HIGH BLOOD CHOLESTEROL

High blood cholesterol is a major risk factor for coronary heart disease and possibly some types of stroke. It is one of the main causes of the process by which the blood vessels that supply the heart and other parts of the body become clogged.

Your blood cholesterol level has a lot to do with your chances of getting heart disease. High blood cholesterol is one of the major risk factors for heart disease. A risk factor is a condition that increases your chance of getting a disease. In fact, the higher your blood cholesterol level, the greater your risk for developing heart disease or having a heart attack. Heart disease is the number one killer of women and men in the United States. Each year, more than a million Americans have heart attacks, and about a half million people die from heart disease.

When there is too much cholesterol (a fat-like substance) in your blood, it builds up in the walls of your arteries. Over time, this buildup causes “hardening of the arteries” so that arteries become narrowed and blood flow to the heart is slowed down or blocked. The blood carries oxygen to the heart, and if enough blood and oxygen cannot reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack.

High blood cholesterol itself does not cause symptoms, so many people are unaware that their cholesterol level is too high. It is important to find out what your cholesterol numbers are because lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack or dying of heart disease, even if you already have it. Cholesterol lowering is important for everyone–younger, middle age, and older adults; women and men; and people with or without heart disease.


WHAT ARE TRIGLYCERIDES AND FATS

Cut back on the cholesterol and total fat, especially saturated and trans fats, that you eat. Saturated fats, like those in meat, full-fat dairy products and some oils, raise your total cholesterol. Trans fats, which are sometimes found in margarines and store-bought cookies, crackers and cakes, are particularly bad for your cholesterol levels. Trans fats raise low-density lipoprotein (LDL), the "bad," cholesterol, and lower high-density lipoprotein (HDL), the "good," cholesterol.
In addition to changing your diet, keep in mind that making additional heart-healthy lifestyle changes are key to lowering your cholesterol. Talk to your doctor about exercising, quitting smoking and maintaining a healthy weight to help keep your cholesterol level low.

What are triglycerides?

Triglycerides are the most common type of fat in your body. They’re also a major energy source. They come from food, and your body also makes them. High levels of blood triglycerides are often found in people who have high cholesterol levels, heart problems, are overweight or have diabetes.

What about fats?

There are different kinds of fats in the foods we eat. Saturated fat is the kind that raises blood cholesterol, so it’s not good for you. Avoid animal fats like lard and meat fat, and some plant fats like coconut oil, palm oil and palm kernel oil. Trans fat comes from adding hydrogen to vegetable oils and tends to raise blood cholesterol. It’s used in commercial baked goods and for cooking in most restaurants and fast-food chains. It’s also in milk and beef. Polyunsaturated fats are found in vegetable oils and fish oils. These tend to lower blood cholesterol. Monounsaturated fats are found in olive, canola, peanut, sunflower and safflower oils. In a low-saturated-fat diet, they may lower blood cholesterol.

FOODS TO LOWER YOUR CHOLESTEROL NUMBERS

1. Oatmeal, oat bran and high-fiber foods

Oatmeal contains soluble fiber, which reduces your low-density lipoprotein (LDL), the "bad," cholesterol. Soluble fiber is also found in such foods as kidney beans, apples, pears, barley and prunes.
Soluble fiber can reduce the absorption of cholesterol into your bloodstream. Five to 10 grams or more of soluble fiber a day decreases your total and LDL cholesterol. Eating 1 1/2 cups of cooked oatmeal provides 6 grams of fiber. If you add fruit, such as bananas, you'll add about 4 more grams of fiber. To mix it up a little, try steel-cut oatmeal or cold cereal made with oatmeal or oat bran.

2. Fish and omega-3 fatty acids

Eating fatty fish can be heart healthy because of its high levels of omega-3 fatty acids, which can reduce your blood pressure and risk of developing blood clots. In people who have already had heart attacks, fish oil — or omega-3 fatty acids — reduces the risk of sudden death.
The American Heart Association recommends eating at least two servings of fish a week. The highest levels of omega-3 fatty acids are in:
  • Mackerel
  • Lake trout
  • Herring
  • Sardines
  • Albacore tuna
  • Salmon
  • Halibut
You should bake or grill the fish to avoid adding unhealthy fats. If you don't like fish, you can also get small amounts of omega-3 fatty acids from foods like ground flaxseed or canola oil.
You can take an omega-3 or fish oil supplement to get some of the benefits, but you won't get other nutrients in fish, such as selenium. If you decide to take a supplement, just remember to watch your diet and eat lean meat or vegetables in place of fish.

3. Walnuts, almonds and other nuts

Walnuts, almonds and other nuts can reduce blood cholesterol. Rich in polyunsaturated fatty acids, walnuts also help keep blood vessels healthy.
Eating about a handful (1.5 ounces, or 42.5 grams) a day of most nuts, such as almonds, hazelnuts, peanuts, pecans, some pine nuts, pistachio nuts and walnuts, may reduce your risk of heart disease. Just make sure the nuts you eat aren't salted or coated with sugar.
All nuts are high in calories, so a handful will do. To avoid eating too many nuts and gaining weight, replace foods high in saturated fat with nuts. For example, instead of using cheese, meat or croutons in your salad, add a handful of walnuts or almonds.

4. Olive oil

Olive oil contains a potent mix of antioxidants that can lower your "bad" (LDL) cholesterol but leave your "good" (HDL) cholesterol untouched.
Try using about 2 tablespoons (23 grams) of olive oil a day in place of other fats in your diet to get its heart-healthy benefits. To add olive oil to your diet, you can saute vegetables in it, add it to a marinade or mix it with vinegar as a salad dressing. You can also use olive oil as a substitute for butter when basting meat or as a dip for bread. Olive oil is high in calories, so don't eat more than the recommended amount.
The cholesterol-lowering effects of olive oil are even greater if you choose extra-virgin olive oil, meaning the oil is less processed and contains more heart-healthy antioxidants. But keep in mind that "light" olive oils are usually more processed than extra-virgin or virgin olive oils and are lighter in color, not fat or calories.

5. Foods with added plant sterols or stanols

Foods are now available that have been fortified with sterols or stanols — substances found in plants that help block the absorption of cholesterol.
Margarines, orange juice and yogurt drinks with added plant sterols can help reduce LDL cholesterol by more than 10 percent. The amount of daily plant sterols needed for results is at least 2 grams — which equals about two 8-ounce (237-milliliter) servings of plant sterol-fortified orange juice a day.
Plant sterols or stanols in fortified foods don't appear to affect levels of triglycerides or of high-density lipoprotein (HDL), the "good" cholesterol.

HOW CAN I LOWER THE BAD CHOLESTEROL IN MY BLOOD?

How's your cholesterol? If you think that the normal reading you got back in 2004 (or earlier) means you're in the clear, think again: Levels of the artery-clogging substance often rise with age, and cardiologists say everyone 20 or older should be screened for high cholesterol at least once every five years, with more frequent screenings for anyone deemed to be at high risk for heart disease. If it's been awhile since your last cholesterol screening, now's a good time to ask your doctor if you're due for one.
The good news? If your fasting total cholesterol level exceeds the desirable level of 200, or if your low-density lipoprotein ( LDL, or "bad”) cholesterol is not at your goal, getting it down to a safer level could be easier than you think.


  • Cut down on foods high in saturated fat and cholesterol. These include fatty meats, butter, cheese, whole-milk dairy products, egg yolks, shellfish, other fish, organ meats, poultry and solid fats (foods from animals). 
  • Enjoy at least 30 minutes of physical activities on most or all days of the week. 
  • Eat more foods low in saturated fat and cholesterol, and high in fiber. These include fruits and vegetables, whole grains and grain products, beans and peas, fat-free and low-fat milk products, lean meats and poultry without skin, fatty fish, and nuts and seeds in limited amounts. 
  • Lose weight if you need to. 
  • Ask your doctor about medicines that can reduce cholesterol (not recommended for all patients).
 

BLOOD CHOLESTEROL LEVEL

Cholesterol is a soft, fat-like substance found in the bloodstream and in all your body’s cells. Your body makes all the cholesterol it needs. The saturated fats, trans fats and cholesterol you eat may raise your blood cholesterol level. Having too much cholesterol in your blood may lead to increased risk for heart disease and stroke. About half of American adults have levels that are too high (200 mg/dL or higher) and about 1 in 5 has a level in the high-risk zone (240 mg/dL or higher). The good news is that you can take steps to control your cholesterol.





Cholesterol and other fats can’t dissolve in your blood. To travel to your cells, they use special carriers called lipoproteins. Lowdensity lipoprotein (LDL) cholesterol is often called “the bad kind.” When you have too much LDL cholesterol in your blood, it can join with fats and other substances to build up in the inner walls of your arteries. The arteries can become clogged and narrow, and blood flow is reduced. If a blood clot forms and blocks the blood flow to your heart, it causes a heart attack. If a blood clot blocks an artery leading to or in the brain, a stroke results. A “good kind” of cholesterol, on the other hand, is called high-density lipoprotein (HDL). It carries harmful cholesterol away from the arteries and helps protect you from heart attack and stroke. It’s better to have a lot of HDL cholesterol in your blood.

RISK OF HIGHER CHOLESTEROL LEVELS

The main goal of cholesterol-lowering treatment is to lower your LDL level enough to reduce your risk of developing heart disease or having a heart attack. The higher your risk, the lower your LDL goal will be. To find your LDL goal, see the box for your risk category below. There are two main ways to lower your cholesterol:

  • Therapeutic Lifestyle Changes (TLC)–includes a cholesterol-lowering diet (called the TLC diet), physical activity, and weight management. TLC is for anyone whose LDL is above goal. 
  • Drug Treatment–if cholesterol-lowering drugs are needed, they are used together with TLC treatment to help lower your LDL.


Category I, High Risk, your LDL goal is less than 100 mg/dL. You will need to begin the TLC diet to reduce your high risk even if your LDL is below 100 mg/dL. If your LDL is 100 mg/dL or above, you will need to start drug treatment at the same time as the TLC diet. If your LDL is below 100 mg/dL, you may also need to start drug treatment together with the TLC diet if your doctor finds your risk is very high, for example if you have had a recent heart attack or have both heart disease and diabetes.

Category II, Next Highest Risk, your LDL goal is less than 130 mg/dL. If your LDL is 130 mg/dL or above, you will need to begin treatment with the TLC diet. If your LDL is 130 mg/dL or more after 3 months on the TLC diet, you may need drug treatment along with the TLC diet. If your LDL is less than 130 mg/dL, you will need to follow the heart-healthy diet for all Americans, which allows a little more saturated fat and cholesterol than the TLC diet.

Category III, Moderate Risk, your LDL goal is less than 130 mg/dL. If your LDL is 130 mg/dL or above, you will need to begin the TLC diet. If your LDL is 160 mg/dL or more after you have tried the TLC diet for 3 months, you may need drug treatment along with the TLC diet. If your LDL is less than 130 mg/dL, you will need to follow the heart-healthy diet for all Americans.

Category IV, Low-to-Moderate Risk, your LDL goal is less than 160 mg/dL. If your LDL is 160 mg/dL or above, you will need to begin the TLC diet. If your LDL is still 160 mg/dL or more after 3 months on the TLC diet, you may need drug treatment along with the TLC diet to lower your LDL, especially if your LDL is 190 mg/dL or more. If your LDL is less than 160 mg/dL, you will need to follow the heart-healthy diet for all Americans.

To reduce your risk for heart disease or keep it low, it is very important to control any other risk factors you may have such as high blood pressure and smoking.

AFFECTS HIGHER CHOLESTEROL LEVELS

The higher LDL level and the more risk factors you have (other than LDL), the greater your chances of developing heart disease or having a heart attack. Some people are at high risk for a heart attack because they already have heart disease. Other people are at high risk for developing heart disease because they have diabetes (which is a strong risk factor) or a combination of risk factors for heart disease. Follow these steps to find out your risk for developing heart disease.




Step. 1.
Check the table below to see how many of the listed risk factors you have; these are the risk factors that affect your LDL goal.
Major Risk Factors That Affect Your LDL Goal
Cigarette smoking
High blood pressure (140/90 mmHg or higher or on blood pressure medication)
❍ Low HDL cholesterol (less than 40 mg/dL)*
❍ Family history of early heart disease (heart disease in father or brother before age 55; heart disease in mother or sister before age 65)
❍ Age (men 45 years or older; women 55 years or older)

*If your HDL cholesterol is 60 mg/dL or higher, subtract 1 from your total count.

Even though obesity and physical inactivity are not counted in this list, they are conditions that need to be corrected.

Step. 2.
How many major risk factors do you have? If you have 2 or more risk factors in the table above, use the risk scoring tables on the back page (which include your cholesterol levels) to find your risk score. Risk score refers to the chance of having a heart attack in the next 10 years, given as a percentage. (Use the Framingham Point Scores on the back page.)

Step. 3.

Use your medical history, number of risk factors, and risk score to find your risk of developing heart disease or having a heart attack in the table below.



CHOLESTEROL NUMBERS

For most people, saturated fat in the diet is regarded as the main factor that raises blood cholesterol levels. Cholesterol in foods can also raise blood cholesterol levels, but less than saturated fat does. Genetic factors can affect blood cholesterol - some people have high cholesterol levels regardless of their saturated fat and cholesterol dietary intake and are at increased risk from coronary heart disease.

Everyone age 20 and older should have their cholesterol measured at least once every 5 years. It is best to have a blood test called a “lipoprotein profile” to find out your cholesterol numbers. This blood test is done after a 9- to 12-hour fast and gives information about your:
■ Total cholesterol
■ LDL (bad) cholesterol – the main source of cholesterol buildup and blockage in the arteries
■ HDL (good) cholesterol – helps keep cholesterol from building up in the arteries
■ Triglycerides – another form of fat in your blood

If it is not possible to get a lipoprotein profile done, knowing your total cholesterol and HDL cholesterol can give you a general idea about your cholesterol levels. If your total cholesterol is 200 mg/dL* or more or if your HDL is less than 40 mg/dL, you will need to have a lipoprotein profile done. See how your cholesterol numbers compare to the tables below.


TYPES OF CHOLESTEROL


Everybody has some risk of developing atheroma which then may cause one or more cardiovascular diseases. However, some situations increase the risk. These include:
  • Lifestyle risk factors that can be prevented or changed:
    • Smoking.
    • Lack of physical activity (a sedentary lifestyle).
    • Obesity.
    • An unhealthy diet - including eating too much salt.
    • Excess alcohol.
  • Treatable or partly treatable risk factors:
    • High blood pressure (hypertension).
    • High cholesterol blood level.
    • High triglyceride (another type of fat) blood level.
    • Diabetes.
    • Kidney diseases that affect kidney function.
Cholesterol travels through the blood attached to a protein  this cholesterol-protein package is called a lipoprotein. Lipoproteins are classified as high density, low density, or very low density, depending on how much protein there is in relation to fat.
  • Low density lipoproteins (LDL): LDL, also called "bad" cholesterol, can cause buildup of plaque on the walls of arteries. The more LDL there is in the blood, the greater the risk of heart disease.
  • High density lipoproteins (HDL): HDL, also called "good" cholesterol, helps the body get rid of bad cholesterol in the blood. The higher the level of HDL cholesterol, the better. If levels of HDL are low, the risk of heart disease increases.
  • Very low density lipoproteins (VLDL): VLDL is similar to LDL cholesterol in that it contains mostly fat and not much protein.
  • Triglycerides: Triglycerides are another type of fat that is carried in the blood by very low density lipoproteins. Excess calories, alcohol, or sugar in the body are converted into triglycerides and stored in fat cells throughout the body.

THE BODY NEEDS SOME CHOLESTEROL


The body needs some cholesterol in order to function properly. Its cell walls, or membranes, need cholesterol in order to produce hormones, vitamin D, and the bile acids that help to digest fat. But the body needs only a limited amount of cholesterol to meet its needs. When too much is present health problems such as heart disease may develop.


Cholesterol needs to help your brain, skin and other organs grow and do their jobs in the body. But having too much of it can cause problems.

You also can get cholesterol by eating foods that contain fat meat, fish, eggs, butter, cheese and whole milk.

When too much cholesterol is present, plaque (a thick, hard deposit) may form in the body's arteries narrowing the space for blood to flow to the heart. Over time, this buildup causes atherosclerosis (hardening of the arteries) which can lead to heart disease.
 
When not enough oxygen-carrying blood reaches the heart chest pain "called angina" can result. If the blood supply to a portion of the heart is completely cut off by total blockage of a coronary artery, the result is a heart attack. This is usually due to a sudden closure from a blood clot forming on top of a previous narrowing.

WHAT IS CHOLESTEROL

What is cholesterol

Cholesterol is a waxy substance which is made in the body by the liver but is also found in some foods. It plays a vital role in how every cell works and is also needed to make Vitamin D, some hormones and bile for digestion. However, too much cholesterol in the blood can increase your risk of getting heart and circulatory disease



Understanding HDL and LDL Cholesterol

  • High Density Lipoproteins (HDL): This “good” cholesterol takes extra cholesterol in your blood back to your liver so your body can get rid of it.
  • Low Density Lipoproteins (LDL): This “bad” cholesterol in your blood builds up in your blood vessels. This can cause your vessels to narrow, making it hard for blood to flow.
  • Triglycerides: Eating too many carbohydrates can increase your triglyceride level.
Cholesterol is carried in the blood attached to proteins called lipoproteins. There are two main forms, LDL (low density lipoprotein) and HDL (high density lipoprotein). LDL cholesterol is often referred to as bad cholesterol because too much is unhealthy. HDL is often referred to as “good cholesterol” because it is protective. Knowing your levels of these can help explain your risk of heart disease. Your doctor should be able to tell you your levels of “good” and “bad” cholesterol.



Cholesterol In Our Diets

Most of our cholesterol is made by the liver, but we get some from our diet as well.  Take a look at our page on Low Cholesterol Diets & High Cholesterol Foods and for ideas for cholesterol-busting foods, then take a look at our Six Super Foods to Help Lower Cholesterol.
Cholesterol is a fatty substance that your body needs to work. It is made in the liver and found in food that comes from animals, such as meat, eggs, milk products, butter, and lard.

Too much cholesterol in your blood can be harmful to your body and can increase your risk for heart disease. You are at risk for high blood cholesterol if:
• Your body makes too much cholesterol
• You eat food high in saturated fats and cholesterol
• You have diabetes, low thyroid level called hypothyroidism, or kidney disease