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Uh Oh... Watch out for that High Cholesterol!

What is high cholesterol?

High cholesterol is caused by

  • High levels of low-density lipoprotein (LDL)
    • “Bad” cholesterol which builds up on the walls of the blood vessels, blocking or decreasing blood flow.
  • Low levels of high-density lipoprotein (HDL)
    • “Good” cholesterol which helps to get rid of cholesterol from the body.
  • High levels of triglycerides (a type of fat)

Risk factors of high cholesterol

Lifestyle

  • Diet.
    • Diet rich in saturated fats and trans fats increases risk.
  • Obesity (BMI of 23.0 and above increases risk).
  • Lack of exercise/Sedentary lifestyle.
  • Smoking.
  • Alcohol.
  • Age (risk increases over 40 years old).

Other factors

  • Diabetes
    • Damages blood vessel walls and increases blood pressure.
    • Increases bad cholesterol and decreases the level of good cholesterol in the blood.
  • Gender
    • Men have higher cholesterol levels than women, though cholesterol levels in women increase after menopause.
  • Family history
    • If your family has a health history of early heart disease or heart attacks, you may have a genetic disorder that causes high cholesterol levels.

Causes of high cholesterol

Lifestyle

  • Diet.
  • Obesity.
  • Lack of exercise/ Sedentary lifestyle.
  • Smoking.
    • Decreases levels of good cholesterol.
  • Alcohol.
    • Increases overall levels of cholesterol.

Pre-existing medical conditions

  • Chronic kidney disease
    • It increases the chances of bad cholesterol collecting on the walls of blood vessels which may block or decrease blood flow.
  • Diabetes
    • Damages blood vessel walls and increases blood pressure.
    • Increases bad cholesterol and decreases the level of good cholesterol in the blood.
  • HIV/AIDS
    • Medication used to treat HIV and AIDS may increase levels of bad cholesterol and decrease levels of good cholesterol.
    • It increases the chances of bad cholesterol collecting on the walls of blood vessels which may block or decrease blood flow.
  • Hypothyroidism
    • The liver removes less bad cholesterol from the body, leading to higher levels of bad cholesterol.
  • Lupus
    • It increases the chances of bad cholesterol collecting on the walls of blood vessels which may block or decrease blood flow.

Medication

  • Beta blockers
    • To treat high blood pressure and heart disease.
  • Prednisone
    • To reduce inflammation.
  • Amiodarone
    • To treat irregular heartbeat.
  • Cyclosporine
    • To help donated organs to work well and treat autoimmune diseases.
  • Anabolic Steroids
    • Used to treat some types of anemia and hypogonadism.
  • Protease inhibitors
    • Used to treat HIV.
  • Diuretics
    • Used to treat high blood pressure and water retention (buildup of excess fluids in the body).

Signs and Symptoms of High Cholesterol

The most worrying part about high cholesterol is that it can only be detected through testing, as at early stages, there are usually no signs and symptoms. It can, however increase your risk for conditions that do have symptoms, including angina (chest pain caused by heart disease), high blood pressure as well as stroke.

Some potential signs of cholesterol could be

  • Chest pain with activity.
  • Soft, yellowish growths (fatty deposits) on the elbows, buttocks and knees (xanthomas) or eyes (xanthelasmas).
  • Gray-white cholesterol deposits around the corneas (corneal arcus).
  • In men, impotence may be caused by arteries affected by too much cholesterol.

However, it is best to find out that you have high cholesterol from a regular health check, than to only realise after you have experienced severe consequences (heart attack, stroke, etc)

How a Diagnosis is Made

A diagnosis of high cholesterol is usually made after your doctor analyses your results from a lipid panel, also known as a standard cholesterol test. The test will measure the amount of cholesterol in your blood, and additionally, the amount of triglycerides.

I’m sure by now that you would have known that there is more than 1 type of cholesterol - Not all cholesterol is bad.

Diagnostic test

A cholesterol test is fairly simple, and is similar to most blood tests. After the test, there are no special considerations, and you can continue on with your day as per normal.

It is important to look at all the numbers from the cholesterol test, not just the total cholesterol level.

What Do Cholesterol Test Numbers Mean?

LDL and HDL levels are two primary indicators of potential heart disease. It is important to look at your results from the cholesterol test as a whole to better identify if your cholesterol levels are too high. While HDL is supposedly “good” cholesterol, too much of a good thing can be bad too, and research has shown that very high levels of HDL cholesterol could be linked to greater risk of heart disease for patients who already were facing/were at high risk of facing heart disease.

Table showing the blood cholesterol level range for desirable, borderline high and high risk Table showing the blood cholesterol level range for desirable, borderline high and high risk

After reviewing the results, your doctor will consider other risk factors that you may have for heart disease (e.g. smoking/high blood pressure will also increase the risk) and advise you on taking steps like exercising more or adjusting your diet, as well as using medication to improve your cholesterol levels.

Importance of Early Screening

Early screening is important as it helps to identify individuals who are likely to have high cholesterol, yet do not present with symptoms yet. The earlier you realise you have high cholesterol, the earlier you can take action by modifying your diet and exercise regimen, which can help to reduce the long-term and drastic complications of high cholesterol, such as, vascular disease and so on. Furthermore, it is very possible to cure high cholesterol. With the right steps advised by your doctor after your screening, it is likely that you will be able to manage your cholesterol levels well and gradually reduce your medication doses (if necessary to begin with).

When should Cholesterol Screening be carried out

According to the National Heart, Lung, and Blood Institute (NHLBI), a person's first cholesterol screening should occur between the ages of 9 and 11, and then be repeated every five years after that. Cholesterol screenings should occur every one to two years for men ages 45 to 65 and for women ages 55 to 65. People over 65 should receive cholesterol tests annually.

However, if your test results are not desirable. your doctor may recommend more regular screenings in order to keep a closer eye on your cholesterol levels. This is also likely if you have risk factors for high cholesterol and heart disease, such as diabetes or high blood pressure.

Complications of High Cholesterol

There are various implications of high cholesterol, some of which can lead to life threatening issues such as heart attacks and blood clots.

1. Plaque rupture

High cholesterol leads to deposits of plaque in your arteries. If they are too large, they may rupture (break open). This causes a blood clot to form on the surface of the plaque, and may affect blood flow in your arteries (larger blood vessels).

If the flow of blood to your heart is reduced or even blocked, there may be chest pain, or life-threatening consequences such as a heart attack or stroke.

2. Plaque Build Up

High cholesterol can cause plaque to build up in other arteries in your body, reducing blood flow to your brain, arms and legs, amongst others. This can lead to problems like carotid artery disease and peripheral arterial disease or strokes.

For more information or if you require a medical consultation, please contact My Healthcare Collective here.