Cholesterol
Cholesterol is a waxy substance made by the liver and found in some animal-based foods. High blood cholesterol is influenced by genetics, diet, body weight, physical activity, and other health conditions. Saturated and trans fats have a greater effect on blood cholesterol than dietary cholesterol alone.
Complications
Elevated LDL cholesterol can contribute to plaque build up in the arteries, increasing the risk of heart attack, stroke, and peripheral artery disease.
What are Healthy Cholesterol Levels?
There is no single cholesterol goal that is right for everyone. Your healthcare professional will interpret your lipid results together with your age, blood pressure, medical and family history, smoking status, and other cardiovascular risk factors.
Current guidelines recommend an LDL cholesterol goal below 100 mg/dL for certain people at lower cardiovascular risk, with lower goals of below 70 mg/dL or below 55 mg/dL for those at progressively higher risk.
How is High Cholesterol Diagnosed?
High cholesterol usually has no obvious symptoms. A blood test measures cholesterol levels and identifies risk early.
- Children should be screened routinely once between ages 9–11 and again between ages 17–21.
- Children at increased risk may be screened beginning at age 2. Risk factors include a family history of very high cholesterol, familial hypercholesterolemia, or premature heart disease or stroke.
- Adults should have their cholesterol checked beginning at age 20 and generally every 4–6 years if their cardiovascular risk remains low. More frequent screening may be recommended for people with cardiovascular risk factors or abnormal results.
A clinician will determine how often it should be repeated.
What Are the Risk Factors for Developing High Cholesterol?
- Diet
- Obesity (BMI higher than 23 in South Asians)
- Age: risk increases after age 45 in men and age 55 in women
- Family history of heart disease and stroke
- High blood pressure
- Diabetes
- Lack of physical activity
- Inherited conditions where cholesterol may be 2-3 times higher than normal
Prevention & Treatment
GOAL: The primary goal is to lower LDL cholesterol and reduce overall cardiovascular risk.
- Your doctor will make recommendations for treatment based on your health condition and lab results
- Lifestyle modifications: Sometimes adjusting your diet and exercise can be enough to control your cholesterol numbers
- Low fat diet (reduce saturated fat to less than 7%)
- Lose weight
- Exercise at least 150 minutes per week
- Medications: If lifestyle modifications are not enough, your doctor will prescribe medications to reduce LDL, lower TGL and reduce inflammation:
- Today’s common medications include:
- Statins
- Ezetimbe
- PCSK9 Inhibitors
- Bempedoic Acid
- Icosapent ethyl (Vascepa)
- Colchcine (Lodoco)
- You must remember to take these medications regularly, as directed by your doctor.
- Today’s common medications include:
Consult your doctor before using any alternative therapies. Sometimes, even “natural” remedies can interact with your prescribed medications. DO NOT stop your medications without discussing with your doctor first!
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References
- American College of Cardiology
- American Heart Association
- WHO statistics on Non-communicable disease
- CDC.gov
- El Camino South Asian Heart Center