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Cholesterol is both beneficial and detrimental. It is a necessary component for the body at regular levels. However, if blood pressure levels grow too high, it becomes a silent hazard, putting people at risk of having a heart attack.
Cholesterol is found in every cell of the body and plays a critical role in digestion, hormone production, and vitamin D production. It is produced by the body, but it is also consumed through food. It has a waxy, fat-like texture.
Cholesterol is classified into two types:
- low-density lipoproteins (LDL), or “bad” cholesterol
- high-density lipoproteins (HDL), or “good” cholesterol
We shall discuss the function of cholesterol in this post. Additionally, we will cover the causes of high cholesterol, as well as the associated symptoms, therapy, and prevention.
- Cholesterol is a necessary chemical that the body generates but that individuals also ingest through diet.
- High cholesterol risk factors include family history and changeable lifestyle choices such as food and exercise.
- Typically, having high cholesterol produces no symptoms.
- If lifestyle modifications are ineffective or if cholesterol levels are extremely high, a doctor may prescribe a statin or another lipid-lowering medication.
How do you define cholesterol?
Cholesterol is an emollient. It does not combine with blood, which is composed of water.
It is transported throughout the body via lipoproteins.
Lipoproteins are classified into two kinds that transport cholesterol parcels:
- Low-density lipoprotein (LDL): This kind of cholesterol is considered unhealthy or “bad” cholesterol.
- High-density lipoprotein (HDL): The cholesterol found in HDL is referred to be “good” cholesterol.
Cholesterol serves four critical roles that we cannot exist without.
These include the following:
- contributing to the structure of cell walls
- making up digestive bile acids in the intestine
- allowing the body to produce vitamin D
- enabling the body to make certain hormones
The causes of hypercholesterolemia
Cholesterol abnormalities are a substantial risk factor for coronary heart disease and a leading cause of heart attacks.
A buildup of cholesterol is a natural component of the process of artery narrowing known as atherosclerosis. Plaques develop and impede blood flow in atherosclerosis.
Consuming less fat in the diet aids in the management of cholesterol levels. It is especially beneficial to minimize meals that contain:
- Cholesterol is found in animal products such as beef and cheese.
- Saturated fat: This type of fat is found in some types of meat, dairy products, chocolate, baked goods, fried meals, and processed foods.
- Trans fats: These are found in a variety of fried and processed meals.
Excess weight or obesity can also result in elevated LDL cholesterol levels in the blood. Genetic factors may play a role in hypercholesterolemia. Individuals with the hereditary disease familial hypercholesterolemia have extremely elevated LDL cholesterol levels.
Other conditions that might result in elevated cholesterol levels include the following:
- diabetes
- liver or kidney disease
- polycystic ovary syndrome
- pregnancy and other conditions that increase levels of female hormones
- underactive thyroid gland
- drugs that increase LDL cholesterol and decrease HDL cholesterol, such as progestins, anabolic steroids, and corticosteroids
Symptoms of high cholesterol
While a person with high cholesterol levels frequently exhibits no signs or symptoms, routine screening and blood testing can assist in detecting elevated levels.
A person who does not undergo testing may experience a heart attack without warning if they are unaware that their cholesterol levels are abnormally high. Regular screenings can help mitigate this risk.
Foods containing cholesterol
According to a Harvard Health study, the following 11 foods actively reduce cholesterol levels:
- oats
- barley and whole grains
- beans
- eggplant and okra
- nuts
- vegetable oil (canola, sunflower)
- fruits (mainly apples, grapes, strawberries, and citrus)
- soy and soy-based foods
- fatty fish (particularly salmon, tuna, and sardines)
- foods rich in fiber
By incorporating these foods into a well-balanced diet, you may help maintain a healthy cholesterol level.
Additionally, the same study includes items that are detrimental to cholesterol levels. These include the following:
- red meat
- full-fat dairy
- margarine
- hydrogenated oils
- baked goods
Online, you may acquire a variety of low cholesterol recipe books.
Levels and intervals
Adults are considered healthy if their total cholesterol level is less than 200 milligrams per deciliter (mg/dL).
- Between 200 and 239 mg/dL is considered borderline high.
- A value of 240 mg/dL or more is regarded to be excessive.
Low-density lipoprotein (LDL) cholesterol levels should be fewer than 100 mg/dL.
- 100–129 mg/dL is acceptable for people with no health problems but may be a concern for anyone with heart disease or heart disease risk factors.
- 130—159 mg/dL is borderline high.
- 160–189 mg/dL is high.
- 190 mg/dL or higher is considered very high.
HDL levels should be maintained at a healthy range.
The optimum HDL level is 60 mg/dL or more.
- A reading of less than 40 mg/dL can be a major risk factor for heart disease.
- A reading from 41 mg/dL to 59 mg/dL is borderline low.
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Preventing hyperlipidemia
Individuals seeking to lower their cholesterol levels or maintain a healthy level can make four significant lifestyle choices.
- eat a heart-healthy diet
- regularly exercise
- avoid smoking
- achieve and maintain a healthy weight
These measures will help to decrease the risk of coronary heart disease and heart attack.
Since 2013, recommendations for lowering or preventing high cholesterol have emphasized treating risk factors associated with lifestyle, even at an early age.
Since 2018, updated guidelines published in the Journal of the American College of Cardiology have advised physicians to also discuss with patients the following risk factors:
- family history and ethnicity
- certain health conditions that increase the risk of high cholesterol, such as chronic kidney disease or chronic inflammatory conditions
Considering these variables will result in a more tailored approach to the treatment and prevention of high cholesterol levels.
How is hypercholesterolemia treated?
There are several treatments to treat high cholesterol, including the following:
Treatment with lipid-lowering agents
The medication treatment regimen for a person with high cholesterol levels is determined by their cholesterol level and other risk factors.
Although diet and exercise are typically the first recommendations, those with a higher risk of a heart attack may require statins or other medicines.
Statins are the most often prescribed class of cholesterol-lowering medications. In the United States, statins are accessible on prescription.
- atorvastatin (brand named Lipitor)
- fluvastatin (Lescol)
- lovastatin (Mevacor, Altoprev)
- pravastatin (Pravachol)
- rosuvastatin calcium (Crestor)
- simvastatin (Zocor)
Apart from statins, a physician may prescribe the following:
- selective cholesterol absorption inhibitors
- resins
- fibrates
- niacin
In 2017, researchers reported that a new medication, ezetimibe, can dramatically lower the chance of a major cardiovascular event in patients at high risk of such occurrences. Etezimibe lowers lipid levels by inhibiting cholesterol absorption in the gut.
Additionally, the authors of the revised review noted a novel class of drugs: pro-protein convertase subtilisin/Kexin 9 (PCSK9) inhibitors. There is evidence that these medications are helpful at lowering cholesterol levels, much more so when used with ezetimibe.
In 2018, revised recommendations advised a graduated strategy based on an individual’s risk level.
If a patient has already experienced a cardiovascular event, such as a heart attack, a doctor may suggest ezetimibe in addition to a statin. Additionally, for individuals at extremely high risk, the recommendations urge the use of a PCSK9 inhibitor.
However, the recommendations caution that PCSK9 inhibitors are costly and may not be covered by insurance. As a result, this choice is likely to be reserved for individuals willing to take a very high risk.
The safety of statins
Statins have sparked controversy because, like any medications, they can produce adverse effects.
These include the following:
- statin-induced myopathy (a muscle tissue disease)
- fatigue
- a slightly greater risk of diabetes and diabetes complications, though this is hotly debated
Without consulting a physician, a person should not discontinue taking a statin, since doing so may raise their risk of cardiovascular issues.
A physician may suggest:
- switching to a different medication
- increasing efforts to reduce cholesterol through lifestyle changes
Consequences of hypercholesterolemia
Historically, individuals sought to lower cholesterol to a goal level, such as less than 100 mg/dL, but this is no longer the case.
Clinical studies including randomization and control have not generated sufficient data to warrant therapy directed at a specific target.
Nevertheless, some clinicians may continue to utilize targets to guide therapy.
Risk of having a heart attack over a ten-year period
Cholesterol levels significantly influence an individual’s chance of experiencing a heart attack during the following decade.
The National Heart, Lung, and Blood Institute offers an online cardiovascular risk calculator.
It assesses the risk in light of the following criteria, based on scientific evidence:
- age
- sex
- cholesterol levels
- smoking status
- blood pressure
According to 2018 guidelines, this calculator is a necessary tool for determining cholesterol levels and associated danger.