Cholesterol And Heart Diseases

By in Cardiology

Oct 31, 2018

Cholesterol and Heart Diseases

Cholesterol is a fat-like substance that travels in your bloodstream as HDL (good cholesterol) and LDL (bad cholesterol). When LDL levels rise, it sticks to artery walls and forms plaque. Over time, this narrows the arteries and restricts blood flow to the heart, brain, and other organs. This can lead to heart attacks, strokes, or heart failure.

There has been debate in recent years about the role of cholesterol in heart disease. However, the American College of Cardiology confirms that high LDL is strongly linked to increased risk of heart disease. A 2016 study also established elevated LDL as a key risk factor.

Small dietary changes—especially improving fat quality—can help lower cholesterol and reduce heart disease risk. Cholesterol comes not only from food but is also produced by the liver. High HDL and low LDL are ideal for protecting heart health.

What Is Cholesterol?

Cholesterol helps your body build cells, insulate nerves, and produce hormones. Although the liver produces the cholesterol your body needs, additional cholesterol comes from foods like meat, eggs, and dairy products.

How Does High Cholesterol Cause Heart Disease?

Excess cholesterol accumulates in the artery walls, a process known as atherosclerosis. As the arteries narrow, blood supply to the heart decreases. Low oxygen to the heart can cause chest pain (ischemia). If a blood vessel becomes completely blocked, it results in a heart attack.

LDL contributes to plaque formation, while HDL helps remove cholesterol from the bloodstream.

Symptoms of High Cholesterol

High cholesterol has no symptoms, which is why many people are unaware of their condition. Regular testing is essential. Lowering cholesterol reduces the risk of heart disease, heart attack, and related complications.

Cholesterol Numbers to Check

Adults over 20 years should get a lipid profile every five years. This includes LDL, HDL, triglycerides, VLDL, and total cholesterol.

Factors Affecting Cholesterol Levels

Diet

Saturated fat, trans fat, carbohydrates, and dietary cholesterol increase LDL. Reducing these and increasing fiber helps improve cholesterol levels.

Weight

Being overweight raises LDL and heart disease risk. Losing weight increases HDL and lowers LDL.

Exercise

Regular activity reduces LDL and raises HDL. Even 30 minutes daily helps improve your lipid profile.

Age & Gender

Cholesterol levels rise with age. Women generally have lower risk before menopause, but their LDL increases afterward.

Genetics

Family history strongly influences how much cholesterol your body makes.

Medical Conditions

Hypothyroidism, liver disease, and kidney disorders may elevate cholesterol levels.

Medications

Steroids and certain hormone medications can raise LDL and lower HDL.

Treatment for High Cholesterol

The main goals are to reduce LDL and increase HDL to lower cardiovascular risk.

Lifestyle changes—healthy eating, exercise, and weight control—are the first steps. Some individuals may need cholesterol-lowering medications based on their risk factors.

Risk Categories

• Low to Moderate Risk (0–1 risk factor)
  Lifestyle changes are usually enough.
• Moderate Risk (2+ risk factors)
  Lifestyle changes plus medications may be required.
• High Risk (diabetes, known heart disease, multiple risk factors)
  Cholesterol-lowering drugs are essential along with diet and exercise.

LDL Cholesterol Goals (Framingham Risk Score)

Category I – Highest Risk (>20% 10-year risk)

LDL goal: <100 mg/dl
For very high-risk patients (recent MI, uncontrolled diabetes): <70 mg/dl

Category II – High Risk (10–20%)

LDL goal: <130 mg/dl
Doctors may target <100 mg/dl.

Category III – Moderate Risk (<10%)

LDL goal: <130 mg/dl
May aim for <100 mg/dl if borderline.

Category IV – Low Risk

LDL goal: <160 mg/dl

Ways to Reduce Heart Disease Risk

• Control smoking, diabetes, and high blood pressure.
• Eat a diet low in saturated fats and refined carbohydrates.
• Maintain a healthy weight.
• Exercise regularly.
• Take prescribed medications consistently.

Cholesterol-Lowering Medications

Statins

They block cholesterol production in the liver and are the primary treatment. They lower LDL and triglycerides and slightly increase HDL. Possible side effects include muscle pain, mild memory issues, and elevated blood sugar.

Other Medications

• Niacin – increases HDL and lowers triglycerides.
• Bile acid resins – reduce fat absorption.
• Fibric acid derivatives – mainly lower triglycerides.
• Cholesterol absorption inhibitors – block cholesterol uptake from food.

Trans Fats & Saturated Fats

Trans fats raise LDL and lower HDL. They offer no nutritional value and are found in processed foods containing partially hydrogenated oils.

Saturated fats in sweets, red meat, fried foods, full-fat dairy, and certain oils should be consumed in limited amounts.

Healthier Food Options

• Oats and oat bran
• Whole grains
• Beans and lentils
• Walnuts and almonds
• Citrus fruits, apples, grapes, berries
• Okra, soy, fish, olive oil

TLC: Therapeutic Lifestyle Changes

TLC Diet

A low-saturated-fat, low-cholesterol diet with:

• <7% calories from saturated fat
• <200 mg dietary cholesterol per day

Includes fruits, vegetables, whole grains, low-fat dairy, fish, poultry, and lean meats. Increasing soluble fiber enhances LDL reduction.

Weight Management

Losing weight reduces LDL and improves HDL.

Physical Activity

At least minimum 30 minutes most days of the week.

Drug Treatment

Medications may be needed if lifestyle changes aren’t enough.

FAQs

1. What is the main cause of high cholesterol?

High cholesterol is mainly caused by unhealthy eating habits, lack of exercise, genetics, and certain medical conditions like hypothyroidism.

2. Can you lower cholesterol without medication?

Yes. Diet changes, weight loss, exercise, and reducing saturated fat intake can significantly lower LDL levels in many people.

3. How often should I check my cholesterol?

Adults over 20 should test their cholesterol at least every five years—or more often if they have risk factors.

4. What is a dangerous LDL level?

LDL above 160 mg/dl is considered high. Levels above 190 mg/dl require immediate treatment.

5. Do statins have side effects?

Statins are generally safe but may cause muscle pain, mild memory issues, or increased blood sugar in some individuals.