CHOLESTEROL 

What is cholesterol?

 

Cholesterol is a waxy, fat-like substance that's found in all the cells in your body. Your body needs some cholesterol to make hormones, vitamin D, and substances that help you digest foods. Your body makes all the cholesterol it needs. Cholesterol is also found in foods from animal sources, such as egg yolks, meat, and cheese.

Total cholesterol levels less than 200 milligrams per decilitre (mg/dL) are considered desirable for adults. A reading between 200 and 239 mg/dL is considered borderline high and a reading of 240 mg/dL and above is considered high. LDL cholesterol levels should be less than 100 mg/dL.

If you have too much cholesterol in your blood, it can combine with other substances in the blood to form plaque. Plaque sticks to the walls of your arteries. This build up of plaque is known as atherosclerosis. It can lead to coronary artery disease, where your coronary arteries become narrow or even blocked.

 

What are HDL, LDL, and VLDL?

 

HDL, LDL, and VLDL are lipoproteins. They are a combination of fat (lipid) and protein. The lipids need to be attached to the proteins so they can move through the blood. Different types of lipoproteins have different purposes:

·         HDL stands for high-density lipoprotein. It is sometimes called "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.

 

·         LDL stands for low-density lipoprotein. It is sometimes called "bad" cholesterol because a high LDL level leads to the build up of plaque in your arteries.

 

·         VLDL stands for very low-density lipoprotein. Some people also call VLDL “BAD” cholesterol because it too contributes to the build up of plaque in your arteries. But VLDL and LDL are different; VLDL mainly carries triglycerides and LDL mainly carries cholesterol.

 

What causes high cholesterol?

The most common cause of high cholesterol is an unhealthy lifestyle. This can include

·         Unhealthy eating habits, such as eating lots of bad fats. One type, saturated fat, is found in some meats, dairy products, and chocolate, baked goods, and deep-fried and processed foods. Another type, Trans fat, is in some fried and processed foods. Eating these fats can raise your LDL (bad) cholesterol.

·         Lack of physical activity, with lots of sitting and little exercise. This lowers your HDL (good) cholesterol.

·         Smoking, which lowers HDL cholesterol, especially in women? It also raises your LDL cholesterol.

Genetics may also cause people to have high cholesterol. For example, familial hypercholesterolemia (FH) is an inherited form of high cholesterol. Other medical conditions and certain medicines may also cause high cholesterol.

What can raise my risk of high cholesterol?

A variety of things can raise your risk for high cholesterol:

·         Age. Your cholesterol levels tend to rise as you get older. Even though it is less common, younger people, including children and teens, can also have high cholesterol.

·         Heredity. High blood cholesterol can run in families.

·         Weight. Being overweight or having obesity raises your cholesterol level.

·         Race. Certain races may have an increased risk of high cholesterol. For example, African Americans typically have higher HDL and LDL cholesterol levels than whites.

 

What health problems can high cholesterol cause?

 

If you have large deposits of plaque in your arteries, an area of plaque can rupture (break open).

This can cause a blood clot to form on the surface of the plaque.

If the clot becomes large enough, it can mostly or completely block blood flow in a coronary artery.

If the flow of oxygen-rich blood to your heart muscle is reduced or blocked, it can cause angina (chest pain) or a heart attack.

Plaque also can build up in other arteries in your body, including the arteries that bring oxygen-rich blood to your brain and limbs.

 This can lead to problems such as carotid artery disease, stroke, and peripheral arterial disease.

 

 

How is high cholesterol diagnosed?

There are usually no signs or symptoms that you have high cholesterol. There is a blood test to measure your cholesterol level. When and how often you should get this test depends on your age, risk factors, and family history. The general recommendations are:

For people who are age 19 or younger:

·         The first test should be between ages 9 to 11

·         Children should have the test again every 5 years

·         Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke

For people who are age 20 or older:

·         Younger adults should have the test every 5 years

·         Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years

 

Recommended levels

Healthy levels of cholesterol don’t vary much for typical adults. Variation of recommended levels tends to change due to other health conditions and considerations.

Cholesterol levels for adults

• Total cholesterol levels less than 200 milligrams per deciliter (mg/dL) are considered desirable for adults. A reading between 200 and 239 mg/dL is considered borderline high and a reading of 240 mg/dL and above is considered high.
• LDL cholesterol levels should be less than 100 mg/dL. Levels of 100 to 129 mg/dL are acceptable for people with no health issues but may be of more concern for those with heart disease or heart disease risk factors. A reading of 130 to 159 mg/dL is borderline high and 160 to 189 mg/dL is high. A reading of 190 mg/dL or higher is considered very high.
• HDL levels should be kept higher. A reading of less than 40 mg/dL is considered a major risk factor for heart disease. A reading from 41 mg/dL to 59 mg/dL is considered borderline low. The optimal reading for HDL levels is of 60 mg/dL or higher.

Cholesterol levels for children

By comparison, acceptable levels of total cholesterol and LDL cholesterol in children are different.

• An acceptable range of total cholesterol for a child is less than 170 mg/dL. Borderline high total cholesterol for a child ranges from 170 to 199 mg/dL. Any reading of total cholesterol over 200 in a child is too high.
• A child’s LDL cholesterol levels should also be lower than an adult’s. The optimal range of LDL cholesterol for a child is less than 110 mg/dL. Borderline high is from 110 to 129 mg/dL while high is over 130 mg/dL.

Tips

The best recommendation for children and adolescents to keep cholesterol levels in check is living a healthful, active lifestyle. This includes eating a healthful diet and getting plenty of exercise.

Sedentary, overweight children who eat a diet high in processed foods are most likely to have high cholesterol. Children who have a family history of high cholesterol may also be at risk.

Generally, the earlier an adult starts living a healthful lifestyle, the better for their cholesterol levels. Cholesterol levels build over time. A sudden change in lifestyle will help eventually, but the older a person is, the less impact they will see in cholesterol levels.

All adults should stay active and maintain regular exercise routines. Women going through menopause and adults with high levels of cholesterol may want to consider medication that will help reduce cholesterol levels more rapidly than diet alone.

High cholesterol at any age puts a person at risk for heart disease, heart attack, and strokes. These risks only increase over time, especially for adults who are not taking action to reduce their cholesterol build up.

 

Some people with familial hypercholesterolemia (FH) 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.