High Cholesterol by Rosalyn Carson-DeWitt, MD

En Español (Spanish Version) More InDepth Information on This Condition

Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Understanding Cholesterol Levels

Definition

You have this condition if there are high levels of cholesterol in the blood.

There are three parts of cholesterol:

• Low density lipoproteins (LDL)—known as bad cholesterol. It causes build up of cholesterol and other fats in the blood vessels. High LDL levels can cause artery and heart disease.
• High density lipoproteins (HDL)—known as good cholesterol. It can remove cholesterol and other fats from the blood vessels. High levels of HDL can protect against heart disease.
• Triglycerides—a common form of fat in the body. Often elevated in people with diabetes or certain genetic conditions.
• Particles—proteins associated with certain types of cholesterols in the body. These may be a better signal about your risk of developing disease in the blood vessels.

Causes

Causes of high cholesterol include:

• Genetics
• High-fat diet
• Overweight
• Sedentary lifestyle
• Liver or kidney disease
• Anorexia nervosa
• Underactive thyroid disease

Risk Factors

These factors increase your chance of high cholesterol:

• Age: cholesterol levels tend to rise with age
• Sex:
  • Males
  • Females after menopause
• Family members with high cholesterol
• High-fat diet
• Obesity , overweight
• Sedentary lifestyle

Symptoms

High cholesterol rarely causes symptoms, but can increase your risk of atherosclerosis . This is a dangerous hardening of the arteries. It can end up blocking blood flow. In some cases, this may result in:

• Angina
• Heart attack
• Stroke
• Other serious complications

If you have an inherited form of high cholesterol, cholesterol deposits in the:

• Tendons
• Under the eyes
• Around the cornea

Diagnosis

The doctor will ask about your symptoms and medical history. Your doctor will ask about other factors that may increase your risk of heart disease or stroke such as high blood pressure, or diabetes. A physical exam will be done. These tests are used to measure the cholesterol levels in your blood:

Blood test to measure:

• Total cholesterol
• HDL cholesterol
• LDL cholesterol
• Triglycerides

Treatment

Treatment is aimed at decreasing not only your cholesterol levels, but also decreasing other risk factors for heart disease and strokes.

Lifestyle Changes

• Eat a low-fat, low-cholesterol diet . Eat high-fiber food. A vegetarian or vegan diet may be helpful in lowering your LDL cholesterol. Talk to your doctor about the best meal plan for you.
• Begin a safe exercise program with the advice of your doctor.
• If you smoke, quit .
• If you are overweight, lose weight .
• Avoid processed and refined sugars and starches (white bread, white potatoes, white rice and simple sugars)
• Drink alcohol in moderation. This means two drinks per day for men, and one drink per day for women.
• Make sure other medical conditions such as high blood pressure and diabetes are being treated and controlled.

Cholesterol-Lowering Medication

Your doctor may prescribe medication to help lower your risk for heart disease and to help lower your cholesterol levels. Examples include:

• Statins
  • Lovastatin (Mevacor)
  • Pravastatin (Pravachol)
  • Atorvastatin (Lipitor)
  • Simvastatin (Zocor)
  • Rosuvastatin (Crestor)
• Gemfibrozil (Lopid)
• Cholestyramine (Questran)
• Colestipol (Colestid)
• Niacin (Niacor)
• Ezetimibe (Zetia)

Statins have been shown to reduce mortality (death), heart attacks , and stroke.

These medicines are best used as additions to diet and exercise and should not replace healthy lifestyle changes.

Prevention

To help reduce your chance of getting high cholesterol, follow the lifestyle changes above. Work with your doctor to monitor and control your cholesterol levels.