What are the main causes of high cholesterol. How can diet and lifestyle changes help lower cholesterol levels. What role do genetics play in cholesterol levels. When should medication be considered for managing high cholesterol.

The Basics of Cholesterol: Types and Functions

Cholesterol is a vital substance produced by the body and consumed through food. It plays essential roles in various bodily functions. There are two main types of cholesterol:

• Low-density lipoproteins (LDL) – often referred to as “bad” cholesterol
• High-density lipoproteins (HDL) – known as “good” cholesterol

Cholesterol serves four primary functions in the human body:

1. Contributing to cell wall structure
2. Forming digestive bile acids in the intestines
3. Enabling vitamin D production
4. Facilitating hormone production

While cholesterol is essential for survival, high levels of LDL cholesterol can pose significant health risks. Understanding the balance between LDL and HDL cholesterol is crucial for maintaining overall health.

Causes of High Cholesterol: Lifestyle and Genetic Factors

High cholesterol levels can result from various factors, including both lifestyle choices and genetic predisposition. Some of the primary causes include:

Dietary Factors

Consuming foods high in cholesterol, saturated fats, and trans fats can contribute to elevated cholesterol levels. These include:

• Animal products (meat, cheese, and full-fat dairy)
• Baked goods and processed foods
• Deep-fried foods
• Margarine and hydrogenated oils

Lifestyle Choices

Certain lifestyle factors can significantly impact cholesterol levels:

• Lack of physical activity
• Excess weight or obesity
• Smoking
• Excessive alcohol consumption

Genetic Factors

Some individuals may have a genetic predisposition to high cholesterol. Familial hypercholesterolemia is an inherited condition that can lead to very high LDL levels. Can genetic testing help identify individuals at risk for inherited high cholesterol? Genetic testing can indeed help identify those with familial hypercholesterolemia, allowing for early intervention and management.

Medical Conditions

Several health conditions can contribute to high cholesterol levels:

• Diabetes
• Liver or kidney disease
• Polycystic ovary syndrome (PCOS)
• Pregnancy and conditions affecting female hormone levels
• Underactive thyroid gland (hypothyroidism)

The Silent Nature of High Cholesterol: Symptoms and Detection

High cholesterol often does not present any noticeable symptoms, earning it the nickname “silent killer.” Regular screening and blood tests are crucial for detecting elevated cholesterol levels. Without routine testing, individuals may be unaware of their high cholesterol until they experience a heart attack or other cardiovascular event.

How often should adults have their cholesterol levels checked? The American Heart Association recommends that adults aged 20 or older have their cholesterol checked every 4-6 years. However, those with risk factors may need more frequent testing.

Cholesterol-Lowering Foods: Dietary Strategies for Management

Incorporating certain foods into your diet can actively help lower cholesterol levels. Harvard Health has identified 11 cholesterol-lowering foods:

1. Oats
2. Barley and whole grains
3. Beans
4. Eggplant and okra
5. Nuts
6. Vegetable oils (canola, sunflower)
7. Fruits (apples, grapes, strawberries, citrus)
8. Soy and soy-based foods
9. Fatty fish (salmon, tuna, sardines)
10. Foods rich in fiber
11. Plant sterols and stanols

Adding these foods to a balanced diet can help manage cholesterol levels effectively. Which of these foods has the most significant impact on lowering cholesterol? While all these foods contribute to cholesterol management, oats and other whole grains containing soluble fiber have been shown to have a particularly strong effect on lowering LDL cholesterol.

The Role of Exercise in Cholesterol Management

Physical activity plays a crucial role in managing cholesterol levels. Regular exercise can help:

• Increase HDL (good) cholesterol levels
• Lower LDL (bad) cholesterol levels
• Improve overall cardiovascular health
• Maintain a healthy weight, which indirectly affects cholesterol levels

How much exercise is needed to impact cholesterol levels? The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity aerobic exercise per week for adults. This can be spread out over several days and combined with strength training for optimal health benefits.

Types of Exercise Beneficial for Cholesterol Management

Various forms of exercise can help manage cholesterol levels:

• Brisk walking
• Jogging or running
• Cycling
• Swimming
• High-intensity interval training (HIIT)
• Strength training

Incorporating a combination of aerobic exercise and strength training can provide the most comprehensive benefits for cholesterol management and overall heart health.

Medical Interventions for High Cholesterol

When lifestyle changes alone are insufficient to manage high cholesterol levels, medical interventions may be necessary. Doctors may prescribe lipid-lowering medications, with statins being the most commonly used class of drugs.

Types of Cholesterol-Lowering Medications

• Statins (e.g., atorvastatin, simvastatin)
• Bile acid sequestrants
• Cholesterol absorption inhibitors
• PCSK9 inhibitors
• Fibrates
• Niacin

When should medication be considered for managing high cholesterol? The decision to start cholesterol-lowering medication depends on various factors, including an individual’s overall cardiovascular risk, LDL cholesterol levels, and the presence of other risk factors. Doctors typically consider medication when lifestyle changes alone have not been sufficient to reach target cholesterol levels, or when an individual has a high risk of cardiovascular disease.

Potential Side Effects of Cholesterol Medications

While cholesterol-lowering medications are generally safe and effective, they can have side effects. Common side effects may include:

• Muscle pain or weakness
• Liver enzyme elevations
• Digestive issues
• Increased blood sugar levels

It’s essential to discuss potential side effects and benefits with a healthcare provider before starting any medication regimen.

The Impact of High Cholesterol on Cardiovascular Health

High cholesterol, particularly elevated LDL levels, is a significant risk factor for coronary heart disease and heart attacks. The process by which high cholesterol affects cardiovascular health is called atherosclerosis.

Understanding Atherosclerosis

Atherosclerosis is the narrowing of arteries due to the buildup of plaque. This process involves:

1. Accumulation of LDL cholesterol in artery walls
2. Inflammation and immune response
3. Formation of plaque, consisting of cholesterol, calcium, and other substances
4. Narrowing of the artery, restricting blood flow

How does atherosclerosis lead to heart attacks and strokes? As atherosclerotic plaques grow, they can rupture, triggering blood clot formation. These clots can block blood flow to the heart (causing a heart attack) or the brain (causing a stroke). Additionally, the narrowed arteries can reduce blood flow to vital organs, leading to various cardiovascular problems.

Other Health Risks Associated with High Cholesterol

While cardiovascular disease is the primary concern, high cholesterol can also contribute to other health issues:

• Peripheral artery disease (PAD)
• Chronic kidney disease
• Erectile dysfunction
• Cognitive decline and dementia

Managing cholesterol levels through lifestyle changes and, when necessary, medical interventions can significantly reduce the risk of these health complications.

Cholesterol Management: A Holistic Approach

Effective cholesterol management typically involves a combination of dietary changes, increased physical activity, and, in some cases, medication. A holistic approach to cholesterol management includes:

Dietary Modifications

• Reducing intake of saturated and trans fats
• Increasing consumption of fiber-rich foods
• Incorporating heart-healthy fats (e.g., olive oil, avocados)
• Limiting alcohol consumption

Lifestyle Changes

• Regular exercise
• Maintaining a healthy weight
• Quitting smoking
• Managing stress

Regular Health Check-ups

• Routine cholesterol screenings
• Monitoring of other cardiovascular risk factors
• Consultation with healthcare providers for personalized advice

What role does stress management play in cholesterol control? Chronic stress can indirectly affect cholesterol levels by influencing behaviors such as overeating, lack of exercise, and increased alcohol consumption. Additionally, stress hormones can trigger the liver to produce more cholesterol. Therefore, stress management techniques like meditation, yoga, or regular relaxation practices can be beneficial as part of a comprehensive cholesterol management plan.

Personalized Treatment Plans

Cholesterol management should be tailored to individual needs, considering factors such as:

• Age and gender
• Family history
• Overall health status
• Lifestyle factors
• Presence of other cardiovascular risk factors

A personalized approach, developed in consultation with healthcare providers, can lead to more effective cholesterol management and improved cardiovascular health.

Future Directions in Cholesterol Research and Management

As our understanding of cholesterol and its impact on health continues to evolve, new approaches to management and treatment are emerging. Some areas of ongoing research and development include:

Novel Therapeutic Approaches

• Gene therapy for familial hypercholesterolemia
• RNA interference therapies targeting cholesterol production
• Development of new classes of cholesterol-lowering medications

Advanced Diagnostic Tools

• Improved genetic testing for cholesterol-related disorders
• More sophisticated lipid profile analyses
• Integration of artificial intelligence in risk assessment

Personalized Medicine

• Tailored treatment plans based on genetic profiles
• Individualized dietary recommendations
• Precision medicine approaches to cholesterol management

How might personalized medicine change the future of cholesterol management? Personalized medicine holds the promise of more effective and targeted cholesterol management. By considering an individual’s genetic makeup, lifestyle factors, and specific health risks, healthcare providers may be able to develop highly tailored treatment plans. This could lead to more efficient cholesterol control, reduced side effects from medications, and better overall cardiovascular outcomes.

Emerging Nutritional Strategies

Research continues to explore the potential of various foods and supplements in cholesterol management:

• Probiotics and their impact on cholesterol metabolism
• Nutraceuticals with cholesterol-lowering properties
• Plant-based diets and their long-term effects on lipid profiles

These ongoing research efforts may lead to new strategies for managing cholesterol levels and reducing the risk of cardiovascular disease in the future.

Understanding the causes of high cholesterol and implementing effective management strategies is crucial for maintaining cardiovascular health. By adopting a holistic approach that includes dietary changes, regular exercise, and appropriate medical interventions when necessary, individuals can significantly reduce their risk of cholesterol-related health issues. As research continues to advance our understanding of cholesterol and its impacts on health, we can look forward to even more effective and personalized approaches to cholesterol management in the future.

Cholesterol: What causes high cholesterol?

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Cholesterol is an essential substance for the body. Dietary factors and some health conditions can lead to high cholesterol, which is a risk factor for several conditions.

Cholesterol is present in every cell of the body and has important natural functions when it comes to digesting foods, producing hormones, and generating vitamin D. The body produces it, but people also consume it in food. It is waxy and fat-like in appearance.

There are two types of cholesterol:

• low-density lipoproteins (LDL), or “bad” cholesterol
• high-density lipoproteins (HDL), or “good” cholesterol

In this article, we will explain the role of cholesterol. We will also discuss the causes of high cholesterol, and its symptoms, treatment, and prevention.

Fast facts on cholesterol:

• Cholesterol is an essential substance that the body produces but which people also consume in foods.
• Risk factors for high cholesterol include family history and the modifiable lifestyle choices of diet and exercise.
• Having high cholesterol does not usually produce any symptoms.
• If lifestyle changes are unsuccessful or cholesterol levels are very high, a doctor may prescribe a lipid-lowering drug, such as a statin.

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Cholesterol is an oil-based substance. It does not mix with the blood, which is water-based.

It travels around the body in lipoproteins.

Two types of lipoprotein carry the parcels of cholesterol:

• Low-density lipoprotein (LDL): Cholesterol that travels in this way is unhealthful or “bad” cholesterol.
• High-density lipoprotein (HDL): Cholesterol that is present in HDL is known as “good” cholesterol.

Cholesterol has four primary functions, without which we could not survive.

These are:

• contributing to the structure of cell walls
• making up digestive bile acids in the intestine
• allowing the body to produce vitamin D
• enabling the body to make certain hormones

High cholesterol is a significant risk factor for coronary heart disease and a cause of heart attacks.

A build-up of cholesterol is part of the process that narrows arteries, called atherosclerosis. In atherosclerosis, plaques form and cause restriction of blood flow.

Reducing the intake of fat in the diet helps to manage cholesterol levels. In particular, it is helpful to limit foods that contain:

• Cholesterol: This is present in animal foods, meat, and cheese.
• Saturated fat: This occurs in some meats, dairy products, chocolate, baked goods, deep-fried, and processed foods.
• Trans fats: This occurs in some fried and processed foods.

Excess weight or obesity can also lead to higher blood LDL levels. Genetic factors can contribute to high cholesterol. People with the inherited condition familial hypercholesterolemia have very high LDL levels.

Other conditions that can lead to high cholesterol levels, include:

• diabetes
• liver or kidney disease
• polycystic ovary syndrome
• pregnancy and other conditions that increase levels of female hormones
• underactive thyroid gland
• drugs that increase LDL cholesterol and decrease HDL cholesterol, such as progestins, anabolic steroids, and corticosteroids

A person with high cholesterol levels often has no signs or symptoms, but routine screening and regular blood tests can help detect high levels.

A person who does not undergo testing may have a heart attack without warning, because they did not know that they had high cholesterol levels. Regular tests can help to reduce this risk.

A report from Harvard Health has identified 11 cholesterol-lowering foods that actively decrease cholesterol levels:

• oats
• barley and whole grains
• beans
• eggplant and okra
• nuts
• vegetable oil (canola, sunflower)
• fruits (mainly apples, grapes, strawberries, and citrus)
• soy and soy-based foods
• fatty fish (particularly salmon, tuna, and sardines)
• foods rich in fiber

Adding these to a balanced diet can help keep cholesterol in check.

The same report also lists foods that are bad for cholesterol levels. These include:

• red meat
• full-fat dairy
• margarine
• hydrogenated oils
• baked goods

Various low cholesterol recipe books are available to purchase online.

In adults, total cholesterol levels less than 200 milligrams per deciliter (mg/dL) are considered healthy.

• A reading between 200 and 239 mg/dL is borderline high.
• A reading of 240 mg/dL and above is considered high.

LDL cholesterol levels should be less than 100 mg/dL.

• 100–129 mg/dL is acceptable for people with no health problems but may be a concern for anyone with heart disease or heart disease risk factors.
• 130—159 mg/dL is borderline high.
• 160–189 mg/dL is high.
• 190 mg/dL or higher is considered very high.

HDL levels should be kept higher. The optimal reading for HDL levels is of 60 mg/dL or higher.

• A reading of less than 40 mg/dL can be a major risk factor for heart disease.
• A reading from 41 mg/dL to 59 mg/dL is borderline low.

People who wish to reduce their cholesterol levels or maintain a suitable level can make four major lifestyle decisions.

• eat a heart-healthy diet
• regularly exercise
• avoid smoking
• achieve and maintain a healthy weight

These actions will reduce the risk of coronary heart disease and heart attack.

Since 2013, guidelines on reducing or preventing high cholesterol have focused on addressing lifestyle risks, even at a young age.

Since 2018, new guidelines published in the Journal of the American College of Cardiology also urged doctors also to discuss with individuals the following factors that may increase a person’s risk:

• family history and ethnicity
• certain health conditions that increase the risk of high cholesterol, such as chronic kidney disease or chronic inflammatory conditions

Taking these factors into consideration will lead to a more personalized approach to the treatment and prevention of high cholesterol levels.

There are a number of ways to treat high cholesterol; these include:

Lipid-lowering therapy

For a person with high cholesterol levels, drug treatment will depend on their cholesterol level and other risk factors.

Recommendatoins usually start with diet and exercise, but people with a higher risk of a heart attack may need to use statins or other medications.

Statins are the leading group of cholesterol-lowering drugs. The statins available on prescription in the United States include:

• atorvastatin (brand named Lipitor)
• fluvastatin (Lescol)
• lovastatin (Mevacor, Altoprev)
• pravastatin (Pravachol)
• rosuvastatin calcium (Crestor)
• simvastatin (Zocor)

Apart from statins, a doctor may prescribe:

• selective cholesterol absorption inhibitors
• resins
• fibrates
• niacin

In 2017, researchers noted that a new drug, ezetimibe, can significantly reduce the risk of a major cardiovascular event in people with a high risk of such events. Etezimibe reduces lipid levels by limiting the absorption of cholesterol in the intestine.

The authors of the updated also mentioned another new type of drug: pro-protein convertase subtilisin/kexin 9 (PCSK9) inhibitors. There is evidence that these drugs are effective at reducing cholesterol levels, especially when a person uses them with ezetimibe.

In 2018, new guidelines recommended a stepped approach, depending on how high an individual’s risk is.

If a person has already had a cardiovascular event, such as a heart attack, a doctor may recommend using ezetimibe as well as a statin. For those at very high risk, the guidelines also recommend adding a PCSK9 inhibitor.

However, the guidelines also note that PCSK9 inhibitors are expensive, and insurance companies may not cover their cost. For this reason, this option is likely to be only for those with a very high risk.

Statin safety

The use of statins has caused some debate because, like all drugs, they can have side effects.

These include:

• statin-induced myopathy (a muscle tissue disease)
• fatigue
• a slightly greater risk of diabetes and diabetes complications, though this is hotly debated

A person should not stop taking a statin without speaking to a doctor, as they may increase their risk of cardiovascular problems.

A doctor might recommend:

• switching to a different medication
• increasing efforts to reduce cholesterol through lifestyle changes

In the past, people have aimed to reduce cholesterol to a target level, for instance, below 100 mg/ dL, but this is no longer the case.

Randomized, controlled clinical trials have not produced enough evidence to support treatment to a specific target.

However, some physicians may still use targets to help guide therapy.

10-year risk of a heart attack

Cholesterol levels play a major part in an individual’s risk of having a heart attack within the next 10 years.

The National Heart, Lung, and Blood Institute provide an online calculator of cardiovascular risk.

Using research evidence, it weighs the risk according to these factors:

• age
• sex
• cholesterol levels
• smoking status
• blood pressure

Guidelines published in 2018 consider this calculator and essential tool for assessing cholesterol levels and their risk.

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.

Blood test for HDL cholesterol (high density) CMD laboratory in Moscow. Call: 8 (495) 120-13-12

Research method

• Colorimetric

High-density lipoproteins (HDL) are considered an anti-atherogenic fraction of lipoproteins, they are involved in the transport of cholesterol from peripheral tissues to the liver (reverse or afferent transport of cholesterol). The main HDL proteins are apolipoproteins A-I and A-II. It is in the composition of HDL that excess cholesterol is removed from the body. Therefore, HDL cholesterol is considered “good” cholesterol.

Main structural components of HDL

• Diagnosis of the risk of atherosclerosis and cardiovascular diseases.

Reference values ​​(standard version):

Age, years	Men	Women	Units
<1	0.36 – 1. 62	0.49 – 1.78	mmol/l
15	0.64 – 1.90	0.64 – 1.9
5 – 10	0.99 – 1.94	0.93 – 1.89
10 – 15	0.96 – 1.92	0.96 – 1.82
15 – 20	0.78 – 1.63	0.91 – 1.92
20 – 25	0.78 – 1.63	0.86 – 2.05
25 – 30	0.81 – 1.63	0.96 – 2.15
30 – 35	0.73 – 1.63	0.94 – 2.00
35 – 40	0.75 – 1.61	0.88 – 2.13
40 – 45	0.7 – 1.74	0.88 – 2.28
45 – 50	0.78 – 1.66	0.88 – 2.26
50 – 55	0.73 – 1.63	0.96 – 2.39
55 – 60	0. 73 – 1.84	0.96 – 2.36
60 – 65	0.78 – 1.92	0.99 – 2.39
65 – 70	0.78 – 1.95	0.91 – 2.49
> 70	0.80 – 1.95	0.86 – 2.39

In accordance with the following international and domestic recommendations:

Cardiovascular Prevention 2017. Russian national guidelines Russian Society of Cardiology, National Society of Preventive Cardiology, Russian Society for the Prevention of Noncommunicable Diseases

Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, 2012

National Cholesterol Education Program. ATP III Guidelines At-A-Glance. Quick Desk Reference, 2002 Public Health Service National Institutes of Health National Heart, Lung, and Blood Institute.

Provided comments on the HDL-cholesterol test.

Optimal values ​​- more than 1.55; low values ​​(increased risk of cardiovascular diseases) – less than 1.04 mmol / l.

Sample result:

Please note that the interpretation of research results, diagnosis, and treatment, in accordance with Federal Law No. doctor of the relevant specialization.

Why cholesterol rises – we analyze the types of lipids, Novosibirsk – December 1, 2022

A sedentary lifestyle, lack of regular exercise in the fresh air, overeating lead to the accumulation of bad cholesterol

Illustration: Yuri Orlov

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In the Medlikbez TV series, we again continue to answer your questions with the help of specialized doctors. Today’s material is devoted to cholesterol. Many have heard that he is good and bad, but what does this mean? What other lipids need to be controlled and why is it not just about nutrition? Maria Tishchenko, a medical observer at the NHS, found out the answers to these questions.

Cholesterol is a fat-like substance that the body produces on its own and also gets from food. It is an indispensable building material for all cell membranes. Cholesterol is also used in the synthesis of adrenal hormones, sex hormones, vitamin D.

– Cholesterol is usually divided into “good” and “bad”. In fact, this characteristic does not refer to the substance itself, but to lipoproteins. These are proteins that carry cholesterol through the bloodstream to tissues and organs. High-density lipoproteins perform a purely useful function, but low-density carriers tend to attach to the walls of blood vessels and form plaques, explains Ekaterina Kashukh, an expert at the Hemotest laboratory.

Since low-density lipoproteins damage the health of blood vessels, the expert explains, the cholesterol in their composition is called “bad”. The higher the level of “bad” cholesterol in the blood, the higher the risk of cardiovascular diseases and their complications: coronary heart disease, heart attack, cerebrovascular accident.

There are different tests to check your cholesterol. The basic study is a test for total cholesterol: it will give a general idea of ​​​​the metabolism of a substance.

According to Ekaterina Kashukh, the norm of total cholesterol in the blood does not differ in men and women over 18: values ​​above 5. 18 mmol/l are considered elevated: more detailed diagnosis. Thus, it is possible to evaluate the content of high and low density lipoproteins separately, as well as their ratio. This study is called the atherogenic index. If the indicator is above 4 units, this indicates a high risk of developing atherosclerosis and coronary heart disease.

Please note that these are averages, in different laboratories the upper limit of the norm may be indicated differently!

Cardiologist of the network of multidisciplinary clinics for the whole family “1 + 1” Maxim Petrunin gives the following example: men have a normal cholesterol level – from 3.5 to 6, preferably even up to 5.5 mmol / l; in women – from 3 to 5.5.

Cholesterol can be tested by donating blood from a vein

Photo: Maria Tishchenko

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– First of all, high cholesterol is associated with malnutrition – eating high-calorie foods, a large amount of animal fats. Indeed, about a quarter of cholesterol enters the body with food, so dietary modification is the basic way to reduce cholesterol. Other well-known causes of high cholesterol are lack of physical activity and being overweight, says Ekaterina Kashukh.

However, there are factors that increase cholesterol, which do not depend on lifestyle. This is heredity, when, due to genetic mutations, an excess of a substance in the blood is formed. Cholesterol can also rise due to pathologies of the liver, the organ that produces most of the substance in the body.

Maxim Petrunin focuses on the fact that foods that increase cholesterol make up 30%, the rest are mechanisms independent of food.

He explains that cholesterol-raising foods include: meat, dairy products, palm and trans fats. Cholesterol-lowering foods include: oatmeal, soy, fruits, vegetables.

Therapist at the Zdravitsa Family Medicine Center Evgenia Shutovich says that now it is important to monitor all blood lipids, not just cholesterol: this issue is very relevant, since lipid metabolism disorders are considered as a leading factor in the development of cardiovascular diseases, atherosclerosis and associated complications:

– Dyslipidemia – a violation of blood lipid metabolism. The concept includes a wide range of lipid metabolism disorders, so it is important to know not only the level of one cholesterol, but it is necessary to donate blood to the lipid spectrum (the so-called lipidogram), where several indicators of lipids and blood lipoproteins are examined.

Here are the main reasons, but not all

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Total cholesterol. Elevated blood cholesterol levels increase the risk of atherosclerosis and coronary heart disease. It is better if the level is not higher than 5–5.5.

Triglycerides are a source of energy and the main form of energy storage in the body. But with an excess of calorie intake, combined with physical inactivity, adipose tissue begins to accumulate triglycerides. Hypertriglyceridemia can occur with overweight, alcohol abuse, diabetes mellitus, kidney disease, hereditary metabolic disorders. The blood level should not exceed 1.7.

Low density lipoproteins (LDL) are particles that transport cholesterol to all cells of the body. High rates indicate an increased risk of cholesterol deposition in the vascular bed, the possible formation of atherosclerotic plaques, which can narrow the lumen of the vessels and contribute to thrombosis. Normal values ​​should be less than 3.0 at low risk of cardiovascular disease, and less than 1.4 at very high risk.

High-density lipoproteins (HDL) – the so-called good lipids – are particles that circulate in the bloodstream that bind excess cholesterol and are transported to the liver, where cholesterol is converted into bile acids and excreted from the body. Women tend to have higher HDL than men. Normally, this fraction is > 1.2 in women and > 1.0 in men.

Atherogenic index is a calculated indicator that reflects the degree of risk of developing diseases of the heart and blood vessels, the higher it is, the higher the risk. Normally, it ranges from 2.2 to 3.5.

If cholesterol is elevated, it is better to look at other lipids in the blood

Infographics: Yuri Orlov

cholesterol:

— When analyzing a lipid profile, it is very important to take into account the peculiarities of the hormonal background. Pre-menopausal women are known to have higher levels of high-density lipoproteins (“good”) than men. Therefore, the risk of cardiovascular diseases in this period is less for them than for men.

However, the doctor notes, after menopause there is a decrease in “good” lipoproteins and an increase in total cholesterol, as a result of which the risk of cardiovascular diseases increases. Therefore, it is important to be screened for pre- and menopausal women.

— It should also be noted that cholesterol levels may increase during pregnancy. In men, the level of cholesterol can rise in middle age, which is again due to the influence of androgens, emphasizes Evgenia Shutovich.

Evgenia Shutovich recommends blood lipid testing for men over 40 and women over 50 or after menopause. And also to patients with various diseases (for example, arterial hypertension, diabetes mellitus, suffered a heart attack or stroke) and those who receive hormonal drugs for a long time.

Those who have these diseases especially need to monitor lipids

Infographics: Yuri Orlov

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In most cases, the doctor selects drugs for treatment that affect the liver and block excess cholesterol production. The specialist also offers a special diet, recommendations on the level of physical activity and physical therapy, in particular to reduce excess weight, if you have such a problem.

It is important to keep a diet, Yevgenia Shutovich draws attention:

— It is necessary to limit the consumption of animal fats, avoid eating white bread and bakery products; add sea fish, fruits, vegetables, cereals to the diet.