Cholesterol: The ‘greasy’ truth uncovered
By Dr Amrish Kamboj
(Consultant Pathologist)
It is important for everyone to know the facts about cholesterol to reduce the risk for a heart attack or stroke.
It is worth noting that cholesterol itself isn’t bad. In fact, cholesterol is just one of the many substances created and used by our bodies to keep us healthy. Some of the cholesterol we need is produced naturally while some of it comes from the food we eat.
There are two types of cholesterol: ‘good’ and ‘bad.’ It’s important to understand the difference, and to know the levels of ‘good’ and ‘bad’ cholesterol in your blood. Too much of one type — or a deficiency of the other — can put you at risk for heart disease, heart attack or stroke.
Frequently asked questions
about cholesterol
What is cholesterol? Why is a
high cholesterol level unhealthy?
Cholesterol is a waxy substance our body uses to protect nerves, make cell membranes and produce certain hormones. All the cholesterol the body needs is made by the liver. Cholesterol taken in the food (such as eggs, meats and dairy products) is extra, and too much cholesterol can have a negative impact on your health.
If you have too much cholesterol in your bloodstream, the excess may be deposited in the arteries of the heart, which could lead to heart disease.
If an artery that supplies blood to the muscles in the heart becomes blocked, a heart attack can occur. If an artery that supplies blood to brain gets blocked, a stroke can occur.
When should I start having
my cholesterol level checked?
Healthy men and women twenty years and older should undergo cholesterol screening every 5 years. Blood samples should be obtained after fasting and should be tested for total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides.
Some authorities recommend that men aged 35 and older and women aged 45 and older should have their cholesterol checked yearly.
Cholesterol is tested at more frequent intervals (often several times per year) in patients who have been prescribed diet and/or drugs to lower their cholesterol.
Are there different types
of cholesterol?
Yes. Cholesterol travels through the blood in different types of packages, called lipoproteins. LDL and HDL are two important lipoproteins.
Too much LDL cholesterol is bad for the body, and a high level of HDL is good. It’s the balance between the types of cholesterol that tells you what your cholesterol level means.
For example, if your total cholesterol level is high because of a high LDL level, you may be at higher risk of heart disease or stroke. If your total level is high only because of a high HDL level, you’re probably not at higher risk. The risk for developing heart disease can be estimated by using the cholesterol blood levels. Lowering cholesterol, especially the LDL form of cholesterol, is an important aspect of preventing heart disease.
What are the symptoms
of high cholesterol?
High cholesterol doesn’t have any symptoms. The only way to know if you have high cholesterol is to have it checked by a laboratory test called a Fasting Lipid Profile
What are the uncontrollable
and controllable risk factors
for high cholesterol?
The risk factors you can’t control are your age (for men, 45 years or older; for women, 55 years or older) and your family history of early heart disease (for men, father or brother affected before age 55 years; for women, mother or sister affected before age 65 years).
The risk factors you can control are lowering blood cholesterol, especially LDL (‘bad’) cholesterol; and raising HDL (‘good’) cholesterol; quitting smoking; controlling high blood pressure; controlling diabetes; losing weight if overweight/obese; and keeping physically active.
Total cholesterol level
Less than 200 is best.
200 to 239 is borderline high.
240 or more means you’re at increased risk for heart disease.
LDL cholesterol levels
The target (goal) level of LDL cholesterol depends on the person’s risk for heart disease
Below 100 is ideal for people who have a higher risk of heart disease.
100 to 129 is near optimal.
130 to 159 is borderline high.
160 or more means you’re at a higher risk for heart disease.
HDL cholesterol levels
Less than 40 means you’re at higher risk for heart disease.
60 or higher greatly reduces your risk of heart disease.
What about medication to
lower cholesterol?
Depending on your risk factors, if healthy eating and exercise don’t work after 6 months to 1 year, your doctor may suggest medication to lower your cholesterol level.
Who should be considered
for lipid-lowering medications?
Patients with prior heart attacks, strokes, bypass surgery, angioplasty or diabetes can greatly reduce their risk of future heart attacks or strokes by aggressively lowering LDL cholesterol below 100 mg/dl.
Patients who have been hospitalized for a heart attack, angioplasty, or bypass surgery should be discharged on a LDL cholesterol lowering medication if the LDL cholesterol is >130 mg/dl. Some experts recommend LDL-lowering medications even if the LDL is 100-129 mg/dl.
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To conclude, it is also important to note that although overweight people are more likely to have high cholesterol, thin people should also have their cholesterol checked regularly. Nobody can “eat anything they want” and stay healthy. Have your cholesterol checked regularly regardless of your weight, physical activity and diet.
We hope this article has provided you with useful information to plan your cholesterol checks.