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High Cholesterol

High cholesterol is a condition in which there is an excess of cholesterol in the blood. Cholesterol is a waxy, fat-like substance that is necessary for building cell membranes, producing hormones, and making vitamin D. However, too much cholesterol in the blood can lead to serious health problems, particularly cardiovascular diseases.

High cholesterol is a condition in which there is an excess of cholesterol in the blood. Cholesterol is a waxy, fat-like substance that is necessary for building cell membranes, producing hormones, and making vitamin D. However, too much cholesterol in the blood can lead to serious health problems, particularly cardiovascular diseases.

Types of Cholesterol

  1. Low-Density Lipoprotein (LDL) – "Bad" Cholesterol:
    • Contributes to the buildup of fatty deposits (plaque) in arteries, leading to a condition called atherosclerosis.
    • High levels increase the risk of heart attacks and strokes.
  2. High-Density Lipoprotein (HDL) – "Good" Cholesterol:
    • Helps remove excess cholesterol from the bloodstream, transporting it to the liver for elimination.
    • Higher levels are associated with a reduced risk of cardiovascular disease.
  3. Triglycerides:
    • A type of fat found in the blood, often elevated alongside high cholesterol.
    • High levels can further increase the risk of heart disease.
  4. Total Cholesterol:
    • The sum of LDL, HDL, and 20% of triglyceride levels.

Causes of High Cholesterol

  1. Lifestyle Factors:
    • Poor diet high in saturated fats, trans fats, and cholesterol.
    • Sedentary lifestyle or lack of exercise.
    • Smoking, which lowers HDL cholesterol.
  2. Genetics:
    • Familial hypercholesterolemia: an inherited condition that causes extremely high cholesterol levels.
  3. Medical Conditions:
    • Diabetes.
    • Obesity.
    • Hypothyroidism.
    • Kidney or liver disease.
  4. Age and Gender:
    • Cholesterol levels tend to increase with age.
    • Men are at higher risk earlier in life; women’s risk rises after menopause.

Symptoms

High cholesterol typically has no symptoms. It is often discovered during routine blood tests. However, prolonged high cholesterol can lead to:

  • Chest pain (angina) due to reduced blood flow to the heart.
  • Fatty deposits on the skin (xanthomas) in severe cases.
  • Complications like heart attack or stroke.

Diagnosis

A blood test called a lipid panel measures cholesterol levels, including:

  • Total cholesterol.
  • LDL cholesterol.
  • HDL cholesterol.
  • Triglycerides.

Healthy Cholesterol Levels (mg/dL)

  • Total Cholesterol: Less than 200 (desirable).
  • LDL: Less than 100 (optimal); 100–129 (near optimal).
  • HDL: 40 or higher (optimal); above 60 is ideal.
  • Triglycerides: Less than 150 (normal).

Complications of High Cholesterol

  1. Atherosclerosis:
    • Hardening and narrowing of arteries due to plaque buildup.
  2. Coronary Artery Disease:
    • Reduced blood flow to the heart.
  3. Heart Attack:
    • Complete blockage of a coronary artery.
  4. Stroke:
    • Blockage or rupture of blood vessels in the brain.
  5. Peripheral Artery Disease (PAD):
    • Reduced blood flow to the limbs.

Treatment

  1. Lifestyle Changes:
    • Diet: Adopt a heart-healthy diet, such as the Mediterranean or DASH diet. Include:
      • Fruits, vegetables, whole grains, and lean proteins.
      • Foods high in omega-3 fatty acids (e.g., salmon, walnuts).
      • Soluble fiber (e.g., oats, beans) to lower LDL.
      • Reduce saturated fats and avoid trans fats.
    • Exercise: Engage in at least 30 minutes of moderate aerobic activity most days of the week.
    • Weight Loss: Even losing 5–10% of body weight can improve cholesterol levels.
    • Quit Smoking: Boosts HDL and reduces cardiovascular risk.
  2. Medications (if lifestyle changes are insufficient):
    • Statins: Reduce LDL and total cholesterol (e.g., atorvastatin, simvastatin).
    • Ezetimibe: Limits cholesterol absorption in the intestines.
    • PCSK9 Inhibitors: Lower LDL significantly for high-risk individuals.
    • Bile Acid Sequestrants: Bind cholesterol in the digestive system.
    • Fibrates: Lower triglycerides and sometimes increase HDL.
  3. Regular Monitoring:
    • Ongoing blood tests to track cholesterol levels and adjust treatment as needed.

Prevention

  • Eat a heart-healthy diet.
  • Exercise regularly.
  • Maintain a healthy weight.
  • Avoid smoking and excessive alcohol.
  • Manage underlying conditions like diabetes or high blood pressure.
  • Get regular cholesterol screenings.

When to See a Doctor

  • Routine screening is recommended for adults starting at age 20 and every 4–6 years after.
  • If you have risk factors (family history, obesity, diabetes), more frequent testing may be necessary.