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Cholesterol is an essential fat-like substance. While you get cholesterol from the food you consume, your liver produces the majority. Cholesterol is an important component in your cells, blood, and body tissues and plays an essential role in allowing your muscles, liver, nerves, skin, heart, intestines, and brain to function.
Introduction 
 
High cholesterol occurs when the blood has excess or an unhealthy balance of cholesterol. Some cholesterol is necessary for the body to function healthily, but too much endangers your health. High cholesterol exhibits no symptoms, so the only way to verify if you have it is with a simple blood test. High cholesterol is relatively easy to treat with dietary changes, lifestyle changes, and medications. Left untreated, high cholesterol increases your risk of blood vessel and heart disease, along with stroke or heart attack.
 
Anatomy
 
Cholesterol is an essential fat-like substance. While you get cholesterol from the food you consume, your liver produces the majority. Cholesterol is an important component in your cells, blood, and body tissues and plays an essential role in allowing your muscles, liver, nerves, skin, heart, intestines, and brain to function. Your body also uses cholesterol in the production of vitamin D, hormones, and bile that helps you digest fat. Cholesterol also helps your brain and nerves send messages around the body. Furthermore, cholesterol is a component of your body fat. Your body needs it to be healthy, but too much cholesterol is bad for your health.
 
You can determine the total amount of cholesterol in your blood through a total cholesterol test. A lipid profile, which is a more detailed test, provides lipoprotein measurements that are more reflective of and useful in determining your health. Your cholesterol travels out from the liver and into the bloodstream riding on protein and fat carriers called lipoproteins. There are two types – high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol.
 
LDL makes up the majority of your cholesterol and transports it away from your liver and into your bloodstream. LDLs hold more fat than protein and is more likely to collect on blood vessel walls, contributing to heart disease, heart attack, and stroke. LDLs are the bad type of cholesterol, so you want low LDL numbers.
 
HDL cholesterol, on the other hand, contains more protein than fat and carries cholesterol out of your arteries and body. HDLs are the good kind of cholesterol, and high levels of HDLs can decrease your risk of heart attack. You want to aim for high HDL levels.
 
Causes
 
High cholesterol means that there is excess or an unhealthy balance of cholesterol in your blood. It can lead to narrowed and clogged arteries, contributing to heart diseases like heart attack and stroke. The primary causes of high cholesterol are believed to be consumption of high-cholesterol and high-fat foods as well as inherited factors.
 
One factor of high cholesterol is uncontrollable – your genes determine how fast your body produces and removes LDL. Some people are born with familial hypercholesterolemia, a certain type of high cholesterol that is inherited.
 
Some medical conditions can contribute to high cholesterol. These include diabetes, kidney disease, Cushing’s syndrome, liver disease, or an underactive thyroid. Some medications, such as estrogen, birth control pills, beta-blockers, some diuretics, and corticosteroids, can also increase your cholesterol levels.
 
Negative lifestyle choices, such as lack of exercise, excess alcohol consumption, and smoking, also contribute to high cholesterol. Being overweight also increases your LDL levels.
 
Cholesterol levels usually increase with age. For women, in particular, cholesterol levels usually rise around menopause. 
 
Symptoms
 
High cholesterol exhibits no symptoms and the only way to verify if you have it is through testing. Unless otherwise specified by your doctor, you should begin regular cholesterol testing around 20 years of age.
 
Diagnosis
 
A blood test can identify your total cholesterol level. If your results show high cholesterol, another test known as a lipid panel will measure your HDL, LDL, and triglyceride levels. Triglycerides are fats that are used in cholesterol production, and high levels of them can contribute to heart disease.
 
A desirable and healthy total cholesterol level is 200 mg/dL or lower. If your total cholesterol is higher than that, so is your risk for heart disease. A total cholesterol of 200-239 mg/dL is thought to be on the threshold of high. Readings of 240 mg/dL or higher are considered high total cholesterol levels. Ideally, you will have high HDL levels and low LDL levels, along with low triglyceride rates to decrease your risk for heart disease.
 
Treatment
 
Lowering your cholesterol levels into healthy ranges is the goal of treatment. High cholesterol is treated with special diets, medications, and lifestyle changes. According to your lipid profile results, your doctor will give you specific recommendations.
 
Change your lifestyle to reduce controllable risk factors like losing and maintaining a healthy weight, exercising regularly, and not smoking. Exercise is important because it helps lower LDL while raising HDL.
 
Eat a healthy diet low in fat and cholesterol while high in fiber. Your doctor may refer you to a nutritionist to help you with healthy meal planning.
 
If dietary and lifestyle changes alone are not enough to lower your cholesterol into the healthy range, your doctor will recommend cholesterol-lowering medications. Usually, you will take more than one type of medication and change medications over time.
 
Your doctor will regularly monitor your cholesterol levels and how your medications are affecting you. Take all your medications as prescribed and attend all your scheduled follow-up appointments.
 
Prevention
 
You can reduce the controllable factors of high cholesterol. Quit smoking, maintain a healthy weight, exercise regularly, and eat a high-fiber, low-fat, and low-cholesterol diet to reduce your risk for high cholesterol. Take your prescribed medications as directed and diligently attend all follow-up appointments.
 
Am I At Risk
 
There are both controllable and inherited risk factors for high cholesterol. Risk factors include aging, menopause, being overweight, smoking, certain medications, sedentary lifestyle, excess alcohol consumption, high-cholesterol and high-fat diet, and inherited genes from parents.
 
Complications
 
The biggest concern regarding high cholesterol is that is significantly increases your risk for heart disease and stroke. High cholesterol causes deposits on the walls of your arteries that result in arterial narrowing and blockages.
 
Advancements
 
Treatment of high cholesterol has improved through cholesterol-lowering medications, particularly in the realm of statin drugs.