What is cholesterol?

Cholesterol is a waxy fat substance found in your blood and in your cells. It's necessary to have cholesterol for your body to function properly. Cholesterol is used to produce cell membranes and sex hormones, and it serves other body functions, such as the digestive process, that are necessary for your well being. But too much cholesterol produces fatty deposits in arteries. High cholesterol is a primary cause of heart disease; it can lead to a heart attack or stroke. High levels of blood cholesterol are known as Hypercholesterolemia.


How is cholesterol produced?

Cholesterol is produced in two ways:

By your body.  Your liver and other cells in your body make about 75% to 80% of your blood cholesterol.  Genetics, or your family's health history can also affect your cholesterol levels.

By your choice of food.  Cholesterol levels are greatly influenced by your diet.  Although you cannot control your genetic history, you can control what you eat, which in turn, helps to control the amount of cholesterol your body produces.


HDL and LDL: good and bad cholesterol and their jobs.

There are two types of cholesterol: “good cholesterol” and “bad cholesterol.” It’s important to know how much good cholesterol and how much bad cholesterol you should have in your blood and what you can do to maintain those levels so you can be healthy. Too much of one -- or not enough of the other -- could put you at risk of a heart attack, stroke or coronary heart disease. The levels must be maintained properly for your health.

The two main types of cholesterol are lipoproteins known as LDL and HDL. Low-density lipoprotein, or LDL, is the “bad cholesterol.” High-density lipoprotein, or HDL, is the “good cholesterol.”

The Low-Density Lipoproteins (LDL) transport the cholesterol from your liver through your bloodstream and then to all your cells. After the cells take what they need, the excess cholesterol is transported back to your liver by the High-Density Lipoproteins (HDL). If your cholesterol levels are where they should be, everything functions properly. But if your LDL is too high and you have too much cholesterol for your HDL to take back to your liver quickly – or if your HDL level is lower than it should be and you don’t have enough HDL to cart all the excess back quickly – the excess cholesterol starts forming a plaque, a thick, hard deposit that clings to the inner walls of your arteries that feed your heart and brain. This plaque can cause a narrowing of your arteries. This condition is known as artherosclerosis. If an artery becomes clogged or blocked, the result could eventually be heart disease, a heart attack or stroke.

HDL (good cholesterol)

--High levels of HDL protect against heart attack.

--Low levels of HDL increase the risk of heart disease.

LDL (bad cholesterol)

--High levels of LDL increase your risk of heart attack and stroke.

LDL and HDL are two types of lipids. They are classified as lipids because they are soluble in fats rather than in water. LDL, HDL, along with triglycerides and Lp(a) cholesterol make up your total cholesterol count.

Lp(a) Cholesterol
Lipoprotein “a,” abbreviated as Lp(a) is a genetic variation of LDL (bad cholesterol). A high level of Lp(a) is associated with increased risk for heart disease. It can sometimes be detected in premature coronary heart disease which is heart disease in men younger than 55 years old or women younger than 65 years old. Lp(a) isn’t fully understood yet, but it may interact with substances found in artery walls and contribute to the buildup of fatty deposits.


Are there certain foods that are higher in cholesterol?

Consuming foods high in cholesterol increases the amount of LDL you have in your system. Foods that are high in cholesterol include, but are not limited to: saturated fats (all fats of animal origin, coconut oil, egg yokes, shellfish, whole milk dairy products); hydrogenated fats and hardened fats and oils (margarine, butter); heated fats and processed oils. Eliminating these foods from your diet is strongly recommended. Avoid alcohol, tobacco, candy, gravies, pastries, coffee, tea, carbonated drinks, white bread, and nondairy creamers.

Foods that could help lower your cholesterol are: grapefruit, carrots, bananas, apples, cold-water fish, and dried beans. Also recommended are the use of garlic and olive oil and fresh juices such as: carrot, celery and beet juices.

If high blood cholesterol runs in your family, changing your diet may not be enough to lower your LDL blood cholesterol. Regular exercise (with the approval of your physician) and the avoidance of stress can help, but it’s important that you consult your doctor to find a treatment plan that will work for you.


Is high cholesterol the only cause of heart disease?

No.  High cholesterol is one of the major causes, but there are others.  The more risk factors you have, the greater you are at risk of developing coronary heart disease.  Some of the other factors include:

High Triglyceride levels

High Blood Pressure

Diabetes

Weight

Family Health History

The higher the level of each risk factor, the higher you are at risk of developing coronary heart disease.  Cholesterol can be controlled, but you must know your cholesterol levels.


Testing your cholesterol levels.

It's very important that you ask your doctor to test your cholesterol the next time he schedules you for blood work.  Then be sure to discuss the findings of your blood tests with your doctor.  You may even want to ask him to make you a copy of your blood test results, so you can compare them with future tests to see if your levels have improved.

A your doctor's office or a blood lab, a small sample of blood will be drawn, usually from the inside of your arm, or occasionally from your hand.  If your doctor has ordered other tests to be run at the same time as your cholesterol test, all the blood samples are drawn at the same time.  This only takes about five minutes.  Your blood sample is then sent to a laboratory where it is analyzed and the results are sent to your doctor, usually within a week.

Your doctor will tell you if you should fast (avoid eating or drinking for 9 to 12 hours) before your blood test.  If you aren't fasting when the blood sample is drawn, only the total cholesterol and HDL cholesterol levels will be usable, as the amount of LDL (had cholesterol) level and triglycerides can be affected by the food you've eaten in the hours prior to your test.  Often, the lab will refuse to draw your blood if you haven't fasted for tests requiring a fast.

Your test report will show your cholesterol level in mg/dL (milligrams per deciliter of blood).  Your doctor will interpret your cholesterol numbers based on other risk factors such as your age, family history, whether or not you have high blood pressure, or smoke.

Your LDL levels are necessary to determine your treatment plan if your total cholesterol is 200 mg/dL or higher, or if your HDL is lower than 40 mg/dL.  If you weren't fasting for your blood test, your doctor may send you back to the lab for another blood test so he can have all the information he needs to treat you properly.


How often should I have my cholesterol checked?

Once every 5 years, all adults should have a fasting lipoprotein profile -- which measures your total cholesterol, LDL, HDL, and triglycerides.  This should be done more frequently if you answer "yes" to one or more of the following questions:

Is your total cholesterol 200 mg/dL or higher?

Are you a man over 45 years of age or a woman over 50?

Is your HDL less than 40 mg/dL?

Do you have other risk factors for heart disease and stroke?


Where should I go to have my cholesterol checked?

It's best to have your regular doctor schedule your cholesterol test as he has your health history on file.  Risk factors such as your age, family health history, smoking history, and blood pressure must be considered when reviewing the results of your blood tests.  After your doctor has discussed the results with you, he will recommend a treatment and/or prevention program for you and tell you how often you will need to follow up with more blood tests to determine if the program is helping you reach your desired cholesterol goals.

If you're admitted to the hospital for a major coronary event, your LDL cholesterol will be measured on admission or within the next 24 hours.  However, it may take time for your fasting lipid profile to stabilize - perhaps even 4 to 6 weeks - before you can get accurate results.  Your doctor will determine whether to begin drug therapy upon your discharge from the hospital.


What is a good cholesterol level?

The normal HDL level for men is 45 to 50mm/dL. The normal HDL level for women is 50 to 60 mg/dL. Even higher levels – 70 or 80 mg/dL may offer better protection against heart disease.  The optimal level for LDL is less than 100 mg/dL.


Managing your cholesterol.

Work closely with your healthcare professionals to monitor your cholesterol levels so you can reduce your risk of heart disease and stroke.  If your cholesterol levels are currently good, it's still a good idea to work closely with your doctor so you can maintain good health.  It's never too early to begin a prevention plan embracing healthy habits that can reduce the risk of problems later.


Developing a prevention and treatment plan.

Whether you have already been diagnosed with heart disease, or you are currently enjoying good health, there are several things you can do to take control of your future.  Your diet, the amount of physical activity you get every day and your exposure to tobacco smoke all affect your health.  Consult your doctor to develop and maintain a successful prevention and/or treatment plan that includes a healthy diet and exercise program you can live with.  Ask your doctor what your cholesterol levels are, as this is very important because if you lower your cholesterol, you can reduce the risk of heart disease and stroke.  The more aware you are of cholesterol and how it affects your body, the more apt you'll be able to make healthy food choices.  Follow your doctor's advice carefully.  If you are prescribed a drug therapy plan, be sure you understand exactly when and how much to take and take it exactly as prescribed, without skipping a dose.  If you don't take it exactly as prescribed, your body won't get all the benefits it could.  Learn how to make your prevention and treatment plan a lifestyle that will work for you.

HEART

FUND

ASSISTANCE

Avoiding alcohol and certain other products can help lower your cholesterol and thus reduce your risk of heart disease.

A regular exercise program can help reduce your risk of heart disease.

WHAT IS CHOLESTEROL

YOUR CHOICE OF FOOD AFFECTS YOUR CHOLESTEROL LEVELS

Go over the results of your blood tests with your doctor and ask about your cholesterol levels.

DISEASE