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High Cholesterol Overview

Cholesterol is a waxy, fatlike substance that the body needs to function normally. Cholesterol is naturally present in cell walls or membranes everywhere in the body, including the brain, nerves, muscles, skin, liver, intestines, and heart.
The body uses cholesterol to produce many hormones, vitamin D, and the bile acids that help to digest fat. It takes only a small amount of cholesterol in the blood to meet these needs. If a person has too much cholesterol in the bloodstream, the excess may be deposited in arteries, including the coronary arteries of the heart, the carotid arteries to the brain, and the arteries that supply blood to the legs. Cholesterol deposits are a component of the plaques that cause narrowing and blockage of the arteries, producing signs and symptoms originating from the particular part of the body that has decreased blood supply.
Blockage to the leg arteries causes claudication (pain with walking) due to peripheral artery disease. Carotid artery blockage may cause stroke, and blockage of the coronary arteries leads to angina (chest pain) and heart attack.
Coronary heart disease (CHD) is caused by cholesterol and fat being deposited in the walls of the arteries that supply nutrients and oxygen to the heart. Like any muscle, the heart needs a constant supply of oxygen and nutrients, which are carried to it by the blood in the coronary arteries. Narrowing of the arteries decreases that supply and can cause angina (chest pain) when the heart muscle does not receive enough oxygen. Cholesterol plaques can rupture, resulting in a blood clot formation that completely blocks the artery, stopping all blood flow and causing a heart attack, in which heart muscle cells die from lack of oxygen and nutrients.

Who has high cholesterol?

• Throughout the world, blood cholesterol levels vary widely. Generally, people who live in countries where blood cholesterol levels are lower, such as Japan, have lower rates of heart disease. Countries with very high cholesterol levels, such as Finland, also have very high rates of coronary heart disease. However, some populations with similar total cholesterol levels have very different heart disease rates, suggesting that other factors also influence risk for coronary heart disease.
  
  
• High cholesterol is more common in men younger than 55 years and in women older than 55 years.
  
  
• The risk for high cholesterol increases with age.

High Cholesterol Causes

High cholesterol levels are due to a variety of factors including heredity, diet, and lifestyle. Less commonly, underlying illnesses affecting the liver, thyroid, or kidney may affect blood cholesterol levels.

• Heredity: Genes may influence how the body metabolizes LDL (bad) cholesterol. Familial hypercholesterolemia is an inherited form of high cholesterol that may lead to early heart disease.

• Weight: Excess weight may modestly increase your LDL (bad) cholesterol level. Losing weight may lower LDL and raise HDL (good) cholesterol levels.

• Physical activity/exercise: Regular physical activity may lower triglycerides and raise HDL cholesterol levels.

• Age and sex: Before menopause, women usually have lower total cholesterol levels than men of the same age. As women and men age, their blood cholesterol levels rise until about 60-65 years of age. After about age 50 years, women often have higher total cholesterol levels than men of the same age.

• Alcohol use: Moderate (1-2 drinks daily) alcohol intake increases HDL (good) cholesterol but does not lower LDL (bad) cholesterol. Doctors don't know for certain whether alcohol also reduces the risk of heart disease. Drinking too much alcohol can damage the liver and heart muscle, lead to high blood pressure, and raise triglyceride levels. Because of the risks, alcoholic beverages should not be used as a way to prevent heart disease.

• Mental stress: Several studies have shown that stress raises blood cholesterol levels over the long term. One way that stress may do this is by affecting your habits. For example, when some people are under stress, they console themselves by eating fatty foods. The saturated fat and cholesterol in these foods contribute to higher levels of blood cholesterol.

For most people, the first high cholesterol treatment to try is three lifestyle changes:

• Eating better
• Maintaining (or losing) weight
• Exercising more

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