Did you know that high cholesterol is one of the leading causes of heart disease in the United States? According to the Centers for Disease Control and Prevention, about 1 in 3 American adults have high cholesterol. If you’re one of them, it’s important to be aware of the risks and take steps to lower your cholesterol levels. In this blog post, we’ll outline some important things you need to know about high cholesterol and how to reduce your risk of heart disease. 

Regardless of your age or lifestyle, if you have high cholesterol, it’s important to understand what that means for your health and how to best address it. To help you get started, here are some key facts about high cholesterol that you should know, courtesy of the medical experts at The VIOS Clinic. 

Which Cholesterol is Dangerous?

Cholesterol is a type of fat that is found in all humans and animals. High cholesterol can be dangerous as it can result in the formation of plaques inside the walls of blood vessels. If this plaque builds up enough, it could lead to physical obstruction of blood flow to the vital organs and thus resulting in Angina or TIA (Transient Ischemic Attack) if the obstruction is mild/transient or a full blown heart attack or a stroke if the obstruction is sudden/complete. 

There are various types of cholesterols that circulate in the body. LDL cholesterol (“bad cholesterol”) is known as a major risk factor for heart disease because it contributes to atherosclerosis, the build-up of fatty deposits on artery walls.

Conversely HDL cholesterol (“good cholesterol”) prevents risk factors from accumulating by transporting them back to the liver where they are broken down or passed out as waste.

Triglycerides are the storage form of cholesterol which also should be below a certain limit.

You should aim for optimal levels of Total cholesterol (<200mg/dL),  LDL cholesterol (<100mg/dL) and Triglycerides (<150mg/dL), while keeping HDL cholesterol (>40mg/dL) high.

The targets are generally more stringent in a patient who is at a high risk of heart attack or stroke.

Is high cholesterol a genetic disease?

Genetics plays an important role in cholesterol levels, since cholesterol is partially responsible for passing cholesterol-related genes to children at conception.

Researchers have identified two major genetic factors associated with cholesterol; cholesterol is approximately 40-60% heritable. Cholesterol has also been linked to cholesterol-related diseases including multiple sclerosis, heart failure, Alzheimer’s disease, and amyotrophic lateral sclerosis (ALS) – which have a strong genetic component.

What causes high cholesterol in your body?

High cholesterol in your body occurs when the high level of LDL(low-density lipoprotein) remains in your bloodstream. 

The main causes of high cholesterol are high intake of saturated fat from diet, lack of exercise and uncontrolled diabetes mellitus. Genetic mutations resulting in deficiency of various cholesterol metabolising enzymes form a minor proportion of this cohort of patients. 

High intake of saturated fat from animal products: high-fat foods such as alcohols, fatty fish, whole milk dairy product, beef steak or lamb chop increase the LDL in our body which leads to a high risk for heart disease.

Lack of physical activity: doing less physical activities is one of the reasons that lead to an increase in LDL causing heart diseases especially when we don’t eat high-fat foods.

Uncontrolled diabetes mellitus: high triglyceride & cholesterol levels as a result of high blood sugars and insulin resistance. 

High blood pressure: Hypertension if associated with high cholesterol puts the person at a higher risk of cardiovascular events. High blood pressure results in a strong force that pushes against artery walls, causing them to enlarge and stiffen which causes a high risk for heart disease because it makes your coronary arteries less flexible and narrow due to the proteins deposited on its inner wall. In this scenario if a person has cholesterol plaques (as a consequence of high circulating cholesterol) in the arteries, this puts him/her at a higher risk of an adverse event should there be a progression of the plaque build up. 

What does high cholesterol mean?

People with high levels of low-density lipoprotein (LDL) cholesterol, most commonly due to lifestyle measures, are at high risk for developing coronary heart disease and CerebroVascular Accidents. Evaluations of blood lipid levels include total cholesterol, high-density lipoprotein (HDL), and triglycerides (TG).

The ratio of TC:HDL is used as a predictor of how likely it is that the patient has coronary artery disease; however, the usefulness of this test has been questioned.

Cholesterol testing is recommended every 5 years starting at age 20 and more often in patients who are considered as high risk (for eg- people with heart disease, or diabetes or a family history of high cholesterol)

What does high cholesterol do to your body?

A high level of cholesterol in the blood has many different effects on the body, not only can high cholesterol cause high blood pressure, but also lead to an increased risk of heart disease and stroke.

High levels of LDL ‘bad’ cholesterol increase your risk for developing coronary artery disease, which narrows your arteries as plaque builds up along artery walls. When this happens, less blood flows through them to nourish your heart muscle with oxygen and other vital substances it needs to function properly.

As high cholesterol works by gradually narrowing or blocking your arteries then shortage of oxygen can affect any part of your body if enough time passes – even early onset Alzheimer’s disease.

Can high cholesterol cause heart disease?

Yes, high cholesterol can cause heart disease. High cholesterol is a high level of lipids in the blood, including low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides.

High cholesterol over time leads to plaque buildup in artery walls, called atherosclerosis. This causes the arteries to narrow and harden, increasing risk for heart attack or stroke.

High cholesterol also increases a person’s chance of having blood clots within the plaques, further progressing  the size of the plaque which can lead to heart attack or stroke. High levels of LDL have been shown to increase risk factors for heart disease by damaging the lining of arteries and promoting inflammation that contributes to plaque formation. 

How does high cholesterol cause coronary artery disease?

The high level of cholesterol in the blood can build up on the artery walls, causing high arterial tension. This allows less space for blood to pass through, thus creating high blood pressure and narrowing of arteries. The buildup also contributes to fatty plaques that clog vessels leading to heart problems.

Cholesterol levels are high when there is high production of low density lipoprotein (LDL) or bad cholesterol or low production of high density lipoprotein (HDL) or good cholesterol . High LDL levels result in high levels of triglycerides which are associated with coronary artery disease by increasing LDL particles which ultimately leads to atherosclerosis. HDL helps clear out excess cholesterol from the body so HDL being decreased will have adverse effects on health.

As mentioned, high LDL is bad for health, however low HDL also contributes to high serum LDL which can cause coronary artery disease. So both high and low levels of this lipoprotein are harmful because high LDL increases the number of LDL particles in blood while decrease in HDL results in increase in the number of these particles .

High triglycerides i.e more than 200mg/dl is another risk factor that causes coronary artery disease. It is often with a high lipid profile characterized by high LDL, high VLDL and high triglycerides. High VLDL also contributes to high levels of LDL which will result in coronary artery disease.

In fact, according to statistics from the National Cholesterol Education Program, more than one-third of Americans over the age of 20 have high cholesterol, defined as a total high-density lipoprotein (HDL) cholesterol less than 40 mg/dL or a low-density lipoprotein (LDL) cholesterol greater than or equal to 130 mg/dL.

If high cholesterol is eliminated, the high arterial tension would be brought under control and thus heart diseases can be prevented.

Is hypercholesterolemia a cardiovascular disease?

Yes, Hypercholesterolemia is a medical condition in which there are elevated levels of cholesterol in the blood. Hyperlipidemia is high levels of fats and lipids in the blood, which can be any form of cholesterol. And this hyperlipidemia increases the risk of cardiovascular disease manyfold.

Is high cholesterol curable?

In most cases high cholesterol is not curable, but there are ways to control it. High cholesterol is caused by high levels of LDL (low density lipoprotein) or VLDL (very low density lipoprotein) which carries cholesterol from the liver to cells that need it.

People may develop high LDL through genetics and family history, high-fat diets, lack of exercise, obesity and age. 

There are medications one can take if their high LDL cannot be controlled with diet and exercise alone.

The diet must be changed drastically for someone who has high cholesterol to reduce their risk factors for heart disease (which kills over 1 million people in America every year). It’s also important for one’s lifestyle habits like getting enough sleep and physical activity, not smoking or drinking too much alcohol, and reducing high cholesterol.

How do you treat high cholesterol?

The treatment of high cholesterol is highly dependent on a variety of factors including age, gender, family history, current medications being taken, etc. There are some general guidelines for how high cholesterol should be treated depending on these variables but ultimately it’s important to talk about your treatment options with your doctor so you know what is best for you specifically. It’s worth noting that there are several types of high cholesterol, which means there are several different types of treatments available as well. 

These are the common types of medications commonly prescribed to lower high cholesterol:

Statins

Statins are drugs used to lower high LDL cholesterol and high total cholesterol. Statins work by helping the liver produce less LDL while at the same time allowing for more HDL to be produced, which ultimately results in a lower total cholesterol level.

For individuals who already have high levels of LDL or high levels of both high LDL and high total cholesterol, statin treatment is often recommended. The most common side effects associated with taking statins include muscle aches and pain as well as upper respiratory tract infections such as sinusitis and bronchitis.

Roughly 20 percent of people taking statins experience these side effects: however, it’s important to note that these types of side effects lessen over time and do not typically become problematic once your body becomes accustomed to them. But if you are not able to cope with side effects, please discuss with your doctor about the different strategies to curb the side effects or even replace statins with other classes of medications.  

Adjunct Medications

Other medications used to treat high cholesterol include bile acid sequestrants, niacin, fibrates, and ezetimibe. Bile acid sequestrants are only able to lower LDL levels by about 10-20 percent on their own. Therefore, they are typically prescribed in addition to statins or other medications in order to achieve an optimal level of high cholesterol treatment. 

Niacin

Niacin is another drug used to treat high cholesterol but it tends to work differently than the others. Niacin works by increasing HDL production while also lowering LDL levels at the same time. The most common type of extended release form of niacin is Niaspan; however, there are other formulations that can be taken by mouth or intravenously.

Niacin is typically only prescribed to high-risk patients who cannot achieve their LDL goal on statins alone. The most common side effect of taking high doses of niacin is flushing which varies from mild warmth to severe “hot flashes” throughout the body. Less commonly reported side effects include liver damage and irregular heartbeats (arrhythmias).

Fibrates

Fibrates are another drug used to treat high cholesterol but they work mainly by lowering triglycerides levels while also helping your liver produce more HDL cholesterol. Fibrates have a low rate of adverse side effects when compared to other medications used for high cholesterol treatment.

However, a high percentage of people who take fibrates do experience side effects which can include diarrhea, nausea, upset stomach, and muscle aches. Fibrates are typically taken along with statins because they tend to work better when paired together.

Ezetimibe

Ezetimibe is another drug used for high cholesterol treatment that works by blocking the absorption of cholesterol from your intestines before it gets into your body. This ultimately results in lower levels of LDL cholesterol as well as total high cholesterol levels.

The most common side effects associated with taking ezetimibe include headache and upper respiratory tract infections such as sinusitis and bronchitis (similar to those experienced with other high cholesterol medications). Like Niaspan, ezetimibe is typically prescribed to high-risk patients who cannot achieve their high cholesterol goals on high doses of statins alone.

Conclusion

High cholesterol can cause many different problems including heart disease and stroke which are two leading causes of death in the United States. The good news is that high cholesterol treatment has advanced significantly over the past several decades, making it possible for people with high levels of LDL or high total cholesterol to experience a reversal in their risk for coronary artery disease (CAD) and other related conditions.

If you are experiencing high cholesterol symptoms such as chest pain, numbness or tingling sensations in your extremities, shortness of breath, or unexplained fatigue, make sure to speak with your doctor about what steps you should take next.

If high cholesterol is affecting your quality of life, then there’s no need to struggle with it. With the right high cholesterol treatment plan put into place, you can live a high-quality lifestyle that doesn’t have to be affected by this silent killer anymore.

If you want more information about how high cholesterol treatment plans are designed or what steps might be taken next if high cholesterol symptoms are present, contact your doctor today. Your doctor will help design a high cholesterol treatment plan that is best suited for your individual circumstances and health goals so the benefits are most effective for you over time.

Come down to our Internal Medicine Dept where our expert panel of medical specialists are available for personalized clinical assessments. Let Dr. Gaurav, Dr. Ravi, Dr. Esther, Dr. Sheela and the rest of the team help you avoid living a life of suffering from heart disease. Click on this link to visit the Internal Medicine dept.