How Does Cholesterol Relate To Cardiovascular Disease?
Cholesterol, also known as lipids, is a type of fat that circulates in the bloodstream. It is produced naturally by the body and has many important functions. For example, it helps build cell membranes, helps produce hormones such as estrogen and testosterone, and is an essential component in the absorption of dietary fats. High cholesterol in the blood can lead to arterial damage and cardiovascular disease.
Cholesterol is carried around the body by particles called lipoproteins, which are a type of cholesterol. Cholesterol is made up of three components that you should know about.
LDL (low-density lipoprotein): Sometimes called “bad” or “bad” cholesterol, LDL carries most of the cholesterol in the blood to be stored for future use. High levels of LDL cause cholesterol to build up in the walls of the arteries, leading to plaque formation. With too much, cholesterol (plaque) builds up on the walls of blood vessels, causing them to narrow and harden and restrict blood flow. This is called atherosclerosis. Narrowing of the blood vessels leading to the heart can lead to coronary heart disease, angina or heart attack. A heart attack occurs when plaque breaks away from the walls of the blood vessels and blocks the arteries. Narrowing of the blood vessels leading to the brain can lead to stroke.
HDL (high-density lipoprotein): Known as “good” or “healthy” cholesterol, HDL carries cholesterol from the body to the liver, where it is removed. The more HDL in the blood, the more it prevents plaque buildup in the arteries; if HDL cholesterol is too low, harmful cholesterol stays in the arteries instead of being taken to the liver where it is eventually removed from the body.
Triglycerides (TC): This is the most common type of fat in your body. Triglycerides have the dual function of storing and transporting fat in the blood. When you consume too many calories (especially sugar and alcohol), they are stored as triglycerides; like LDL, excess triglycerides can increase your risk of cardiovascular disease. High triglyceride levels are dangerous to cardiovascular health because they increase the likelihood of atherosclerosis, which increases the risk of heart disease, stroke and heart attack.
Total cholesterol/HDL cholesterol (TC/HDL) is a ratio used to measure cardiovascular risk, and TC/HDL is calculated by dividing the total cholesterol index by the total HDL cholesterol index.
Who is at risk for high cholesterol?
In general, women have lower cholesterol levels than younger men, but women have much higher cholesterol levels after age 65. If your LDL cholesterol is high, your doctor may prescribe cholesterol-lowering medications, changes in diet and exercise.
However, you are at risk for high cholesterol regardless of your gender, age or race.
The following factors may increase your risk of developing high cholesterol If:
- You are a man over the age of 40.
- You are a woman over 50, or are going through menopause.
- You have a first-degree relative under the age of 60 who has died of cardiovascular disease.
- You have had a heart attack or stroke.
- You are a diabetic.
- You have high blood pressure.
- You have kidney disease.
- You are a smoker.
- You are obese.
- You have inflammation.
- You are infected with HIV.
* Obesity is defined as a waist circumference of 102 cm or more for men and 88 cm or more for women. For Chinese or South Asians, a waist circumference of 90 cm or more for men and 80 cm or more for women indicates obesity.
Causes of high cholesterol levels
Some causes of high cholesterol are beyond your control. High cholesterol levels can be genetic, and LDL levels naturally increase with age. Your cholesterol can also be affected by these constant factors: age, family history, and gender (postmenopausal women are at higher risk).
There are a number of factors and habits that can negatively affect your cholesterol. These include.
- Consuming too much saturated fat, trans fat and cholesterol
- Being overweight or obese
- Lack of exercise
- High blood pressure
How do I know if I have high cholesterol?
There are no symptoms of high cholesterol. Many people with high cholesterol are unaware that they have high cholesterol levels and are at risk for cardiovascular disease. Your doctor will calculate your risk level (low, medium or high) using a specific assessment tool and two or more risk factors, such as previous heart attack or stroke; blocked arteries in the neck, arms or legs; diabetes; age; smoking; high blood pressure; low HDL; and a family history of cardiovascular disease.
If none of the above apply to you and you are over the age of 20, your doctor will decide if you need to be tested and how often. The blood test will be performed after an overnight fast or after 10 to 12 hours of fasting. Total cholesterol, triglyceride, LDL and HDL levels will be measured.
What happens if my cholesterol level is too high?
There are two main means of controlling cholesterol, and many patients require both medication and lifestyle changes. Making the recommended lifestyle changes can improve cholesterol by 5% to 10%, while medications have been shown to lower LDL cholesterol by 20% to 55%. Therefore, lifestyle changes, such as quitting smoking and increasing physical activity, are often required along with medication.
Many medications can lower LDL and triglycerides, increase HDL, and reduce the amount of cholesterol absorbed by the digestive system. Patients can take more than one cholesterol-lowering medication at the same time.
All patients who already have coronary heart disease or diabetes should be treated with a statin drug. Statins are safe and effective cholesterol-lowering medications. Some patients may need to take the drug a second time.
Treatment guidelines for high triglycerides are not as clear as for cholesterol. However, for people with relatively normal cholesterol levels, fibrates are the drug of choice for lowering triglycerides to a very high range. The most powerful fibrates can reduce triglycerides by up to 40%. Statins are effective for both cholesterol and triglycerides. Successful treatment requires continuous control of blood glucose, avoidance of alcohol, oral estrogens and retinoids in diabetic patients.
Treatment of low HDL
Vitamin B niacin can increase HDL by 30% (often more if treated for a long time.) It is the most effective drug for raising HDL levels.
Knowing your cholesterol levels is an important step in keeping your heart healthy. Talk to your doctor about whether you should have your cholesterol checked and get advice on managing it.