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Cholesterol Covered

Understanding Cholesterol

What Is Cholesterol?

Cholesterol

Cholesterol is soft, fat-like, waxy substance found your blood and in every cell in your body. Every single person has cholesterol, it’s normal! Cholesterol is an important part of a healthy body because it plays a vital role in many biochemical processes, such as the production of cell membranes and the synthesis of steroid hormones, as well as serving other necessary functions. Cholesterol does not dissolve in your blood, rather, it must be transported to and from your cells via a carrier. This carrier is called a lipoprotein.

Your bodies total cholesterol count, measured by a blood test, is made up of HDL cholesterol, LDL cholesterol, triglycerides and Lp(a) cholesterol.

Hypercholesterolemia

Hypercholesterolemia is the medical term for high levels of blood cholesterol.

Too much cholesterol in the blood is a major risk for coronary heart disease (which can lead to a heart attack) and stroke.

High cholesterol (hypercholesterolemia) is, for the most part, preventable and treatable. A healthy diet, regular exercise, and for some people, medication can go a long way toward reducing their high cholesterol.

If left untreated, high cholesterol levels (hypercholesterolemia), or more accurately, higher concentrations of LDL cholesterol and lower or not enough concentrations of functional HDL cholesterol, are strongly associated with the onset of cardiovascular disease. Cardiovascular Disease refers to any disease that affects the cardiovascular system, although they mainly involve the heart or the blood vessels.

LDL Cholesterol – “Bad” Cholesterol

LDL or “low density lipoprotein” cholesterol is the “bad” cholesterol. When too much of it circulates in the blood, it can build up in the inner walls of your arteries that feed blood into your heart and brain, which may cause atherosclerosis and increase your risk of heart attack and stroke. Generally, high LDL Cholesterol levels have been found to have a great association with heart disease; so the higher your LDL levels are, the more you are at risk for heart disease.

HDL Cholesterol – “Good” Cholesterol

HDL or “high density lipoprotein” cholesterol is what is known as “good” cholesterol. Between 25% and 35% of all blood cholesterol is carried by HDL. High levels of HDL seemingly protect against heart attack, whereas low levels of HDL – less than 40 mg/dL (milligrams per deciliter of blood) – increase your risk of heart disease. Generally, the higher your levels of HDL cholesterol are, the lower risk you have for heart disease

Lp(a) Cholesterol

Lp(a) cholesterol is another undesirable low density lipoprotein that is part of a protein called apo(a). Although Lp(a) cholesterol is not as commonly evaluated as LDL and HDL cholesterol and the way Lp(a) cholesterol works is not fully understood, Lp(a) cholesterol levels should be kept lower than 20 mg/dL and amounts higher than 20 – 30 mg/dL are considered high. Some medical experts believe that high levels of Lp(a) cholesterol in the blood are as dangerous as LDL cholesterol levels in causing plaque build up in your arteries and the diseases associated with such build up.

Triglycerides

Triglycerides are another form of fat produced in your body. High levels of triglycerides in your blood can be due to cigarette smoking, being overweight or obesity, excessive alcohol consumption, physical inactivity, and/or a very high carbohydrate diet (60% of total calories or more comes from carbohydrates). High triglyceride levels are associated with high total cholesterol levels, which include a high LDL (bad) level and a low HDL (good) level. Many people with heart disease and/or diabetes also have high triglyceride levels.

Related Terms & Conditions

What is Atherosclerosis and the consequences of this medical condition?

Atherosclerosis is a medical condition in which the process of LDL cholesterol, cellular waste products, calcium and fibrin (clotting material in the blood), forms plaque. Atherosclerosis is sometimes known as coronary atherosclerosis.
Atherosclerosis is a type of arteriosclerosis, which is a general medical term to describe the thickening and hardening of the arteries.

Plaque is a substance that can narrow arteries and make them less flexible by building up in the inner lining of your arteries.
If plaque partially or completely blocks the flow of blood through an artery, it may result in hemorrhaging (bleeding) into the plaque, or it may result in a thrombus (a blood clot) forming on the surface of the plaque. If this type of bleeding or clotting occurs and blocks the entire artery, it may result in a heart attack or a stroke.

If there is a blood clot that reduces blood flow in the arteries that supply blood to the heart –>
- then you may experience angina (chest pain) or a heart attack
If there is a clot that reduces blood flow that supplies blood to the brain –>
- then the result is a stroke

Cholesterol Facts and Figures

Every cell in everybody contains cholesterol.
Your total cholesterol count is made up of HDL cholesterol, LDL cholesterol, triglycerides and Lp(a) cholesterol.
Approximately 75% of your total cholesterol is made in your body. That means only 25% of your total blood cholesterol levels come from your food.
Cholesterol levels tend to elevate as you get older.

High Cholesterol Causes

What Causes High Cholesterol Levels in the blood?

Cholesterol only comes from 2 places: from your body and from the food you eat. Your liver and other cells in your body produce approximately 75% of your cholesterol; the remaining 25% or so comes from your food.

Your body naturally produces LDL cholesterol. People also inherit genes that cause their body to make too much LDL cholesterol. Eating saturated fat, trans fats and dietary cholesterol also increases the LDL cholesterol levels in your body. If high blood cholesterol runs in your family, lifestyle modifications may not be enough to help lower your LDL blood cholesterol. Everyone is different, so work with your doctor to find a treatment plan that’s best for you

Risk Factors

Am I at risk for having high cholesterol levels?

There are many risk factors that determine whether you are at risk of having high blood LDL cholesterol levels. These include genetic factors as well as lifestyle factors. If you have a family history of high cholesterol or heart disease, and if then you indeed also develop high cholesterol levels, this places you in even higher risk for developing heart disease.

What Affects Cholesterol Levels?

A variety of things can affect cholesterol levels. These are things you can do something about:

Diet
- A poor diet consisting of foods that are high in cholesterol and trans fats can raise your LDL cholesterol levels to risky levels. Saturated, or trans fat and cholesterol in the food you eat make your blood cholesterol level go up, especially your LDL bad cholesterol levels. Saturated fat is the main culprit, but cholesterol in foods also matters. Reducing the amount of saturated fat and cholesterol in your diet helps lower your blood cholesterol level.
Exercise/Physical Activity
- Not being physically active is a risk factor for heart disease. Regular physical activity can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also helps you lose weight. You should try to be physically active for 30 minutes on most, if not all, days.
Stress levels
Weight
- Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol. Losing weight can help lower your LDL and total cholesterol levels, as well as raise your HDL and lower your triglyceride levels.If you are overweight (being overweight is medically defined as having a Body Mass Index ["BMI"] between 25 and 29.9) or obese (obesity is medically defined as having a Body Mass Index ["BMI"] of 30 or greater), you’re at high risk!
- Body Mass Index ["BMI"] – A person’s body mass index (BMI) is a mathematical formula that takes into account a person’s height and weight. The formula is a person’s weight in kilograms divided by height in meters squared (BMI = kg/m²). Generally, BMI is a useful measure of body composition since it correlates highly with body fat in most people.
Smoking
- Cigarette smoking accounts for about 440,000 deaths each year. More than 135,000 of those deaths are due to smoking related cardiovascular diseases. Smoking damages your blood vessel walls, making them more susceptible to fatty cholesterol deposits. Smoking may also lower your HDL “good” cholesterol levels.
Diabetes
- High blood sugar levels caused by diabetes has been found to be a contributing factor to higher LDL cholesterol levels and lower HDL cholesterol levels. High blood sugar additionally damages the lining of your arteries, making them more susceptible to fatty cholesterol deposits.
High Blood Pressure
- High blood pressure is an increased pressure on your artery walls, which may damage them, making them more susceptible to fatty cholesterol deposits.
Alcohol Consumption

Things you cannot do anything about also can affect cholesterol levels. These include:

Age and Gender. As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women’s LDL levels tend to rise.
Heredity. Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.

Symptoms of High Cholesterol

How Is Cholesterol Diagnosed?

There are no symptoms for people with high cholesterol levels.

However, certain risk factors should alert you that you may possibly have high cholesterol levels. If you have a family history of high cholesterol or heart disease, even if you eat healthy and exercise regularly, treat it as a symptom and get your levels checked!

Since genetic factors are largely at play when it comes to high cholesterol levels, don’t wait to get tested. Started getting blood tests for cholesterol early, so that even your 20′s you know and monitor your levels especially if they are high.

Testing for High Cholesterol

What tests are available to determine my cholesterol levels?

Blood Test
A blood test is used to check cholesterol levels. Doctors refer to this blood test as a “lipid panel” or “lipid profile.” Your lipid panel results generally will report the following numbers:

Your total cholesterol level
Your HDL cholesterol level
Your LDL cholesterol level
Your triglyceride levels

Your physician should advise you that to attain the most accurate measurements, you cannot eat or drink anything besides water for 12 hours before your blood is drawn.

Nuclear Magnetic Resonance (NMR) Spectroscopy
A new type of cholesterol test called nuclear magnetic resonance (NMR) spectroscopy is becoming available. The NMR is a technique using radio waves to determine to structure, including the size and concentration, of organic compounds. Hence, this test measures the actual size and number of your LDL and HDL cholesterol particles. It is possible that the size and amount of each type of cholesterol is a more precise indicator of your risk of heart disease.

Because so much research using NMR technology is being conducted, physicians may be able to develop better treatment plans for their patients. The research results of will give physicians the insight to select the most efficient medications for each individualized patient, depending on their lipoprotein size and concentration. Patients may achieve optimal results faster and even help certain patients receive life saving help more quickly by eliminating the need to switch medications when they are not working.

Treatment Options

How can you lower high cholesterol levels?

YOU CAN REDUCE YOUR CHOLESTEROL NUMBERS!

If you have been diagnosed with high cholesterol, don’t stress! (Stress may only increase your cholesterol levels). You must develop a proper treatment plan – treatments for high cholesterol can not only reduce your cholesterol levels, but also directly reduce your chances of cardiovascular disease, a heart attack or stroke.

Treatments for high cholesterol should always involve lifestyle changes first and foremost. Such changes include:

Eating healthier,
Exercising regularly, and/or
Losing weight.

In some patients, this will not be enough and they will need medications as well. However, be aware that medication alone is not a good approach to lowering cholesterol. If medications are necessary, make sure that these drugs are not just used as a replacement for healthier lifestyle choice, you must incorporate both.

What is the Goal of Treatment?

You might be wondering what the goal of treatment is since you don’t feel any symptoms. The main goal of cholesterol-lowering treatment is to lower your LDL level enough to reduce your risk of developing heart disease or having a heart attack. The higher your risk, the lower your LDL goal will be. There are two main ways to lower your cholesterol:

Therapeutic Lifestyle Changes (TLC) – includes a cholesterol-lowering diet (called the TLC diet), physical activity, and weight management. TLC is for anyone whose LDL is above goal.
Drug Treatment–if cholesterol-lowering drugs are needed, they are used together with TLC treatment to help lower your LDL.

Treatment Intensity

If you have been diagnosed with high cholesterol, how do you know whether you have to make lifestyle changes or take prescription medication or both?

The intensity of your treatment will be tied to the degree of your heart disease risk. But whatever your degree of risk, you’ll need to follow the TLC Program. This section gives you the steps to follow. The program uses a step-by-step approach to help make it easier for you to adopt the changes. For instance, during the first 3 months of treatment, your main aim will be to lower your LDL cholesterol to its goal level through diet and physical activity. You will take in only enough calories to maintain a healthy weight, or achieve it if you’re overweight.You’ll be working with your doctor and possibly other health professionals for tips on how to forge a heart healthy partnership. Your progress will be reviewed regularly and, if needed, your treatment will be adjusted to get your LDL cholesterol down to its goal level.

Category I, Highest Risk, your LDL goal is less than 100 mg/dL. you will need to begin the TLC diet to reduce your high risk even if your LDL is below 100 mg/dL. If your LDL is 100 or above, you will need to start drug treatment at the same time as the TLC diet. If your LDL is below 100 mg/dL, you may also need to start drug treatment together with the TLC diet if your doctor finds our risk is very high, for example if you had a recent heart attack or have both heart disease and diabetes.
Category II, Next Highest Risk, your LDL goal is less than 130 mg/dL. If your LDL is 130 mg/dL or above, you will need to begin treatment with the TLC diet. If your LDL is 130 mg/dL or more after 3 months on the TLC diet, you may need drug treatment along with the TLC diet. If your LDL is less than 130 mg/dL, you will need to follow the heart healthy diet for all Americans, which allows a little more saturated fat and cholesterol than the TLC diet.
Category III, Moderate Risk, your LDL goal is less than 130 mg/dL. If your LDL is 130 mg/dL or above, you will need to begin the TLC diet. If your LDL is 160 mg/dL or more after you have tried the TLC diet for 3 months, you may need drug treatment along with the TLC diet. If your LDL is less than 130 mg/dL, you will need to follow the heart healthy diet for all Americans.
Category IV, Low-to-Moderate Risk, your LDL goal is less than 160 mg/dL. If your LDL is 160 mg/dL or above, you will need to begin the TLC diet. If your LDL is still 160 mg/dL or more after 3 months on the TLC diet, you may need drug treatment along with the TLC diet to lower your LDL, especially if your LDL is 190 mg/dL or more. If your LDL is less than 160 mg/dL, you will need to follow the heart healthy diet for all Americans.

To reduce your risk for heart disease or keep it low, it is very important to control any other risk factors you may have such as high blood pressure and smoking.

Should I Take Drugs to Lower My Cholesterol?

First, speak to your doctor about possible good, safe treatment options for high cholesterol. Before taking medications for high cholesterol, you should always integrate lifestyle changes first and foremost. Such changes include eating healthier, exercising regularly and/or losing weight.

In some patients, this will not be enough and they will need medications as well. However, be aware that drug treatment alone is not a good approach to lowering cholesterol. If medications are necessary, make sure that these drugs are not just used as a replacement for healthier lifestyle choice, you must incorporate both.

After you have made appropriate lifestyle changes and are eating a healthy diet as well as incorporating an exercise regimen into your lifestyle, and your cholesterol levels still remain high, it’s time to speak to your doctor about cholesterol medications that are right for you. Your doctor will analyze your risk factors, your current health, and possible side effects as well as other factors when selecting a cholesterol medication that is right for you.

Cholesterol Lowering Medications

What are the prescription drugs available to lower my cholesterol levels?

If you have been diagnosed with high blood cholesterol, you may have a lot of questions. What if diet and lifestyle changes alone are not good enough? What are the next steps to lowering cholesterol numbers? How do cholesterol medications work? Which prescription medications are best for lowering LDL Bad cholesterol levels? Are these drugs safe? Not everyone’s cholesterol levels respond the same. While lifestyle changes alone can help some people lower their cholesterol levels, others must combine changes in their lifestyle with medications. The following cholesterol medication guide will help you understand your options.

The following is a list of medications available for treating high cholesterol and how they work. Although your doctor will chose your medications, you should be informed when speaking to your doctor so you can understand the possibilities.

Statins- Statins are the most common medications prescribed for lowering cholesterol. Stantins work by blocking an enzyme your liver that is responsible for producing the cholesterol in your body. They are best for lowering LDL cholesterol, although they have been shown to have modest effects on lowering triglyceride levels and raising HDL cholesterol.

Generic Name: Atorvastatin
Brand Name: Lipitor

Generic Name: Fluvastatin
Brand Name: Lescol

Generic Name: Lovastatin
Brand Name: Altoprev, Mevacor

Generic Name: Pavastatin
Brand Name: Pravachol

Generic Name: Rosuvastatin
Brand Name: Crestor

Generic Name: Simvastatin
Brand Name: Zocor

Bile-Acid Binding Resins – this class of cholesterol lowering medications work in the intestines to promote increased disposal of cholesterol.

Generic Name: Cholestyramine
Brand Name: Prevalite, Questran, Questran Light, Locholest, Locholest Light

Generic Name: Colesevelam Hcl
Brand Name: WelChol

Generic Name: Colestipol
Brand Name: Colestid

Cholesterol Absorption Inhibitors – this class of cholesterol lowering medications prevent absorption of cholesterol from the intestine. They are best for lowering LDL cholesterol, although they have been shown to have modest effects on lowering triglyceride levels and raising HDL cholesterol. Can be used in combination with any statin drug.

Generic Name: Ezetimibe
Brand Name: Zetia

Combination Statin & Cholesterol Absorption Inhibitor

Generic Name: Simvastatin & Ezetimibe
Brand Name: Vytorin

Combination Statin & Calcium Channel Blocker – this class of medications is used to treat high blood pressure (hypertension) and high cholesterol.

Generic Name: Atorvastatin & Amlodipine Besylate
Brand Name: Caduet

Side Effects include: swelling of legs or ankles (edema), headache, dizziness

Which Medications Treat High Triglyceride Levels?

Medications that treat high triglyceride levels:

Fibrates

Generic Name: Fenofibrate
Brand Name: Antara, Lofibra, TriCor, Triglide

Generic Name: Gemfibrozil
Brand Name: Lopid

Niacin

Generic Name: Niacin
Brand Name: Niaspan

Combination Niacin and Statin

Generic Name: Niacin & Lovastatin
Brand Name: Simcor or Advicor

Managing Your Cholesterol

Prevention

High cholesterol prevention is straightforward: lead a healthy lifestyle! This includes maintaining a healthy weight, eating well by choosing heart healthy foods, limiting foods high in cholesterol, and eliminating trans fats, excising regularly, and if you smoke, quit.

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