High Blood Cholesterol

Overview

High blood cholesterol, specifically high LDL cholesterol (the "bad" cholesterol), can increase your risk of heart disease. It occurs when there is an excessive amount of cholesterol in your blood, which can lead to the formation of fatty deposits within your blood vessels. These deposits can hinder blood flow and, in extreme cases, cause heart attacks or strokes. High cholesterol can be caused by unhealthy lifestyle choices or genetic factors, and it is often detected through a blood test.

Understanding the disease

Symptoms

High cholesterol typically has no symptoms, which is why it's often referred to as a "silent condition." The only way to detect high cholesterol is through a blood test. A healthcare professional will typically perform a lipid profile, which measures your levels of total cholesterol, LDL (bad) cholesterol, and HDL (good) cholesterol. High levels of LDL cholesterol and low levels of HDL cholesterol are considered risk factors for heart disease. If you are concerned about your cholesterol levels, it's important to consult with a healthcare professional for appropriate testing and guidance.

Risk Factors

Risk factors for developing high blood cholesterol include poor diet, obesity, lack of exercise, smoking, alcohol consumption, and age. Other medical conditions such as diabetes, hypothyroidism, and chronic kidney disease can also contribute to high cholesterol levels. Certain medications, such as those used to treat acne, cancer, high blood pressure, HIV/AIDS, irregular heart rhythms, and organ transplants, may also affect cholesterol levels.

Development

High blood cholesterol can develop due to a combination of factors, both controllable and uncontrollable. Controllable factors include an unhealthy diet high in saturated and trans fats, lack of exercise, smoking, and excessive alcohol consumption. These lifestyle choices can lead to an increase in LDL (bad) cholesterol and a decrease in HDL (good) cholesterol. Uncontrollable factors that may contribute to high blood cholesterol include genetics, certain medical conditions like diabetes, hypothyroidism, or kidney disease, and some medications taken for other health issues such as high blood pressure or cancer treatment. To maintain healthy cholesterol levels, it's important to adopt a balanced diet low in saturated and trans fats, engage in regular physical activity, maintain a healthy weight, and avoid smoking and excessive alcohol consumption. It's also essential to manage any underlying medical conditions and discuss any concerns with a healthcare professional.

Assessment and Diagnosis

Triage

If you suspect high blood cholesterol, you should see a doctor for a cholesterol screening test. The National Heart, Lung, and Blood Institute (NHLBI) recommends that a person's first cholesterol screening should occur between the ages of 9 and 11, and then be repeated every five years after that. For people over 65, annual cholesterol tests are recommended. If your test results aren't within desirable ranges, your doctor might recommend more-frequent measurements. Your doctor might also suggest more-frequent tests if you have a family history of high cholesterol, heart disease or other risk factors such as diabetes or high blood pressure.

Diagnosis

To diagnose high blood cholesterol, you'll likely need to undergo a blood test called a lipid panel or lipid profile. This test checks your cholesterol levels, including total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. It's important to fast for nine to 12 hours before the test, consuming only water during that time. Following your doctor's instructions is crucial, as some cholesterol tests may not require fasting. After the test, your healthcare provider will interpret your cholesterol levels based on the general guidelines provided. High blood cholesterol can be diagnosed if your LDL cholesterol is above the recommended target of 130 milligrams per deciliter (mg/dL), or 3.4 millimoles per liter (mmol/L). However, if you have other risk factors for heart disease, your target LDL cholesterol may need to be below 100 mg/dL (2.6 mmol/L). Consult your healthcare provider for personalized guidance on your cholesterol levels.

Management and Treatment

Complications

High blood cholesterol can lead to complications such as atherosclerosis, which can cause chest pain, heart attack, and stroke. There are usually no symptoms of high cholesterol, so it's important to get a blood test to detect it. Unhealthy lifestyle choices and medical conditions can contribute to high cholesterol levels, and factors like poor diet, obesity, lack of exercise, smoking, and aging can increase the risk.

Prevention

High cholesterol can be prevented through lifestyle changes and healthy habits. To lower your cholesterol levels and prevent high cholesterol, you can:

1. Follow a low-salt, cholesterol-lowering diet that emphasizes fruits, vegetables, and whole grains.
2. Limit animal fats and consume good fats in moderation.
3. Maintain a healthy weight by losing extra pounds and exercising regularly.
4. Quit smoking and avoid exposure to secondhand smoke.
5. Limit alcohol consumption to moderate levels. By adopting these healthy habits and managing stress, you can reduce your risk of developing high cholesterol and maintain a healthy heart.

Treatment

The recommended treatment for high blood cholesterol involves a combination of lifestyle changes and medications. Lifestyle changes include regular exercise and a heart-healthy diet focused on plant-based foods, limiting saturated and trans fats, and including healthy fats such as monounsaturated fats from olive and canola oils, avocados, nuts, and oily fish. Losing weight and quitting smoking, if applicable, are also important. In some cases, medications may be necessary even after making lifestyle changes. Common cholesterol-lowering medications include statins, which block a substance your liver needs to make cholesterol. Statins available include atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Altoprev), pitavastatin (Livalo), pravastatin (Pravachol), rosuvastatin (Crestor), and simvastatin (Zocor). For children with high cholesterol or who are obese, diet and exercise are the primary treatments. In some cases, children aged 10 and older with extremely high cholesterol levels may be prescribed cholesterol-lowering drugs, such as statins. Alternative medicine and supplements like alpha-linolenic acid, barley, beta-sitosterol, blond psyllium, calcium, cocoa, fish oil, garlic, green tea, oat bran, and sitostanol may also help in managing high cholesterol. However, it's essential to consult with a healthcare provider before starting any supplements, as they can interact with medications and cause side effects. Remember to follow up with your doctor and make any necessary lifestyle changes to effectively manage high blood cholesterol.

Preparing for medical consultation

To prepare for an appointment for high blood cholesterol, follow these steps:

1. Make an appointment with your doctor.
2. Ask if there are any pre-appointment restrictions, such as dietary limitations, that you need to follow before the appointment.
3. Write down any symptoms you're experiencing, including those that may seem unrelated to high blood cholesterol. Note when they began and the circumstances surrounding them.
4. Gather information about your personal and family medical history, including any instances of high blood pressure, diabetes, heart disease, or stroke.
5. Compile a list of all medications, vitamins, or supplements you're taking, including dosages.
6. Bring a family member or friend with you to the appointment for support and to help remember important information.
7. Prepare a list of questions to ask your doctor during the appointment. Some questions to consider include:

• What tests do I need to determine my cholesterol levels?
• Are there any lifestyle changes I should make to improve my cholesterol levels?
• Should I be taking any medications to manage my cholesterol?
• What dietary changes can I make to lower my cholesterol?
• What is a healthy cholesterol level, and how often should I have my cholesterol checked? Remember to discuss your concerns about high blood cholesterol with your healthcare provider, and work together to develop a plan to manage the condition.