Your Health - High Cholesterol

High Cholesterol

(Cholesterol, High; Hypercholesterolemia)

by Rosalyn Carson-DeWitt, MD

Animation Movie Available Understanding Cholesterol Levels

Definition

You have this condition if there are high levels of cholesterol in the blood. There are three parts of cholesterol:

Low density lipoproteins (LDL)—known as bad cholesterol. It causes build up of cholesterol and other fats in the blood vessels. High LDL levels can cause artery and heart disease.
High density lipoproteins (HDL)—known as good cholesterol. It can remove cholesterol and other fats from the blood vessels. High levels of HDL can protect against heart disease.
Triglycerides—a common form of fat in the body. Often elevated in people with diabetes or certain genetic conditions.
Particles—proteins associated with certain types of cholesterols in the body. These may be a better signal about your risk of developing disease in the blood vessels.

Causes

Causes of high cholesterol include:

Genetics
High-fat diet
Overweight
Sedentary lifestyle
Excess alcohol intake
Liver or kidney disease
Anorexia nervosa
Underactive thyroid disease

Risk Factors

These factors increase your chance of high cholesterol:

Age: cholesterol levels tend to rise with age
Sex:
- Males
- Females after menopause
Family members with high cholesterol
High-fat diet
Obesity, overweight
Sedentary lifestyle

Symptoms

The condition itself will rarely cause any symptoms. If not treated, it often leads to atherosclerosis . This is a dangerous hardening of the arteries. It can end up blocking blood flow through arteries. In severe cases, this may result in:

Angina
Heart attack
Stroke
Other serious complications

If you have an inherited form of high cholesterol, cholesterol deposits in the:

Tendons
Under the eyes
Around the cornea

Atherosclerosis

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. These tests are used to measure the cholesterol levels in your blood:

Total cholesterol
HDL cholesterol
LDL cholesterol
Triglycerides

Treatment

Treatment may include:

Lifestyle Changes

Eat a low-fat, low-cholesterol diet . Eat high-fiber food.
Begin a safe exercise program with the advice of your doctor.
If you smoke, quit.
If you are overweight, lose weight.
Avoid processed and refined sugars and starches (white bread, white potatoes, white rice and simple sugars)
Drink alcohol in moderation. This means two drinks per day for men, and one drink per day for women.

Cholesterol-Lowering Medication

If diet and exercise do not work, you may need medication. Examples include:

Cholestyramine (Questran)
Colestipol (Colestid)
Niacin (Niacor)
Statins
- Lovastatin (Mevacor)
- Pravastatin (Pravachol)
- Atorvastatin (Lipitor)
- Simvastatin (Zocor)
- Rosuvastatin (Crestor)
Ezetimibe (Zetia)

Statins are often prescribed for high cholesterol. They have been shown to reduce mortality (death), heart attacks, and stroke. Ezetimibe has reduced plaque in arteries. However, it has not been shown to reduce mortality.

Some may have a high risk for coronary artery disease. In this case, combination therapy may be needed to lower LDL.

Prevention

To help reduce your chance of getting high cholesterol, follow the lifestyle changes above. Work with your doctor to monitor and control your cholesterol levels.

RESOURCES:

American Heart Association
http://www.americanheart.org/

National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov/

CANADIAN RESOURCES:

Canadian Cardiovascular Society
http://www.ccs.ca/

Heart and Stroke Foundation of Canada
http://ww2.heartandstroke.ca/

References:

Goroll AH, Mulley AG. Primary Care Medicine . 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2000.

Heart disease and stroke statistics update. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=1928 . Updated 2008. Accessed July 7, 2008.

How can I lower high cholesterol? American Heart Association website. Available at: http://www.americanheart.org . Published October 2007. Accessed July 7, 2008.

Lipid-lowering pharmacotherapy overview. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated September 2008. Accessed September 23, 2008.

Third report of the expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). National Cholesterol Education Program website. Available at: http://www.nhlbi.nih.gov/guidelines/cholesterol/index.htm . Accessed December 17, 2007.

What is cholesterol? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/Hbc/HBC_WhatIs.html . Updated February 2006. Accessed July 7, 2008.

Last reviewed November 2009 by David N. Smith, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.