Learn All About Cholesterol.

This article was compiled by Dr. G. M. Siddiqui M.D

CEO, Medical Services, Lifeline Healthcare.

Often my patients ask me various questions about Cholesterol, and want to learn the role it plays in their health. I summarize here answers to some of their frequently asked questions.

What is cholesterol and where does it come from?

Cholesterol is a waxy substance that comes from two sources: your body and food. Your body, and especially your liver, makes all the cholesterol you need and circulates it through the blood. But cholesterol is also found in foods from animal sources, such as meat, poultry and full-fat dairy products. Your liver produces more cholesterol when you eat a diet high in saturated and trans fats.

There are two types of cholesterol: "good" and "bad." Too much of one type — or not enough of another — can put you at risk for coronary heart disease, heart attack or stroke. It's important to know the levels of cholesterol in your blood so that you and your doctor can determine the best strategy to lower your risk.

Making healthy eating choices and increasing exercise are important first steps in improving your cholesterol. For some people, cholesterol-lowering medication may also be needed to reduce the risk for heart attack and stroke.

Good vs. Bad Cholesterol

LDL (Bad) Cholesterol

LDL cholesterol is considered the “bad” cholesterol because it contributes to plaque, a thick, hard deposit that can clog arteries and make them less flexible. If a clot forms and blocks a narrowed artery, heart attack or stroke can result.

HDL (Good) Cholesterol

HDL cholesterol is considered “good” cholesterol because it helps remove LDL cholesterol from the arteries back to the liver, where it is broken down and passed from the body. A healthy level of HDL cholesterol may also protect against heart attack and stroke, while low levels of HDL cholesterol have been shown to increase the risk of heart disease.

Triglycerides

Triglycerides are another type of fat, and they’re used to store excess energy from your diet. High levels of triglycerides in the blood are associated with blocks of arteries. Elevated triglycerides can be caused by overweight and obesity, physical inactivity, cigarette smoking, excess alcohol consumption and a diet very high in carbohydrates (more than 60 percent of total calories).

Lp(a) Cholesterol

Lp(a) is a genetic variation of LDL (bad) cholesterol. A high level of Lp(a) is a significant risk factor for the premature development of fatty deposits in arteries. Lp(a) interacts with substances found in artery walls and contribute to the buildup of fatty deposits.

Why Cholesterol Matters

What Can Cholesterol Do?

High cholesterol is one of the major controllable risk factors for coronary artery disease and stroke.
As your blood cholesterol rises, so does your risk of coronary heart disease. If you have other risk factors such as smoking, high blood pressure or diabetes, this risk increases even further. When too much LDL (bad) cholesterol circulates in the blood, it can slowly build up in the inner walls of the arteries that feed the heart and brain. Together with other substances, cholesterol can form a thick, hard deposit called plaque that can narrow the arteries and make them less flexible. This condition is known as atherosclerosis. If a clot forms and blocks a narrowed artery, a heart attack or stroke can result. Plaque may also partially or totally block the blood's flow through an artery in the heart, brain, pelvis, legs, arms or kidneys, causing their damage.

Prevention and Treatment of High Cholesterol

Too much cholesterol in the blood can lead to Heart Attack and Stroke. The good news is, you can lower your cholesterol and reduce your risk of heart disease and stroke.

A. Working with your doctor is the key.
You and your doctor each play an important role in maintaining and improving your heart health. Work with your doctor to determine your risk and the best approach to manage it. This may contain following issues:

B. Lifestyle Changes
Your diet, weight, physical activity and exposure to tobacco smoke all affect your cholesterol level.

C. Know Your Fats
Knowing which fats raise LDL cholesterol and which ones don't is the first step in lowering your risk of heart disease.

D. Eating healthy diet
A heart-healthy eating plan can help you manage your blood cholesterol level.

E. Understand Drug Therapy Options
For some people, lifestyle changes alone aren't enough to reach healthy cholesterol levels. Your doctor may prescribe medication which you may need to take regularly.

F. Avoid Common Misconceptions

Here are some common misconceptions about cholesterol.

1. Using margarine instead of butter will help lower my cholesterol.

Both margarine and butter are high in saturated fat, so use both in moderation. From a dietary perspective, the major factor affecting blood cholesterol is how much saturated fat and trans fat are in the foods you eat. Margarine contains high level of trans fat which is more harmful than pure butter. Vegetable oil does not contain saturated fat, and is better than both margarine and butter.

2. Thin people don't have to worry about high cholesterol.

A person with any body type can have high cholesterol. Overweight people are more likely to have high cholesterol, but thin people should also have their cholesterol checked regularly. Have your cholesterol checked regularly regardless of your weight, physical activity and diet.

3. My doctor hasn't said anything about my cholesterol, so I don't have to worry.

Your health is your responsibility. Ask your healthcare professional to assess your cholesterol and other risk factors to estimate your risk for a heart attack or stroke. Once you know your risk, you can do something about it. Your doctor may recommend diet and lifestyle changes and/or medication. Follow all of your doctor's instructions, and have your cholesterol and other risk factors reassessed every four to six years.

4. Since I started taking medicine for my high cholesterol, I don't have to worry about what I eat.

Drug therapy is usually prescribed to those who have elevated risks for heart disease and stroke. But making diet and lifestyle changes — as well as taking the medication your doctor prescribes — is the best way to prevent heart disease and stroke. To lower cholesterol, you should eat a heart-healthy diet and get 40 minutes of aerobic exercise of moderate to vigorous intensity three to four times a week. It's also very important to take your medication exactly as your doctor has instructed so it can work most efficiently.

5. I am a woman so I don't have to worry about high cholesterol. It's a man's problem.

Premenopausal women may have some protection from high LDL (bad) levels of cholesterol because the female hormone estrogen tends to raise HDL (good) cholesterol levels. But cholesterol levels tend to increase as you age. If you're approaching menopause, it's especially important to have your cholesterol and other risk factors checked and talk with your doctor about your options.

6. You don't need to have your cholesterol checked until you reach middle age.

Everyone should start getting tested for cholesterol and other risk factors at age 20. These measurements help to determine risk for a heart attack or stroke. In some cases, children can have high cholesterol levels. Lack of regular physical activity, poor dietary habits and genetics can all affect a child's cholesterol levels.