls of arteries. This buildup is called plaque. Over time, this plaque narrows the arteries and makes them less flexible.
This condition is known as atherosclerosis. The plaque can also rupture, causing a blood clot to form and completely block an artery, leading to a heart attack or stroke. Therefore, high LDL cholesterol significantly increases the risk of cardiovascular disease.
Other effects of high cholesterol on the body include increased inflammation and oxidative stress. Cholesterol crystals may also deposit in tendons and skin, leading to xanthomas. High cholesterol has also been linked to cognitive decline and dementia.
How Is High Cholesterol Diagnosed?
High cholesterol does not produce any definitive symptoms, so the only way to diagnose it is to get a lipoprotein profile blood test. This test measures the levels of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides.
The standard lipid profile test requires 9-12 hours of fasting beforehand for accurate results. The blood sample is drawn by a nurse or phlebotomist and then sent to a lab for analysis.
The optimal lipid profile levels are:
- Total cholesterol – less than 200 mg/dL
- LDL cholesterol – less than 100 mg/dL
- HDL cholesterol – 60 mg/dL or higher
- Triglycerides – less than 150 mg/dL
If total cholesterol or LDL cholesterol levels are elevated, further testing may be done to analyze particle size, rightly properties, and genetic factors to determine the exact causes and risks.
After diagnosis, cholesterol levels should be monitored every 4-6 months with repeat lipid panels to assess the effectiveness of lifestyle changes and medication. Regular testing allows prompt adjustment of treatment plans if needed to prevent cardiovascular complications.
How To Treat High Cholesterol?
The main goals of treating high cholesterol are to lower LDL levels and raise HDL levels in order to reduce the risk of atherosclerosis, heart attack, and stroke. Treatment typically involves lifestyle changes, medications, and sometimes other procedures or surgery.
✅ Lifestyle Changes
The first line of defense against high cholesterol is making healthy lifestyle changes:
- Diet – Eat a diet low in saturated and trans fats, sodium, sugar, and refined carbohydrates. Emphasize fruits, vegetables, whole grains, legumes, fish, and healthy fats like olive oil. Avoid excess red meat and highly processed foods.
- Exercise – Get at least 30 minutes a day of moderate physical activity to boost HDL and lower triglycerides. Brisk walking, swimming, or biking are excellent choices.
- Weight loss – Losing excess body fat, especially around the abdomen, can help raise HDL and lower LDL. Aim to reach and maintain a healthy body weight.
- Smoking cessation – Quitting smoking is essential to improve cholesterol levels and overall heart health.
If cholesterol remains uncontrolled through lifestyle changes alone, cholesterol-lowering medications may be prescribed. Common medications include:
- Statins – Statins lower LDL cholesterol production in the liver and are usually the first-line medication. Examples include atorvastatin (Lipitor), rosuvastatin (Crestor), and simvastatin (Zocor).
- Bile acid sequestrants – These resins bind to bile acids to remove cholesterol. Cholestyramine (Prevalite) is often prescribed.
- Cholesterol absorption inhibitors – Ezetimibe (Zetia) blocks cholesterol absorption in the intestines.
- PCSK9 inhibitors – Evolocumab (Repatha) and alirocumab (Praluent) are injectable monoclonal antibodies that lower LDL levels.
- Niacin – Also known as vitamin B3, niacin raises HDL and lowers triglycerides. Side effects often limit its use.
- Fibrates – Gemfibrozil (Lopid) and fenofibrate primarily lower triglycerides but also raise HDL.
The doctor will determine the most appropriate medication or combination based on the patient’s cholesterol levels, other health conditions, and potential side effects.
✅ Other Procedures And Surgery
For patients with very high cholesterol that is difficult to control with other methods, alternative procedures may be utilized:
- LDL apheresis – This procedure filters LDL cholesterol out of the blood, similar to dialysis.
- Bile acid sequestrant resin – Cholestyramine may be taken with orange juice in powdered form for more intensive LDL lowering.
- Ileal bypass or jejunoileal bypass surgery – This procedure diverts the flow of nutrients to bypass bowel segments responsible for cholesterol absorption.
Prevention Of High Cholesterol
The best way to avoid developing high cholesterol is to adopt prevention strategies early in life:
- Eat a heart-healthy diet low in saturated fats, trans fats, cholesterol, sodium, and added sugars. Enjoy plenty of fruits, vegetables, whole grains, beans, fish, nuts and seeds.
- Exercise regularly to boost HDL, lower triglycerides, and keep weight in check. Aim for at least 30 minutes per day of brisk activity.
- Maintain a lean body weight for your height. Excess body fat, especially visceral belly fat, raises cholesterol levels.
- Limit alcohol intake to moderate levels at the most. Heavy drinking raises triglycerides significantly.
- Quit smoking and avoid exposure to tobacco smoke. Smoking cigarettes lowers HDL.
- Have regular cholesterol checkups starting in childhood. Early identification of high cholesterol allows prompt treatment.
Following these simple prevention tips can help keep cholesterol levels optimized for a lifetime.
High cholesterol is a prevalent condition that substantially increases cardiovascular disease risk if left uncontrolled. Diagnosis requires a lipoprotein profile blood test to check total cholesterol, LDL, HDL, and triglyceride levels. Treatment centers around therapeutic lifestyle changes, cholesterol-lowering medications, and sometimes intensive procedures.
Lowering LDL and raising HDL can help rein in high cholesterol and prevent the buildup of artery-clogging plaque. Beginning heart-healthy habits at an early age provides the best protection against dangerously high cholesterol levels. With proper diagnosis, treatment, and prevention strategies, it is possible to effectively manage cholesterol.
A: Foods that help lower cholesterol include oats, barley, beans, eggplant, apples, grapes, strawberries, citrus fruits, olive oil, almonds, walnuts, fatty fish, and avocados.
A: Health experts recommend getting a lipoprotein profile blood test every 4-6 years starting at age 20, and more frequently if you have risk factors for heart disease or already have elevated cholesterol.
A: Aerobic exercises like walking, jogging, cycling, and swimming are excellent for raising HDL and lowering LDL cholesterol. Aim for 30-60 minutes most days.
A: Eggs were previously limited due to high dietary cholesterol content. However, research shows dietary cholesterol has a modest impact on blood cholesterol. Eggs can be part of a heart-healthy diet in moderation.
A: High cholesterol can often be reversed through lifestyle measures like diet, exercise, and weight loss. But some people need medications to reach optimal cholesterol levels and reduce cardiovascular risk.