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Cholesterol is a waxy substance that is found in your bloodstream. Although your body requires cholesterol to build healthy cells, high cholesterol levels can increase your risk of heart disease.
High cholesterol can cause fatty deposits in your blood vessels. These deposits eventually grow, making it difficult for enough blood to flow through your arteries. These deposits can rupture suddenly and form a clot, resulting in a heart attack or stroke.
High cholesterol can be inherited, but it is more often the result of poor lifestyle choices, making it both preventable and treatable. High cholesterol can be reduced with a healthy diet, regular exercise, and, in some cases, medication.
What are the symptoms of high cholesterol?
There are no symptoms of high cholesterol. The only way to find out if you have it is through a blood test.
WHAT ARE THE CAUSES OF HIGH CHOLESTEROL?
Cholesterol travels through your bloodstream attached to proteins. This protein-cholesterol complex is known as a lipoprotein. There are various types of cholesterol depending on what the lipoprotein carries. They are as follows:
Low-density lipoprotein (LDL): LDL cholesterol, also known as "bad" cholesterol, transports cholesterol particles throughout your body. LDL cholesterol accumulates in the walls of your arteries, hardening and narrowing them.
High-density lipoprotein (HDL): HDL, or "good" cholesterol, collects excess cholesterol and transports it to your liver.
Triglycerides, a type of fat found in the blood, are typically measured as part of a lipid profile. High triglyceride levels can also increase your risk of heart disease.
Inactivity, obesity, and an unhealthy diet are all factors that contribute to high cholesterol and triglyceride levels. Factors beyond your control may also play a role. Your genetic make-up, for example, may make it more difficult for your body to remove LDL cholesterol from your blood or break it down in the liver.
The following medical conditions can result in high cholesterol levels:
- Chronic kidney disease
- Diabetes
- HIV/AIDS
- Hypothyroidism
- Lupus
Cholesterol levels can also be exacerbated by certain medications you may be taking for other health issues, such as:
- Acne
- Cancer
- Hypertension
- HIV/AIDS
- Irregular heartbeats
- Transplants of organs
WHAT ARE THE RISK FACTORS OF HIGH CHOLESTEROL?
The following factors can increase your risk of having high cholesterol:
- Poor diet: Excessive consumption of saturated or trans fats can result in elevated cholesterol levels. Saturated fats can be found in high-fat dairy products and fatty cuts of meat. Trans fats are frequently found in processed snacks and desserts.
- Obesity: A body mass index (BMI) of 30 or higher puts you at risk of having high cholesterol.
- Lack of physical activity: Exercise increases your body's HDL, or "good" cholesterol.
- Smoking: Cigarette smoking may lower your HDL, or "good" cholesterol level.
- Alcohol: Excessive alcohol consumption can raise your total cholesterol level.
- Age: Even young children can have high levels of bad cholesterol, but it is much more common in people over the age of 40. As you get older, your liver's ability to remove LDL cholesterol decreases.
WHAT ARE THE COMPLICATIONS OF HIGH CHOLESTEROL?
High cholesterol levels can result in a dangerous buildup of cholesterol and other deposits on the walls of your arteries (atherosclerosis). These deposits (plaques) can reduce blood flow through your arteries, resulting in complications like:
- Chest pain: If the arteries that supply blood to your heart (coronary arteries) are damaged, you may experience chest pain (angina) and other symptoms of coronary artery disease.
- Heart attack: When plaques tear or rupture, a blood clot can form at the site of the rupture, obstructing blood flow or breaking free and plugging an artery downstream. A heart attack occurs when blood flow to a portion of your heart ceases.
- Stroke: A stroke, like a heart attack, occurs when a blood clot prevents blood flow to a portion of your brain.
HOW IS HIGH CHOLESTEROL DIAGNOSED?
A lipid panel or lipid profile is a blood test that checks cholesterol levels and typically reports:
- Cholesterol total
- LDL cholesterol
- HDL cholesterol
- Triglycerides, a type of fat in the blood
Generally, you must fast for nine to twelve hours before the test, consuming no food or liquids other than water. Some cholesterol tests do not necessitate fasting, so follow your doctor's advice.
CHOLESTEROL TESTING IN CHILDREN
The National Heart, Lung, and Blood Institute recommends one cholesterol screening test between the ages of 9 and 11, followed by a five-year interval.
If your child comes from a family with early-onset heart disease or has a personal history of obesity or diabetes, your doctor may recommend more frequent or earlier cholesterol testing.
WHAT ARE THE TREATMENTS FOR HIGH CHOLESTEROL?
The first line of defense against high cholesterol is to make lifestyle changes such as exercising and eating a healthy diet. However, if you've made these important lifestyle changes and your cholesterol levels still remain high, your doctor may advise you to take medication.
The medication or combination of medications you choose is determined by a variety of factors, including your personal risk factors, age, health, and potential drug side effects. Typical options include:
PCSK9 inhibitors: These medications can help the liver absorb more LDL cholesterol, lowering the amount of cholesterol in your blood. Alirocumab (Praluent) and evolocumab (Repatha) may be used in people who have a genetic condition that causes extremely high LDL levels, or in people who have a history of coronary disease and are intolerant to statins or other cholesterol medications. They are costly and are injected under the skin every few weeks.
Statins: Statins inhibit a substance required by your liver to produce cholesterol. As a result, your liver removes cholesterol from your blood. Avastatin (Lipitor), fluvastatin (Lescol), lovastatin (Altoprev), pitavastatin (Livalo), pravastatin (Pravachol), rosuvastatin (Crestor), and simvastatin are some options (Zocor).
Cholesterol absorption inhibitors: The cholesterol in your diet is absorbed by your small intestine and released into your bloodstream. The drug ezetimibe (Zetia) lowers blood cholesterol by limiting dietary cholesterol absorption. Ezetimibe can be combined with a statin medication.
Bempedoic acid: This newer medication functions similarly to statins but is less likely to cause muscle pain. Adding bempedoic acid (Nexletol) to a maximum statin dosage can significantly lower LDL. There is also a combination pill (Nexlizet) that contains both bempedoic acid and ezetimibe.
Bile-acid-binding resins: Cholesterol is used by the liver to produce bile acids, which are necessary for digestion. Cholestyramine (Prevalite), colesevelam (Welchol), and colestipol (Colestid) are medications that lower cholesterol indirectly by binding to bile acids. This causes your liver to use extra cholesterol to produce more bile acids, lowering the level of cholesterol in your blood.
Medications for high triglycerides
If you have high triglycerides as well, your doctor may prescribe:
- Fibrates: Fenofibrate (Tricor, Fenoglide, and others) and gemfibrozil (Lopid) reduce your liver's production of very-low-density lipoprotein (VLDL) cholesterol and accelerate the removal of triglycerides from your blood. Triglycerides make up the majority of VLDL cholesterol. The use of fibrates in conjunction with a statin may increase the risk of statin side effects.
- Niacin: Niacin inhibits the ability of your liver to produce LDL and VLDL cholesterol. However, niacin has no additional benefits over statins. Niacin has also been linked to liver damage and strokes, so it is now only recommended for people who are unable to take statins.
- Omega-3 fatty acid supplements: Triglyceride levels can be reduced by taking omega-3 fatty acid supplements. They are available with or without a prescription. If you decide to take over-the-counter supplements, get your doctor's approval first. Omega-3 fatty acid supplements may interfere with other medications you are taking.
Tolerance differs.
Medication tolerance varies from person to person. Statins are commonly associated with muscle pain and damage, reversible memory loss and confusion, and elevated blood sugar. If you decide to take cholesterol medication, your doctor may advise you to have liver function tests to monitor how the medication affects your liver.
Cholesterol treatment for children
Diet and exercise are the most effective first-line treatments for children aged 2 and up who have high cholesterol or are obese. Children aged 10 and up with extremely high cholesterol levels may be prescribed cholesterol-lowering medications such as statins.
HOW CAN HIGH CHOLESTEROL BE PREVENTED
The same heart-healthy lifestyle changes that can help lower your cholesterol can also help you avoid having high cholesterol in the first place. You can help prevent high cholesterol by doing the following:
- Consume a low-salt diet rich in fruits, vegetables, and whole grains.
- Limit your intake of animal fats and use good fats sparingly.
- Lose excess weight and maintain a healthy weight
- Give up smoking.
- Exercise for at least 30 minutes on most days of the week.
- If you must consume alcohol, do so in moderation.
- Control your stress.