High Cholesterol Overview
Cholesterol is a waxy substance that helps the body make hormones, Vitamin D, bile acids and cell membranes. It is carried through the blood in lipoproteins, which are protein orbs filled with fat. Our bodies naturally produce cholesterol in the liver. We also ingest cholesterol through our diets.
Not all cholesterol is the same. When physicians talk about high cholesterol, also known as hypercholesterolemia, they are typically describing high levels of the kind carried in low-density lipoproteins (LDL). This cholesterol combines with fat, fibrin, calcium and cell debris to form plaque in the arteries. Over time, the plaque causes atherosclerosis, a narrowing and hardening of the arteries that deliver oxygen-rich blood to the heart and the brain. Restriction of the blood flow to the heart may result in angina, or chest pain. A complete blockage occurs when plaque buildup is severe or when the thin top layer of the plaque ruptures, releasing material that clots the blood in an already restricted artery. If such a blockage deprives the heart of oxygen, a heart attack occurs. If it deprives the brain of oxygen, a stroke occurs. If it deprives the extremities of oxygen, gangrene can occur. Pieces of plaque or clots also can travel through the arteries, ultimately causing a heart attack, stroke or pulmonary embolism.
Good cholesterol is found in high-density lipoproteins (HDL). Research suggests that HDL may carry cholesterol to the liver to be discarded by the body. HDL also may collect excess cholesterol from arterial plaque, slowing buildup of the dangerous substance.
When your WellStar physician measures the LDL and the HDL in your bloodstream, he or she will also look for triglycerides, blood fats that are common in people with diabetes or heart disease. A high count of triglycerides is sometimes genetically determined, but is often seen in people who smoke, eat a high-carbohydrate diet (60 percent or more of total calories), are overweight, are sedentary or consume excessive alcohol. People with high triglycerides usually have lower HDL (good cholesterol) and are at a higher risk of heart attack or stroke.
WellStar recommends a lipoprotein profile to measure the amount of HDL, LDL and triglycerides in the blood every five years starting at age 20. Men should be screened more frequently after age 35. Women should be screened more frequently after age 45. Children at risk of developing premature heart disease may be tested as early as 2 years of age. Your WellStar physician may increase the frequency of screenings anytime your total cholesterol measurement is 200 mg/dL or your HDL level is less than 40 mg/dL. You will also be screened if you develop diabetes, high blood pressure or heart disease.
Just how much LDL and HDL you have in your blood depends on your gender, your age, your family history, your lifestyle and your health. If high cholesterol or heart disease was an issue for a parent or grandparent, it’s a good idea to tell your WellStar physician so he or she can watch your cholesterol levels more closely. Being honest about your diet, exposure to cigarette smoke, alcohol consumption and exercise habits is also critical. Some people can make changes in their lifestyle to lower bad cholesterol, raise good cholesterol and lower triglycerides. Others require medication, in combination with dietary or other changes. Your WellStar physician can tailor a plan specifically for you.
People with high cholesterol typically show no symptoms at all. However, your WellStar physician typically will screen for cholesterol readings if you show symptoms of atherosclerosis, once these more serious conditions are stabilized:
- Angina (chest pains)
- Shortness of breath
- Heart attack
Are you at risk for high cholesterol? Risk factors include:
- Family history of high cholesterol
- Heart disease
- History of heart disease before age 55 in father or brother, or before age 65 in mother or sister
- High blood pressure
- Family history of high blood pressure
- Too much dietary cholesterol, especially saturated fats and trans fats
- Not maintaining a healthy weight
- Little or no physical activity
- Exposure to cigarette smoke
- Drinking excessive alcohol
- Being a woman over the age of 55 (or postmenopausal)
- Being a man over the age of 45