Everything you need to know about cholesterol

Your body needs cholesterol, a waxy, fatty molecule, in the proper proportions for overall health. High blood cholesterol is a disorder that can result from unfavourable cholesterol levels. 

Cholesterol performs three primary functions: 

• It is a component of all of your cells’ membrane, or outer layer. 
• It is used to create steroid hormones and vitamin D, which maintains the health of your bones, teeth, and muscles. 
• Bile is produced using it, and bile aids in the digestion of dietary lipids.  

Your blood’s lipoproteins carry the cholesterol:

1. LDL, also known as “bad” cholesterol, is a type of low-density lipoprotein. 
2. HDL, also known as “good” cholesterol, is a high-density lipoprotein. 

Your blood vessels develop plaque, or fatty deposits, when your “bad” LDL cholesterol levels are high. Heart attack, stroke, or other health issues could result from this. Your chance of developing health issues may actually be lowered by high levels of “good” HDL cholesterol.

In order to be eliminated from the body, HDL cholesterol transports artery-bound cholesterol and plaque to the liver. Each and every cell in your body has cholesterol. It is crucial to your body’s functioning and is especially crucial to your brain, nerves, and skin. 

Cholesterol levels  

Every person over the age of 20 should get their cholesterol levels checked at least once every five years. A blood test termed a lipid profile is the screening test that is typically performed. Men and women should both have more frequent screenings for lipid problems if they are 35 years of age or older.  

Your blood test results will be presented as numerical results. How to interpret your cholesterol readings is given below. 

The first thing you should be aware of is that the numbers by themselves cannot predict your risk of developing heart problems or the steps that needs to be to take to reduce that risk. 

They only make up a small portion of a broader calculation that also takes into account factors like your age, blood pressure, smoking status, and use of blood pressure medications. Your doctor will use this data to estimate your 10-year risk for major cardiac issues.

Taking actions to lessen any of these risks, such as lowering cholesterol, may also assist in lowering other risks. 

LDL Cholesterol 

LDL cholesterol can accumulate on the artery walls, increasing your risk of heart disease. LDL cholesterol is referred as “bad” cholesterol for this reason. Your risk decreases when your LDL cholesterol level decreases. 

Your LDL is deemed to be very high if it is 190 or more. In addition to recommending a statin, your doctor may also advise you to lead a healthy lifestyle. Drugs called statins can reduce cholesterol levels. 

Even if your LDL level is less than 190, you may still need to take a statin. Your doctor will suggest a percentage you should strive to lower your LDL level by through diet, exercise, and medication if necessary after calculating your 10-year risk. 

HDL Cholesterol 

A greater score indicates a decreased risk when it comes to HDL cholesterol or the “good” cholesterol. Because HDL cholesterol removes the “bad” cholesterol from your blood and prevents it from accumulating in your arteries, it protects against heart disease. Both exercise and a statin can slightly raise your HDL levels. 

Triglycerides 

The majority of fat in meals in the body is found as triglycerides. High risk of coronary artery disease is associated with high triglyceride levels. 

There is a considerable likelihood that you also have low HDL “good” cholesterol and high LDL “bad” cholesterol if you have high triglyceride levels. This combination increases your risk of suffering a heart attack or stroke. The good news is that many drugs used to treat high cholesterol also work to lower high triglyceride levels. 

Your doctor could advise you to take additional drugs, such as those that lower blood pressure and your risk of diabetes, heart disease, and stroke. You may also be prescribed medication to decrease your triglycerides if they are really high (above 500 mg/dL). 

Total Cholesterol 

HDL cholesterol, LDL cholesterol, and other lipid components are included in your total blood cholesterol measurement. Your doctor will use your total cholesterol value to assess your risk for heart disease and the best course of treatment. 

Diagnosis 

Based on your medical and family history, a physical examination, a blood test to measure your cholesterol levels, and other factors, your doctor will determine that you have high blood cholesterol. 

Physical examination and medical history 

Your doctor will inquire about your diet, exercise routine, family history, current medications, and factors that increase your risk of developing heart or blood vessel disorders. 

Your doctor will look for indications of extremely high blood cholesterol, such as xanthomas, or indications of other medical disorders that can result in high blood cholesterol during your physical examination. 

Screening for high cholesterol 

A lipid panel blood test may be prescribed by your doctor to check for unhealthy cholesterol levels. 

Lipoprotein Panel 

A lipoprotein panel, also known as a lipid panel or lipid profile, assesses your total cholesterol , HDL (good cholesterol) , LDL(bad cholesterol) and Triglycerides profiles. A higher risk of coronary heart disease may be indicated by cholesterol and triglyceride levels that are either higher or lower than usual.

Your risk factors , age, and family history of high blood cholesterol or cardiovascular conditions like atherosclerosis, heart attack, or stroke will all affect how frequently you have a lipid panel performed. 

The following general advice: 

Age of 19 or less: Every five years, screening should be redone and starts at ages 9 to 11. If there is a family history of high blood cholesterol, heart attacks, or strokes, screening may begin as early as age 2. 

Age 20 to 65: Every five years, younger adults should be tested. Every one to two years, screenings for men and women between the ages of 45 and 65 are recommended. 

65 years old: Seniors should be tested every year. Your doctor can recommend a second lipid profile test if your blood cholesterol levels are not within the normal range for your age and sex, particularly if you did not fast before the first lipid panel.

It’s also critical to understand that, in addition to your cholesterol levels, there are a number of other factors that might affect your risk of developing coronary heart disease and stroke. Your age, race, and lifestyle choices are a few examples of these variables. 

A typical lipid panel does not typically include a lipoprotein-a, or Lp(a), test. Even if your other cholesterol levels are normal, having high levels of Lp(a) may indicate that you have a greater risk of developing heart or blood vessel disorders. The amount of Lp(a) you have is determined by the genes .

If you have a family history of early heart illness, such as a heart attack, or if your doctor does not know your family’s medical history, they may prescribe a Lp(a) test. Even if your other cholesterol readings are within the healthy range, if you have a high Lp(a) level, your doctor may recommend a statin, a medication to help prevent heart disease. 

Treatment 

Your doctor may suggest heart-healthy lifestyle modifications and prescribe medications to manage unfavourable blood cholesterol levels. Your doctor may treat the underlying medical condition or alter the medication or dosage if it is the source of your blood cholesterol issue. 

Discuss your lifestyle, other medical illnesses you may have, cholesterol levels, and risk of heart disease with your doctor. 

Medicines 

Statin  

The most popular drug used to treat high blood cholesterol is statin. Statins reduce the risk of heart attack and stroke in adults with high LDL cholesterol, according to studies. Statins often have no side effects, although they might increase the chance of developing diabetes.  

However, those who are already at a high risk for diabetes, such as those who have prediabetes, are overweight or obese, or have metabolic syndrome, tend to experience this more frequently. Although true liver damage is extremely rare, statins may also result in aberrant liver enzyme test findings. Muscle injury is one of a few uncommon side effects. 

Medicine to treat familial hypercholesterolemia 

They consist of lomitapide, ezetimibe, and mipomersen. Ezetimibe may also be used if statins have undesirable side effects or if statin therapy and lifestyle modifications are insufficient to reduce your “bad” LDL level. These medications occasionally can harm the liver. Your doctor will routinely check your liver enzymes and might suggest taking vitamin E. 

Bile acid sequestrants  

If you are unable to take statins or if you need to lower your cholesterol even more than a statin administered alone, bile acid sequestrants may be given. Bile acids, which aid in the digestion of fats and oils, are kept in the intestines rather than being reabsorbed with the aid of bile acid sequestrants. This medication may increase your blood triglyceride level, cause diarrhoea, or reduce the effectiveness of several other medications. 

PCSK9 inhibitors  

PCSK9 inhibitors are a class of medication that is administered intramuscularly every two to four weeks. If you have familial hypercholesterolemia or are at high risk of consequences like a heart attack or stroke, your doctor may recommend both a PCSK9 inhibitor and a statin. The most typical adverse effects are itchiness, discomfort, or edoema.

Maintain your healthy lifestyle modifications even if your doctor prescribes medicine as part of your treatment plan. Your blood cholesterol levels can be lowered and controlled with the use of the medications and heart-healthy lifestyle modifications. 

Apheresis of lipoproteins 

Lipoprotein apheresis may help some persons with familial hypercholesterolemia reduce their blood cholesterol levels.  

Lifestyle changes to improve cholesterol 

Make heart-healthy eating choices

Your “bad” LDL cholesterol can be decreased with the use of the therapeutic Lifestyle Changes and DASH eating programmes. Additionally, these programmes promote minimising saturated fats, which are present in fatty meats, dairy products, and desserts, as well as choosing whole grains, fruits, and vegetables over processed carbs like sugar. 

Engage in regular exercise 

Studies have demonstrated physical activity to increase “good” HDL cholesterol and lower LDL cholesterol and triglycerides. Ask your doctor what level of physical activity is good for you before beginning any workout programme. 

Be mindful of your weight 

According to research, individuals who are overweight or obese can raise “good” HDL cholesterol and lower “bad” LDL cholesterol by decreasing just 3% to 5% of their body weight. 

Quit smoking and limit alcohol intake 

The root cause of today’s so many health issues stems from smoking and Consuming alcohol. For an overall improvement of health, it’s essential to quit smoking and limiting alcohol intake. 

Get enough rest

Your heart and blood vessels can recover and be repaired as you sleep. Adults should get atleast 7 to 9 hours of sleep per night. 

Summary 

Our bodies all require a certain amount of cholesterol to function. Having too much can clog your arteries and cause future health issues, such as heart disease. Most people may maintain healthy cholesterol levels by getting a quick cholesterol test and changing their lifestyles. 

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