What does a total cholesterol level of 274 mg/dL mean. How does it affect your health. What are the potential causes of high cholesterol. What steps can you take to lower your cholesterol levels. Are there any medications or supplements that can help improve cholesterol results.

Decoding Your Total Cholesterol Level: What 274 mg/dL Signifies

A total cholesterol level of 274 mg/dL is considered high and raises concerns about cardiovascular health. This value is calculated by combining LDL (low-density lipoprotein) cholesterol, HDL (high-density lipoprotein) cholesterol, and 20% of triglyceride levels. While cholesterol plays essential roles in the body, excessive amounts can significantly increase the risk of heart disease.

To better understand this number, let’s break down the components:

• LDL Cholesterol: Often referred to as “bad” cholesterol, it should ideally be below 100 mg/dL.
• HDL Cholesterol: Known as “good” cholesterol, optimal levels are above 60 mg/dL.
• Triglycerides: Another type of blood fat, should be below 150 mg/dL.

Is high cholesterol accompanied by noticeable symptoms? Generally, high cholesterol is asymptomatic, which underscores the importance of regular blood tests to monitor your levels. Without visible signs, many people remain unaware of their elevated cholesterol until they face serious health complications.

The Hidden Dangers: Health Risks Associated with High Cholesterol

Elevated cholesterol levels pose significant health risks, primarily affecting the cardiovascular system. How does high cholesterol impact your body? The excess cholesterol can accumulate in your arteries, forming plaques that narrow blood vessels and impede blood flow. This process, known as atherosclerosis, can lead to several serious conditions:

• Coronary Artery Disease: Reduced blood flow to the heart
• Heart Attack: Complete blockage of a coronary artery
• Stroke: Blockage or rupture of blood vessels in the brain
• Peripheral Artery Disease: Reduced blood flow to limbs

Can high cholesterol affect organs other than the heart? Indeed, it can. Excessive cholesterol can impact various body systems, including:

• Liver: Increased risk of fatty liver disease
• Kidneys: Potential for kidney damage and chronic kidney disease
• Brain: Higher risk of cognitive decline and dementia

Unraveling the Causes: Factors Contributing to High Cholesterol

What leads to a total cholesterol level of 274 mg/dL? Several factors can contribute to elevated cholesterol levels:

Dietary Habits

How does your diet influence cholesterol levels? Consuming foods high in saturated fats, trans fats, and added sugars can significantly raise blood cholesterol. Conversely, diets rich in fiber, lean proteins, and healthy fats can help maintain optimal cholesterol levels.

Lifestyle Choices

Can your lifestyle affect cholesterol levels? Absolutely. Sedentary behavior, smoking, and excessive alcohol consumption can all contribute to higher cholesterol. Regular physical activity, on the other hand, can help raise HDL (good) cholesterol and lower LDL (bad) cholesterol.

Genetic Factors

Is high cholesterol always diet-related? Not necessarily. Familial hypercholesterolemia (FH) is a genetic disorder that can cause high cholesterol levels regardless of lifestyle. If you have a family history of high cholesterol or early heart disease, genetic testing may be warranted.

Medical Conditions

Can other health issues lead to high cholesterol? Indeed, certain medical conditions can affect cholesterol levels:

• Diabetes: Can lower HDL and increase LDL and triglycerides
• Hypothyroidism: May elevate LDL cholesterol
• Obesity: Often associated with higher LDL and lower HDL levels

Taking Action: Strategies to Lower Your Cholesterol

How can you reduce a total cholesterol level of 274 mg/dL? Implementing lifestyle changes is often the first line of defense:

Dietary Modifications

What dietary changes can help lower cholesterol? Consider the following:

• Increase fiber intake to 30-40 grams per day
• Limit saturated and trans fats
• Incorporate omega-3 rich foods like fatty fish
• Add plant sterols and stanols to your diet

Exercise Regimen

How much exercise is needed to impact cholesterol levels? Aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week. This can help raise HDL cholesterol and lower LDL cholesterol.

Weight Management

Can losing weight help lower cholesterol? Yes, achieving and maintaining a healthy weight can significantly improve your cholesterol profile. Even a modest weight loss of 5-10% can have a positive impact.

Smoking Cessation

How does quitting smoking affect cholesterol? Smoking lowers HDL cholesterol, so quitting can help improve your HDL levels and overall cardiovascular health.

Medical Interventions: Medications and Supplements for Cholesterol Management

When lifestyle changes aren’t sufficient, what medical options are available for managing high cholesterol?

Prescription Medications

Which medications are commonly prescribed for high cholesterol? Several classes of drugs can help manage cholesterol levels:

• Statins: The most commonly prescribed cholesterol-lowering drugs
• Bile Acid Sequestrants: Help remove cholesterol from the body
• Cholesterol Absorption Inhibitors: Reduce cholesterol absorption in the intestines
• PCSK9 Inhibitors: Newer drugs for those with genetic high cholesterol

Supplements

Are there any natural supplements that can help lower cholesterol? Some supplements have shown promise in cholesterol management:

• Fish Oil: Rich in omega-3 fatty acids
• Niacin: A B vitamin that can raise HDL levels
• Red Yeast Rice: Contains compounds similar to statins
• Plant Sterols and Stanols: Can help block cholesterol absorption

It’s crucial to consult with a healthcare provider before starting any new supplement regimen, as some can interact with medications or have side effects.

Monitoring Progress: The Importance of Regular Cholesterol Checks

How often should you have your cholesterol levels checked? For adults with no risk factors, the American Heart Association recommends cholesterol screening every 4-6 years. However, if you have high cholesterol or other risk factors, more frequent testing may be necessary.

What does a comprehensive cholesterol test include? A lipid panel typically measures:

• Total Cholesterol
• LDL Cholesterol
• HDL Cholesterol
• Triglycerides

Your healthcare provider may also calculate your non-HDL cholesterol and total cholesterol to HDL ratio for a more complete picture of your cardiovascular risk.

Beyond Cholesterol: Other Factors in Heart Health

While managing cholesterol is crucial, what other factors contribute to overall heart health? A comprehensive approach to cardiovascular wellness includes:

• Blood Pressure Management: Aim for levels below 120/80 mmHg
• Blood Sugar Control: Particularly important for those with diabetes
• Stress Reduction: Chronic stress can negatively impact heart health
• Adequate Sleep: Poor sleep is associated with increased cardiovascular risk

How do these factors interact with cholesterol levels? They can work synergistically, either promoting heart health when well-managed or increasing risk when neglected. A holistic approach to cardiovascular health considers all these elements together.

The Future of Cholesterol Management: Emerging Treatments and Research

What new developments are on the horizon for cholesterol management? Researchers are exploring several promising avenues:

Gene Therapy

Can genetic interventions help manage cholesterol? Scientists are investigating gene editing techniques to permanently lower cholesterol levels, particularly for those with familial hypercholesterolemia.

Nanotechnology

How might nanotechnology impact cholesterol treatment? Researchers are developing nanoparticles that can target and remove cholesterol from arterial plaques, potentially reversing atherosclerosis.

Personalized Medicine

Will future cholesterol treatments be tailored to individual genetic profiles? Advances in genomics are paving the way for more personalized approaches to cholesterol management, taking into account an individual’s unique genetic makeup and risk factors.

As research continues, new treatments may offer more effective and targeted approaches to managing high cholesterol and reducing cardiovascular risk.

Managing a total cholesterol level of 274 mg/dL requires a multifaceted approach, combining lifestyle modifications, possibly medication, and regular monitoring. By understanding the risks associated with high cholesterol and taking proactive steps to address it, you can significantly improve your cardiovascular health and overall well-being. Remember, cholesterol management is a long-term commitment, but the benefits to your health are well worth the effort.

Total Cholesterol: 274 mg/dL

Elle Penner, MPH, RD

5 mins

What does a total cholesterol level of 274 mean? Are there any symptoms associated with this level?

A total cholesterol level of 274 mg/dL is considered high. Although cholesterol has several essential functions in the body, high cholesterol puts you at greater risk for heart disease.

Your total cholesterol is calculated by adding your LDL (bad) cholesterol, HDL (good) cholesterol, and 20% of triglyceride levels. 

• LDL is often referred to as “bad” cholesterol because it accumulates in your blood vessels and increases your risk for heart disease. Ideally, LDL levels should be less than 100 mg/dL, but lower is better. 

• HDL is considered “good” cholesterol because it scavenges “bad” blood cholesterol and returns it to the liver for excretion. A HDL level >60 mg/dL is considered optimal and protective against heart disease, though levels >40 mg/dL for men and >50 mg/dL for women are still considered good.

• Triglycerides are another type of fat that builds up in the bloodstream and increases your risk of heart disease. Ideally, triglycerides should be <150 mg/dL.  

While high cholesterol is commonly linked to diet and lifestyle factors, familial hypercholesterolemia (FH) can also cause high cholesterol levels. FH is a common genetic disorder that causes high levels of LDL cholesterol. If untreated, FH leads to early heart attacks and heart disease, even in young adults and children. Because FH is inherited, when someone in your family is diagnosed, it’s important all family members are also screened for this condition.

High cholesterol doesn’t have symptoms, so it is important to know your levels. Lowering your cholesterol will lower your risk of developing heart disease and other health issues. If you already have heart disease, lowering your cholesterol can reduce your odds of serious complications, like a heart attack or stroke. 

Factors that could contribute to a total cholesterol level of 274: 

• Diet: Diets low in fiber and high in saturated fats, trans fats, and added sugar can increase blood cholesterol.  

• Weight. Being overweight also tends to increase cholesterol levels. 

• Physical Activity. Being active can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. 

• Smoking: Smoking lowers your HDL (good) cholesterol, which can contribute to a higher level of bad cholesterol.

• Medications: Some medications can increase cholesterol levels, including corticosteroids, beta-blockers, thiazide diuretics, antivirals, retinoids, and growth hormones.

• Diseases: Some diseases may elevate total cholesterol, including chronic kidney disease, diabetes, and HIV/AIDS.

• Age and Sex: Premenopausal women tend to have lower total cholesterol levels than men of the same age. However, cholesterol levels tend to increase with age in both women and men. After the age of menopause, women’s LDL (bad) cholesterol levels tend to rise.

• Genetics (heredity): Genes partly determine how much cholesterol your body makes; therefore, high blood cholesterol can run in families. 

• Race: Certain races may have an increased risk of high blood cholesterol. For example, Blacks/African Americans typically have higher HDL and LDL cholesterol levels than Caucasians.

• Elevated HDL (good) cholesterol: A HDL level above 70 mg/dL may contribute to high total cholesterol. High HDL is considered protective against heart disease; however, LDL and triglyceride levels should be in the healthy range.

What to do if your total cholesterol level is 274?

Making changes to your diet and adopting healthier habits can lower your total cholesterol level. Here are a few things you can do to reduce your cholesterol:

• Eat fiber-rich foods daily, including veggies, fruit, whole grains, and legumes. Gradually increase your fiber intake to 30-40 grams of fiber per day.  

• Limit refined carbs and added sugars such as soda, chips, candy, baked goods, sweetened yogurt, and ice cream. 

• Avoid trans fats (partially hydrogenated oils) and reduce your saturated fat intake to < 10% total calories. 

• Eat small, fatty fish at least twice a week, including salmon, sardines, and trout. 

• Get 30-60 minutes of physical activity most days of the week.

• Incorporate plant sterols and stanols daily (2g) in the form of food or a supplement. 

• Lose weight if you are overweight or obese.

• Quit smoking.

• If you have diabetes, achieve and maintain good blood sugar control (HbA1c).

Medications and supplements used to improve total cholesterol results

If diet and lifestyle changes are not enough to lower your cholesterol, some medications and supplements can be helpful to get them into a safer range. Some common ones include: 

Medications

Medications can help if diet and lifestyle changes do not lower total cholesterol levels enough on their own. Some common cholesterol medications include:

• Statins: Statins (including atorvastatin, simvastatin, and rosuvastatin) reduce cholesterol production in your liver. Because they typically need to be taken for life, statins are only prescribed if diet and lifestyle changes aren’t enough [3].

• Ezetimibe can be helpful for those with familial hypercholesterolemia and who have side effects with statins. 

• Bile acid sequestrants: These medications block cholesterol-rich bile acid from being absorbed into the bloodstream and can be taken in place of or in addition to a statin. 

• PCSK9 inhibitors: This medicine is prescribed alongside a statin if you are at high risk of heart attack or stroke, or have familial hypercholesterolemia. It is typically injected under your skin every 2 or 4 weeks.

• Lomitapide: Typically prescribed if you have familial hypercholesterolemia and requires liver enzyme monitoring as it can cause liver damage. Lomitapide is commonly also taken with vitamin E.

Supplements

• Plant sterols and stanols: Plant sterols and stanols (also called phytosterols) are found in plant cell membranes and are similar in structure to cholesterol in the body. When consumed, phytosterols block dietary cholesterol from being absorbed. They are found in small quantities in vegetable oils, nuts, legumes, whole grains, fruits, and vegetables; however, the average daily intake (500 mg) is typically not enough to lower cholesterol. Studies show that consuming 2000 mg (2g) of plant sterol and stanols daily from diet and supplements lowers total cholesterol [4]. Plant sterol and stanol supplements taken before or with meals can help lower total cholesterol in parallel with other recommended diet and lifestyle changes [4]. 

• Omega-3 (EPA & DHA): Omega-3 fatty acids (specifically EPA & DHA) can significantly reduce blood triglyceride levels. For cholesterol-lowering benefits, aim to consume 2,400-3,000 mg of omega-3 fats per day from your diet (salmon, mackerel, and trout are all good sources) and a quality fish oil supplement. 

• Beta-glucan: Beta-glucan is a form of soluble fiber that has been shown to help lower cholesterol levels. It’s found naturally in whole grains like barley, oats, rye, wheat, mushrooms, and seaweed. It is also available as a nutritional supplement. For cholesterol-lowering benefits, consume 3-7 g/day from your diet and a supplement.

• Psyllium: Another type of soluble fiber made from the husk of psyllium seeds, psyllium is good for digestive health and regularity and can also help lower cholesterol. Psyllium supplements are sold in powder form and can help reduce lipid levels when taken daily at a dose of 8-12 g/day. 

• Alpha-lipoic acid: Alpha-lipoic acid is a potent antioxidant. It is made in the body and occurs naturally in foods like carrots, beets, spinach, broccoli, potatoes, and red meat. Research suggests that 600 mg/day of alpha-lipoic acid from your diet and a supplement may help lower total cholesterol and LDL (bad) cholesterol [8]. 

• Turmeric: A spice commonly used to flavor and color curry dishes, turmeric may help lower pro-inflammatory markers, blood cholesterol, and triglycerides [9]. More research is needed to determine optimal form and dosage but supplementing with 500 mg/day appears safe and potentially beneficial for lowering cholesterol.

• Bergamot extract: Taking bergamot extract (made from the juice of the bergamot fruit) may help lower cholesterol and triglyceride levels in adults with high cholesterol [10,11]. One study suggests taking bergamot extract daily for a month may be as effective as taking a low dose of the cholesterol-lowering drug called rosuvastatin (Crestor) [11]. A recent research review indicates that 1000 mg/day may be most effective for lowering cholesterol. 

• Green tea extract: Green tea extract is a natural supplement that can help lower LDL (bad) and total cholesterol [12]. A daily dose of 400 mg may help lower your cholesterol but check with your doctor first as green tea extract can interact with certain medications, including beta-blockers and blood thinners. In addition, green tea extract may also have a stimulant effect.

Symptoms, Causes, Levels, and More

Causes of high cholesterol include diet, smoking, and genetics. High cholesterol rarely causes symptoms, so it’s important to have routine cholesterol screenings if you’re at risk.

High cholesterol is a pretty common issue in the U.S. In fact, according to the Centers for Disease Control and Prevention (CDC), nearly 94 million U.S. adults ages 20 or older have what could be considered borderline high cholesterol.

However, because this condition can often present without any real symptoms, you may not even know you have it until you visit your doctor.

If you’re wondering what causes high cholesterol, what to do if you’ve been diagnosed with it, and if there are ways to reverse it (hint: there are), read on for all the answers.

Cholesterol is a type of lipid. It’s a waxy, fat-like substance that your liver produces naturally. It’s vital for the formation of cell membranes, certain hormones, and vitamin D.

Cholesterol doesn’t dissolve in water, so it can’t travel through your blood on its own. To help transport cholesterol, your liver produces lipoproteins.

Lipoproteins are particles made from fat and protein. They carry cholesterol and triglycerides, another type of lipid, through your bloodstream. The two major forms of lipoprotein are low-density lipoprotein (LDL) and high-density lipoprotein (HDL).

LDL cholesterol is any cholesterol carried by low-density lipoproteins. If your blood contains too much LDL cholesterol, you may be diagnosed with high cholesterol. Without treatment, high cholesterol may lead to many health issues, including heart attack and stroke.

High cholesterol rarely causes symptoms in the beginning. That’s why it’s important to get your cholesterol levels checked on a regular basis.

In most cases, high cholesterol is a “silent” condition. It typically doesn’t cause any symptoms. Many people don’t even realize they have high cholesterol until they develop serious complications, such as a heart attack or stroke.

That’s why routine cholesterol screening is important. If you’re 20 years or older, ask your doctor if you should have routine cholesterol screening. Learn how this screening could potentially save your life.

Eating too many foods that are high in cholesterol, saturated fats, and trans fats may increase your risk of developing high cholesterol. Living with obesity can also increase your risk. Other lifestyle factors that can contribute to high cholesterol include inactivity and smoking.

Your genetics can also affect your chances of developing high cholesterol. Genes are passed down from parents to children. Certain genes instruct your body on how to process cholesterol and fats. If your parents have high cholesterol, you may be at a greater risk of having it too.

In rare cases, high cholesterol is caused by familial hypercholesterolemia. This genetic disorder prevents your body from removing LDL. According to the National Human Genome Research Institute, most adults with this condition have total cholesterol levels above 300 milligrams per deciliter and LDL levels above 200 milligrams per deciliter.

Other health conditions, such as diabetes and hypothyroidism, may also increase your risk of developing high cholesterol and related complications.

LDL cholesterol is often called “bad cholesterol.” It carries cholesterol to your arteries. If your levels of LDL cholesterol are too high, it can build up on the walls of your arteries.

This buildup is also known as cholesterol plaque. This plaque can narrow your arteries, limit your blood flow, and raise your risk of blood clots. If a blood clot blocks an artery in your heart or brain, it can cause a heart attack or stroke.

HDL cholesterol is sometimes called “good cholesterol. ” It helps return LDL cholesterol to your liver to be removed from your body. This helps prevent cholesterol plaque from building up in your arteries.

When you have healthy levels of HDL cholesterol, it can help lower your risk of blood clots, heart disease, and stroke.

Triglycerides are another type of lipid. They’re different from cholesterol. While your body uses cholesterol to build cells and certain hormones, it uses triglycerides as a source of energy.

When you eat more calories than your body can use right away, it converts those calories into triglycerides. It stores triglycerides in your fat cells. It also uses lipoproteins to circulate triglycerides through your bloodstream.

If you regularly eat more calories than your body can use, your triglyceride levels may become too high. This can raise your risk of several health problems, including heart disease and stroke.

Your doctor can use a simple blood test to measure your triglyceride level, as well as your cholesterol levels.

If you’re 20 years or older, the American Heart Association recommends getting your cholesterol levels checked at least once every 4 to 6 years. If you have a history of high cholesterol or other risk factors for cardiovascular disease, your doctor may encourage you to get your cholesterol levels tested more often.

Your doctor can use a lipid panel to measure your total cholesterol level, as well your LDL cholesterol, HDL cholesterol, and triglyceride levels. Your total cholesterol level is the overall amount of cholesterol in your blood. It includes LDL and HDL cholesterol.

If your levels of total cholesterol or LDL cholesterol are too high, your doctor may diagnose you with high cholesterol. High cholesterol can be dangerous when your LDL levels are too high and your HDL levels are too low.

If you need help finding a primary care doctor, then check out our FindCare tool here.

Cholesterol levels chart

Being diagnosed with high cholesterol doesn’t automatically mean you will be put on medication. If your doctor does prescribe you medication, different factors may influence the type of medication they recommend.

With this in mind, most physicians use generalized measurements to decide on treatment plans. They may categorize these measurements as desirable, borderline high, or high cholesterol.

According to the National Library of Medicine, the total cholesterol of most adults can be categorized as:

The National Library of Medicine also provides optimal to high categories of LDL (“bad”) cholesterol levels:

Again, these measurements are general. You and your doctor will consider other personal factors before deciding on a treatment plan.

Your body needs some cholesterol to function properly, including some LDL. But if your LDL levels are too high, it can raise your risk of serious health problems.

In 2018, the American College of Cardiologists and the American Heart Association updated their recommendations for the treatment of high cholesterol.

Under the new guidelines, in addition to your cholesterol levels, treatment recommendations analyze other risk factors for heart disease, such as family history and other health issues. The guidelines use all these factors to consider a person’s overall chance of developing complications during the next 10 years.

You may be at a higher risk of developing high cholesterol if you:

• are living with obesity
• consume a lot of saturated and trans fats, like those found in fast food
• have limited physical activity
• smoke tobacco products
• have a family history of high cholesterol
• have diabetes, kidney disease, or hypothyroidism

People of all ages, genders, and ethnicities can have high cholesterol.

Without treatment, high cholesterol can cause plaque to build up in your arteries. Over time, this plaque can narrow your arteries. This condition is known as atherosclerosis.

Atherosclerosis is a serious condition. It can limit the flow of blood through your arteries. It also raises your risk of developing dangerous blood clots.

Atherosclerosis can result in many life threatening complications, such as:

• stroke
• heart attack
• angina, or chest pain
• high blood pressure
• peripheral vascular disease
• chronic kidney disease

High cholesterol can also create a bile imbalance, raising your risk of gallstones. See the other ways that high cholesterol can impact your body.

If you have high cholesterol, your doctor may recommend lifestyle changes to help lower it. For instance, they may recommend changes to your diet, exercise habits, or other aspects of your daily routine. If you smoke, they will likely advise you to quit.

Your doctor may also prescribe medications or other treatments to help lower your cholesterol levels. In some cases, they may refer you to a specialist for more care.

Lowering cholesterol through diet

To help you achieve and maintain healthy cholesterol levels, your doctor may recommend changes to your diet.

For example, they may advise you to:

• limit your intake of foods that are high in cholesterol, saturated fats, and trans fats
• choose lean sources of protein, such as chicken, fish, and legumes
• eat a wide variety of high fiber foods, such as fruits, vegetables, and whole grains
• opt for baked, broiled, steamed, grilled, and roasted foods instead of fried foods
• avoid fast food and sugary, pre-packaged options when possible

Foods that are high in cholesterol, saturated fats, or trans fats include:

• red meat, organ meats, egg yolks, and high fat dairy products
• processed foods made with cocoa butter or palm oil
• deep-fried foods, such as potato chips, onion rings, and fried chicken
• certain baked goods, such as some cookies and muffins

Eating fish and other foods that contain omega-3 fatty acids may also help lower your LDL levels. For example, salmon, mackerel, and herring are rich sources of omega-3s. Walnuts, almonds, ground flaxseeds, and avocados also contain omega-3s.

Cholesterol medications

In some cases, your doctor might prescribe medications to help lower your cholesterol levels.

Statins are the most commonly prescribed medications for high cholesterol. They block your liver from producing more cholesterol.

Examples of statins include:

• atorvastatin (Lipitor)
• fluvastatin (Lescol)
• rosuvastatin (Crestor)
• simvastatin (Zocor)

Your doctor may also prescribe other medications for high cholesterol, such as:

• niacin
• bile acid resins or sequestrants, such as colesevalam (Welchol), colestipol (Colestid), or cholestyramine (Prevalite)
• cholesterol absorption inhibitors, such as ezetimibe (Zetia)
• PCSK9 inhibitors, such as alirocumab (Praluent) and evolocumab (Repatha)

Some products contain a combination of drugs to help decrease your body’s absorption of cholesterol from foods and reduce your liver’s production of cholesterol. One example is a combination of ezetimibe and simvastatin (Vytorin). Learn more about the drugs used to treat high cholesterol.

Home remedies to lower cholesterol naturally

In some cases, you may be able to lower your cholesterol levels without taking medications. For example, it may be enough to eat a nutritious diet, exercise regularly, and avoid smoking tobacco products.

Some people also claim that certain herbal and nutritional supplements may help lower cholesterol levels. For instance, claims have been made about:

• garlic
• hawthorn
• astragalus
• red yeast rice
• plant sterol and stanol supplements
• blond psyllium, found in psyllium seed husk
• ground flaxseed

However, the level of evidence supporting these claims varies. Also, the Food and Drug Administration (FDA) hasn’t approved any of these products for treating high cholesterol. More research is needed to learn if they can help treat this condition.

Always talk with your doctor before taking any herbal or nutritional supplements. In some cases, they might interact with other medications you’re taking.

You can’t control the genetic risk factors for high cholesterol. However, lifestyle factors can be managed.

To lower your risk of developing high cholesterol:

• Eat a nutritious diet that’s low in cholesterol and animal fats, and high in fiber.
• Avoid excessive alcohol consumption.
• Maintain a moderate weight.
• E.xercise regularly.
• Avoid smoking.

Follow your doctor’s recommendations for routine cholesterol screening. If you’re at risk of high cholesterol or coronary heart disease, they will likely encourage you to get your cholesterol levels tested on a regular basis.

In most cases, high cholesterol has no symptoms. But without treatment, high cholesterol can cause serious health issues. The good news is that your doctor can help you manage this condition, and in many cases, can help you avoid complications.

To learn if you have high cholesterol, ask your doctor to test your cholesterol levels, especially if you’re 20 years or older. If they diagnose you with high cholesterol, ask them about your treatment options.

To lower your risk of complications from high cholesterol, practice healthy lifestyle habits and follow your doctor’s recommended treatment plan.

Eating a balanced diet, exercising regularly, and avoiding tobacco products may help you achieve and maintain healthy cholesterol levels. It could also help lower your risk of complications from high cholesterol.

Two faces of cholesterol

Author: Elena OGANOVA, head. Clinical Diagnostic Laboratory 9 GKB Minsk

A biochemical blood test revealed an elevated cholesterol level in me – 6.8 mmol/l. How to bring it back to normal?

Cholesterol is essential for the formation and repair of cell membranes, the formation of connections between brain cells, the synthesis of hormones, and the production of vitamin D in the skin. We get a third of cholesterol from food, two-thirds are synthesized by the liver (the process is stimulated by saturated fats found in meat and dairy foods).

There are gender differences in the concentration of cholesterol: in men, its level increases in early and middle age, decreases in old age; in women, it slowly increases until menopause, but in the future it may exceed the figure in men. This is due to the action of sex hormones: estrogens reduce, and androgens increase the level of total cholesterol.

To determine the exact level of cholesterol, proper preparation for the study is necessary: ​​at least 12–14 hours must pass between the last meal and blood sampling for analysis. Juice, tea, coffee are not allowed; you can drink water. For people over 20 years of age, a study of the lipid spectrum of blood serum is indicated once every 5 years.

When assessing the risk of developing atherosclerosis, the cholesterol atherogenic coefficient is calculated, which in newborns is 1 mmol/L; in women under 30 years old – approximately 2. 2 mmol / l, and in men – 2.5 mmol / l. In healthy people over 40 years old, it does not exceed 3.5 mmol/l; in those suffering from coronary heart disease or other manifestations of atherosclerosis, it often reaches 5 mmol / l or more.

In addition to assessing the risk of atherosclerosis and its complications, lipid profile tests are used to detect changes in lipid metabolism in diseases of the liver, kidneys, endocrine disorders, obesity, etc.

Indicators of lipid metabolism in many cases can be corrected with the help of an individual diet (because they largely depend on the amount and composition of dietary fats), as well as drugs.

An increase in the concentration of cholesterol can lead to different consequences, depending on which of its 2 main types prevails.

The first is low-density lipoprotein cholesterol (LDL-C). When bound to receptors in peripheral tissue cells, LDL releases cholesterol, which is normally used in synthesis processes. The main LDL-C carrier protein is apolipoprotein B (ApoB).

The second type is high-density lipoprotein cholesterol (HDL-C). It provides “reverse” transport – removal of excess cholesterol from tissues to the liver.

The main carrier protein of HDL-C is apolipoprotein A1 (ApoA1). Once in the liver, HDL-C is broken down, and the cholesterol contained in it is excreted in the form of bile salts or reused for subsequent redistribution in tissues.

HDL-C also has other beneficial properties – anti-inflammatory and antioxidant.

Apolipoproteins are proteins located on the surface of lipoproteins and determine what will happen to cholesterol: it will be released from the “package” and absorbed by cells, or excess cholesterol will be removed from tissues and blood.

The risk of atherosclerosis is associated not so much with cholesterol concentrations, but with the amount of circulating atherogenic and anti-atherogenic particles that bind to the vessel walls and penetrate the walls of the arteries. The indicator of the balance of atherogenic and anti-atherogenic ApoB/ApoA1 particles is the most accurate indicator of the risk of cardiovascular diseases in asymptomatic individuals and those suffering from diabetes mellitus. The ApoB/ApoA1 ratio is the most adequate indicator of the effectiveness of therapy aimed at lowering the level of LDL-C.

Identification and detailed analysis of lipoprotein metabolism disorders is the basis for laboratory diagnosis of early “preclinical” stages of atherosclerotic lesions. The results of lipid profile tests are compared with reference values ​​corresponding to age and gender. There are also “recommended” limits at which the risk of developing atherosclerotic changes is statistically unlikely.

Tab. 1. Cholesterol levels (in mmol/l) depending on the risk of coronary artery disease (according to the third report of NCEP experts (National Cholesterol Education Program)

	Optimal	Above optimal	Borderline high	High
Total cholesterol	3. 60–5.20	–	5.21–6.21	> 6.24
Triglycerides, male	male 0.40–1.54 female 0.45–1.69	1.70–2.26	2.27–5.66	> 5.67
LDL cholesterol	2.32–3.50	2.6–3.35	3.38–4.13	4.16-4.91
VLDL cholesterol	.030–0.45	–	–	–
HDL cholesterol	male 0.90–1.80 female 1.16–2.10	low < 1.04	high > 1.56

Tab. 2. Risk of myocardial infarction depending on the ratio of ApoB/ApoA1

	Desired level	Low	Medium	High
Men	0. 4	0.7	0.9	1.1
Women	0.3	0.6	0.8	1.0

For recovering from COVID-19. For recovered from COVID-19. Heart risk assessment

Synonyms: Cardio risk tests after covid-19.

Analyzes to assess cardiorisk after COVID-19.

Profile composition:

No. 5/119 Clinical blood test: general analysis, leukoformula (with microscopy of a blood smear in the presence of pathological changes)

No. 16 Glucose (in the blood) (Glucose)

No. 30 Trigli cerides (Triglycerides )

No. 31 Cholesterol total (cholesterol, Cholesterol total)

No. 32 Cholesterol-HDL (High density lipoprotein cholesterol, HDL Cholesterol)

No. 33 LDL-Cholesterol

No. NHDL Non-HDL Cholesterol (non-HDL cholesterol, non-HDL)

No. 157 Troponin-I, high sensitivity (hs-TnI)

No. 1643 High sensitivity C-reactive protein (cardio), (CRP, high sensitivity CRP, hs-CRP)

Description

A comprehensive examination is aimed at assessing the risk of cardiovascular disorders, the likelihood of which may increase after a new coronavirus infection. This may be due to the presence of pre-existing pathologies such as cardiovascular disease (CVD), diabetes mellitus (DM) and kidney disease, direct and indirect damage to the heart muscle and blood vessels, and possibly the cardiotoxic effect of certain drugs.

The study can be used to assess the individual risk of cardiovascular diseases for the purpose of primary and secondary prevention, in the presence of risk factors for cardiovascular pathologies (age over 45 years for men and 55 years for women, smoking, overweight, carbohydrate metabolism disorders, high blood pressure), hereditary predisposition to metabolic and cardiovascular diseases.

Complete blood count and leukocyte formula are aimed at assessing the general state of health, and are also used to diagnose many diseases. The tests make it possible to identify inflammatory processes, allergic reactions, anemia, assess the state of platelet hemostasis, etc. lipid metabolism, metabolic syndrome. The determination of glucose concentration is used to assess carbohydrate metabolism. Carbohydrate metabolism disorders are considered as conditions associated with an increased risk of cardiovascular diseases. In addition to indicators of lipid and carbohydrate metabolism, the determination of highly sensitive C-reactive protein and highly sensitive cardiac troponin I is used to clarify potential cardiovascular risks.

References:

1. Barbarash O. L. et al. Guidelines for the diagnosis and treatment of diseases of the circulatory system (CVD) in the context of the COVID-19 pandemic (short version).
2. Boytsov S. A., Shakhmatova O. O. Damage to the cardiovascular system in coronavirus infection. Prevention of complications, possible consequences and further treatment.
3. Dolgov VV, Menshikov VV Clinical laboratory diagnostics. National leadership //M.: GEOTAR-Media. – 2016. – S. 688.
4. Kozlov I. A., Tyurin I. N. Cardiovascular complications of COVID-19 //Bulletin of anesthesiology and resuscitation. – 2020. – T. 17. – No. 4.
5. Larina V. N., Golovko M. G., Larin V. G. Influence of coronavirus infection (COVID-19) on the cardiovascular system // Bulletin of the Russian State Medical University. – 2020. – no. 2. – S. 5-13.
6. Mikhailovskaya T.V. et al. Potential impact of COVID-19 on the cardiovascular system //Physical and Rehabilitation Medicine, Medical Rehabilitation. – 2020. – Vol. 2. – No. 2. – S. 133-139.
7. Poteshkina N. G. et al. Cardiac injury in patients with coronavirus infection COVID-19 //Arterial hypertension.