High Blood Cholesterol Causes, Symptoms, Diagnosis, Treatment And Prevention

High Blood Cholesterol Causes, Symptoms, Diagnosis, Treatment And Prevention


What Is High Blood Cholesterol?


High blood cholesterol is a condition in which you have too much cholesterol in your blood. By itself, the condition usually has no signs or symptoms. Thus, many people don’t know that their cholesterol levels are too high.

People who have high blood cholesterol have a greater chance of getting coronary heart disease, also called coronary artery disease. (In this article, the term “heart disease” refers to coronary heart disease.)

The higher the level of LDL cholesterol in your blood, the GREATER your chance is of getting heart disease. The higher the level of HDL cholesterol in your blood, the LOWER your chance is of getting heart disease.

High Blood Cholesterol Causes, Symptoms, Diagnosis, Treatment And Prevention
High Blood Cholesterol

Coronary heart disease is a condition in which plaque (plak) builds up inside the coronary (heart) arteries. Plaque is made up of cholesterol, fat, calcium, and other substances found in the blood. When plaque builds up in the arteries, the condition is called atherosclerosis.


Over time, plaque hardens and narrows your coronary arteries. This limits the flow of oxygen-rich blood to the heart.

Eventually, an area of plaque can rupture (break open). This causes 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 through a coronary artery.

If the flow of oxygen-rich blood to your heart muscle is reduced or blocked, angina or a heart attack may occur.

Angina is chest pain or discomfort. It may feel like pressure or squeezing in your chest. The pain also may occur in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion.

A heart attack occurs if the flow of oxygen-rich blood to a section of heart muscle is cut off. If blood flow isn’t restored quickly, the section of heart muscle begins to die. Without quick treatment, a heart attack can lead to serious problems or death.

Plaque also can build up in other arteries in your body, such as 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.

What are the functions of cholesterol?


  • It builds and maintains cell membranes (outer layer), it prevents crystallization of hydrocarbons in the membrane
  • It is essential for determining which molecules can pass into the cell and which cannot (cell membrane permeability)
  • It is involved in the production of sex hormones (androgens and estrogens)
  • It is essential for the production of hormones released by the adrenal glands (cortisol, corticosterone, aldosterone, and others)
  • It aids in the production of bile
  • It converts sunshine to vitamin D. Scientists from the Rockefeller University were surprised to find that taking vitamin D supplements do not seem to reduce the risk of cholesterol-related cardiovascular disease.
  • It is important for the metabolism of fat soluble vitamins, including vitamins A, D, E, and K
  • It insulates nerve fibers

Why Is Cholesterol Important?


Your blood cholesterol level has a lot to do with your chances of getting heart disease. High blood cholesterol is one of the major risk factors for heart disease. A risk factor is a condition that increases your chance of getting a disease. In fact, the higher your blood cholesterol level, the greater your risk for developing heart disease or having a heart attack. Heart disease is the number one killer of women and men in the United States. Each year, more than a million Americans have heart attacks, and about a half million people die from heart disease.

What causes high cholesterol? 


Lifestyle causes


Nutrition - although some foods contain cholesterol, such as eggs, kidneys, eggs and some seafoods, dietary cholesterol does not have much of an impact in human blood cholesterol levels. However, saturated fats do! Foods high in saturated fats include red meat, some pies, sausages, hard cheese, lard, pastry, cakes, most biscuits, and cream (there are many more).

Sedentary lifestyle - people who do not exercise and spend most of their time sitting/lying down have significantly higher levels of LDL (bad cholesterol) and lower levels of HDL (good cholesterol).

Bodyweight - people who are overweight/obese are much more likely to have higher LDL levels and lower HDL levels, compared to people who are of normal weight.

Smoking - this can have quite a considerable effect on LDL levels.

Alcohol - people who consume too much alcohol regularly, generally have much higher levels of LDL and much lower levels of HDL, compared to people who abstain or those who drink in moderation.

Treatable medical conditions


These medical conditions are known to cause LDL levels to rise. They are all conditions which can be controlled medically (with the help of your doctor, they do not need to be contributory factors):

Risk factors which cannot be treated


These are known as fixed risk factors:

Your genes 1 - people with close family members who have had either a coronary heart disease or a stroke, have a greater risk of high blood cholesterol levels. The link has been identified if your father/brother was under 55, and/or your mother/sister was under 65 when they had coronary heart disease or a stroke.

Your genes 2 - if you have/had a brother, sister, or parent with hypercholesterolemia (high cholesterol) or hyperlipidemia (high blood lipids), your chances of having high cholesterol levels are greater.

Your sex - men have a greater chance of having high blood cholesterol levels than women.

Your age - as you get older your chances of developing atherosclerosis increase.

Early menopause - women whose menopause occurs early are more susceptible to higher cholesterol levels, compared to other women.

Certain ethnic groups - people from the Indian sub-continent (Pakistan, Bangladesh, India, Sri Lanka) are more susceptible to having higher cholesterol levels, compared to other people.

How Does Cholesterol Cause Heart Disease?


When there is too much cholesterol (a fat-like substance) in your blood, it builds up in the walls of your arteries. Over time, this buildup causes "hardening of the arteries" so that arteries become narrowed and blood flow to the heart is slowed down or blocked. The blood carries oxygen to the heart, and if enough blood and oxygen cannot reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack.

High blood cholesterol itself does not cause symptoms, so many people are unaware that their cholesterol level is too high. It is important to find out what your cholesterol numbers are because lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack or dying of heart disease, even if you already have it. Cholesterol lowering is important for everyone--younger, middle age, and older adults; women and men; and people with or without heart disease.

What Do Your Cholesterol Numbers Mean?


Everyone age 20 and older should have their cholesterol measured at least once every 5 years. It is best to have a blood test called a "lipoprotein profile" to find out your cholesterol numbers. This blood test is done after a 9- to 12-hour fast and gives information about your:
High Blood Cholesterol Causes, Symptoms, Diagnosis, Treatment And Prevention

  • Total cholesterol
  • LDL (bad) cholesterol--the main source of cholesterol buildup and blockage in the arteries
  • HDL (good) cholesterol--helps keep cholesterol from building up in the arteries
  • Triglycerides--another form of fat in your blood
If it is not possible to get a lipoprotein profile done, knowing your total cholesterol and HDL cholesterol can give you a general idea about your cholesterol levels. If your total cholesterol is 200 mg/dL* or more or if your HDL is less than 40 mg/dL, you will need to have a lipoprotein profile done. See how your cholesterol numbers compare to the tables below.

Total Cholesterol Level               Category
Less than 200 mg/dL               Desirable
200-239 mg/dL                       Borderline High
240 mg/dL and above               High

* Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood.

LDL Cholesterol Level                    LDL-Cholesterol Category
Less than 100 mg/dL                    Optimal
100-129 mg/dL                            Near optimal/above optimal
130-159 mg/dL                            Borderline high
160-189 mg/dL                            High
190 mg/dL and above                    Very high

HDL (good) cholesterol protects against heart disease, so for HDL, higher numbers are better. A level less than 40 mg/dL is low and is considered a major risk factor because it increases your risk for developing heart disease. HDL levels of 60 mg/dL or more help to lower your risk for heart disease.

Triglycerides can also raise heart disease risk. Levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more) may need treatment in some people.

What Is Your Risk of Developing Heart Disease or Having a Heart Attack?


In general, the higher your LDL level and the more risk factors you have (other than LDL), the greater your chances of developing heart disease or having a heart attack. Some people are at high risk for a heart attack because they already have heart disease. Other people are at high risk for developing heart disease because they have diabetes (which is a strong risk factor) or a combination of risk factors for heart disease. Follow these steps to find out your risk for developing heart disease.

Step 1: Check the table below to see how many of the listed risk factors you have; these are the risk factors that affect your LDL goal.

Major Risk Factors That Affect Your LDL Goal
  • Cigarette smoking
  • High Blood Pressure (140/90 mmHg or higher or on blood pressure medication)
  • Low HDL cholesterol (less than 40 mg/dL)*
  • Family history of early heart disease (heart disease in father or brother before age 55; heart disease in mother or sister before age 65)
  • Age (men 45 years or older; women 55 years or older)

* If your HDL cholesterol is 60 mg/dL or higher, subtract 1 from your total count.

Even though obesity and physical inactivity are not counted in this list, they are conditions that need to be corrected.

Step 2: How many major risk factors do you have? If you have 2 or more risk factors in the table above, use the attached risk scoring tables (Men - Women) to find your risk score. Risk score refers to the chance of having a heart attack in the next 10 years, given as a percentage. My risk score is ________%.

Step 3: Use your medical history, number of risk factors, and risk score to find your risk of developing heart disease or having a heart attack in the table below.


If You Have                                                                      You Are in CategoryHeart disease, diabetes, or risk score more than 20%*        I. Highest Risk
2 or more risk factors and risk score 10-20%                      II. Next Highest Risk
2 or more risk factors and risk score less than 10%              III. Moderate Risk
0 or 1 risk factor                                                              IV. Low-to-Moderate Risk
* Means that more than 20 out of 100 people in this category will have a heart attack within 10 years.

 What Affects Cholesterol Levels?


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

Diet


Saturated fat and cholesterol in the food you eat make your blood cholesterol level go up. 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.

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.

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.

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.

How is high cholesterol diagnosed?


Cholesterol levels may be measured by means of a simple blood test. It is important not to eat anything for at least 12 hours before the blood sample is taken. The blood sample can be obtained with a syringe, or just by pricking the patient's finger.

The blood sample will be tested for LDL and HDL levels, as well as blood triglyceride levels. The units are measure in mg/dl (milligrams/deciliter) or 5mmol/liter (millimoles/liter).

Researchers at the Sree Sastha Institute of Engineering and Technology, India, developed a photographic cholesterol test, which they describe as a completely non-invasive way to test cholesterol levels.

People who have risk factors should consider having their cholesterol levels checked.

Treating High Cholesterol


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. To find your LDL goal, see the boxes below for your risk category. 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.

If you are in...

Category I, Highest Risk


Your LDL goal is less than 100 mg/dL. If your LDL is 100 or above, you will need to begin the TLC diet. If your LDL is 130 or higher, you will need to start drug treatment at the same time as the TLC diet. If your LDL is 100 to 129, you may also need to start drug treatment together with the TLC diet. Even if your LDL is below 100, you should follow the TLC diet on your own to keep your LDL as low as possible.

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.

Drug Treatment for High Blood Cholesterol


Even if you begin drug treatment to lower your cholesterol, you will need to continue your treatment with lifestyle changes. This will keep the dose of medicine as low as possible, and lower your risk in other ways as well. There are several types of drugs available for cholesterol lowering including statins, bile acid sequestrants, nicotinic acid, and fibric acids. Your doctor can help decide which type of drug is best for you. The statin drugs are very effective in lowering LDL levels and are safe for most people. Bile acid sequestrants also lower LDL and can be used alone or in combination with statin drugs. Nicotinic acid lowers LDL and triglycerides and raises HDL. Fibric acids lower LDL somewhat but are used mainly to treat high triglyceride and low HDL levels.

Once your LDL goal has been reached, your doctor may prescribe treatment for high triglycerides and/or a low HDL level, if present. The treatment includes losing weight if needed, increasing physical activity, quitting smoking, and possibly taking a drug.

Lowering Cholesterol With Therapeutic Lifestyle Changes (TLC)


TLC is a set of things you can do to help lower your LDL cholesterol. The main parts of TLC are:

The TLC Diet


This is a low-saturated-fat, low-cholesterol eating plan that calls for less than 7% of calories from saturated fat and less than 200 mg of dietary cholesterol per day. The TLC diet recommends only enough calories to maintain a desirable weight and avoid weight gain. If your LDL is not lowered enough by reducing your saturated fat and cholesterol intakes, the amount of soluble fiber in your diet can be increased. Certain food products that contain plant stanols or plant sterols (for example, cholesterol-lowering margarines and salad dressings) can also be added to the TLC diet to boost its LDL-lowering power.

Weight Management


Losing weight if you are overweight can help lower LDL and is especially important for those with a cluster of risk factors that includes high triglyceride and/or low HDL levels and being overweight with a large waist measurement (more than 40 inches for men and more than 35 inches for women).

Physical Activity


Regular physical activity (30 minutes on most, if not all, days) is recommended for everyone. It can help raise HDL and lower LDL and is especially important for those with high triglyceride and/or low HDL levels who are overweight with a large waist measurement.

Foods low in saturated fat include fat free or 1% dairy products, lean meats, fish, skinless poultry, whole grain foods, and fruits and vegetables. Look for soft margarines (liquid or tub varieties) that are low in saturated fat and contain little or no trans fat (another type of dietary fat that can raise your cholesterol level). Limit foods high in cholesterol such as liver and other organ meats, egg yolks, and full-fat dairy products.
Good sources of soluble fiber include oats, certain fruits (such as oranges and pears) and vegetables (such as brussels sprouts and carrots), and dried peas and beans.

Preventing High Blood Cholesterol Level | How to Prevent Hypercholesterolemia


The advice emanating from health experts in order to prevent high blood cholesterol level is to maintain a healthy lifestyle. A healthy lifestyle involves regular exercises as well as eating only the right kind of foods. Exercising helps the body in burning down excess cholesterol that may otherwise accumulate around vital organs and lead to a serious disease. On the other hand, eating fresh fruits and vegetables provide the body with sufficient nutrients that are vital in the functioning of the body.
Aside from exercise and consumption of fruits, the following are the other means to prevent having the disease:

  • Avoid smoking and alcohol consumption. These are known to affect blood circulation while allowing bad cholesterol in the body to accumulate.
  • Consult your doctor regularly and undergo blood tests. The blood test will help the doctor determine if you have high blood cholesterol level.
  • Drink plenty of water. Water is known to help eliminate bad cholesterols from the body, thus reducing the symptoms that one is likely to experience due to the condition.
  • Increase the intake of soluble fiber. The best source for it are cereal grains, beans, peas, as well as from fruits and vegetables.
  • When consuming fats, make sure to obtain the unsaturated variety that is available from vegetables as well as from fishes.