What is cholesterol?
Cholesterol is a type of fat found in your blood and is needed to help build cell membranes, hormones, and vitamin D.
There are two types of cholesterol:
Low-Density Lipoprotein Cholesterol (LDL) – commonly known as the “bad cholesterol” since high levels of LDL in the blood can cause plaque build-up (blockages) in the arteries, which may lead to cardiovascular concerns
High-Density Lipoprotein Cholesterol (HDL) – or “good cholesterol” helps carry the LDL away from the artery walls into the bloodstream and back to the liver for excretion.
Triglycerides are another type of fat found in the blood, which is normally measured along with your cholesterol during blood tests. If your triglyceride level is high, it can be due to excess weight, sedentary lifestyle, or uncontrolled diabetes, which may cause a blood clot. Your liver makes 80% of the cholesterol in your body, and the rest comes from the food you eat known as dietary cholesterol. High blood cholesterol is a major risk factor for heart attack, angina, and stroke since it can lead to the build-up of plaque (atherosclerosis) and result in a narrowing of your arteries.
There are no obvious symptoms of high blood cholesterol. It can only be determined through blood tests. These blood tests will help your doctor assess your risk for heart disease. The tests are broken down into the following categories, each with its own target range:
Total Cholesterol: the total amount of cholesterol in your blood
- Target: less than 5.2 mmol/L
LDL: “bad cholesterol”
- Target: less than 3.5 mmol/L
HDL: “good cholesterol”
- Target: higher than 1.0 mmol/L for men and 1.3mmol/L for women
Triglycerides
- Target – less than 1.7 mmol/L
Total Cholesterol/HDL Cholesterol Ratio
- Target – less than 5.0 mmol/L
Your doctor will help establish the specific target levels that are right for you, considering all of your risk factors.
What are the risk factors?
The following risk factors may increase your chances of having high cholesterol:
- Age and Gender: men over 55 years of age and women after menopause
- Obesity: a body mass index (BMI) of 30 or more; men with a waist circumference greater than 40 inches and greater than 35 inches for women
- Ethnicity: people of First Nations, African, or South Asian descent
- Smoking: can make blood vessels more receptive to plaque build-up as well as lower HDL levels
- High Blood Pressure: which can damage arteries and increase the accumulation of fatty deposits
- Diabetes: which can damage the lining of the arteries, lower HDL, and increase LDL levels
- Sedentary Lifestyle: exercise increases HDL and lowers LDL
- Family History of Heart Disease: a higher risk if a close family member experienced a heart attack or stroke before age 55 for a male member and before 65 years of age for a female member
The more risk factors you have, the more important it is for you to maintain your cholesterol levels within their target range.
What is the treatment for high cholesterol?
Lifestyle changes, including a healthy diet and exercise, are the first steps to controlling high cholesterol. However, if this is not sufficient in lowering your LDL, then your doctor may recommend medication. Some of the medications for high cholesterol, depending on your risk factors, may include:
- Statins: a widely prescribed medication which blocks an enzyme your liver needs to produce cholesterol; therefore, your liver produces less cholesterol and picks up more LDL to excrete
- Bile-Acid-Binding Resins: lowers cholesterol by binding to bile acids which prompt your liver to use excess cholesterol to make more bile acids to compensate (bile is needed for digestion)
- Cholesterol Absorption Inhibitors: limits the absorption of dietary cholesterol
If you have high levels of triglycerides, your doctor may prescribe:
- Fibrates: reduces your liver’s production of very-low-density lipoprotein (VLDL) and increases the removal of triglycerides from your blood
- Niacin: limits the liver’s production of LDL and VLDL. Niacin should only be prescribed by your doctor to lower cholesterol even though it is a form of Vitamin B. Flushing of the upper body and face are some of its side effects.
- Omega-3 Fatty Acid Supplements: can help lower cholesterol. However, consult with your physician first, as these may react with your other medications.
What are the lifestyle changes that lower high cholesterol?
Lifestyle changes are something within your control that will help lower your cholesterol as well as your risk of a heart attack, angina, and stroke. To achieve and maintain healthy cholesterol levels, consider:
- Dietary Changes: try to eat nutritious, balanced meals by choosing foods from each of the four major food groups recommended by Canada’s Food Guide, which are:
- Vegetables and Fruit: rich in dietary fiber and help lower cholesterol
- Grain Products: whole grain products promote heart health
- Milk and Alternatives: choose lower-fat milk products and reduce your intake of egg yolks and whole milk
- Meat and Alternatives: choose lean meats, poultry, fish, and products that are “trans-fat-free.” Eliminate organ meats with high concentrations of cholesterol.
- Lower-Fat Cooking Methods: cook by baking, broiling, or steaming and avoid frying foods
- Reduce Salt Intake: this will help lower blood pressure
- Check Food Labels: check the Nutrition Fact Table on your food packages before making your choices.
- Choose Healthy Snacks: use Canada’s Food Guide
- Limit Alcohol Intake: try to consume no more than one drink a day for women and one to two a day for men.
- Lose Extra Weight: since excess weight contributes to high cholesterol
- Exercise Regularly: helps improve cholesterol levels. Speak to your doctor about an exercise plan. Start by walking daily.
- Quit Smoking: this can improve your HDL, and your blood pressure can drop within 20 minutes after quitting.
For more information about cholesterol and heart health, visit the following sites:
CANADIAN CARDIOVASCULAR SOCIETY
CANADIAN HYPERTENSION EDUCATION PROGRAM
AMERICAN HEART ASSOCIATION
SODIUM 101