High Cholesterol Level Risk Factors Treatment Options

High Cholesterol Level Risk Factors Treatment Options

What is​ cholesterol?

Cholesterol is​ a​ type of​ fat (lipid) made by the​ body. About 80% of​ cholesterol is​ made by the​ body, the​ other 20% comes from the​ diet. Cholesterol is​ a​ building block for​ cell membranes. Our body uses cholesterol to​ produce many hormones (e.g., progesterone, estrogen, testosterone), vitamin D, and​ the​ bile acids that help to​ digest fat.

Many foods contain cholesterol and​ high intake of​ these foods can increase the​ level of​ cholesterol in​ the​ blood. Having too much cholesterol in​ the​ blood is​ not a​ disease in​ itself, but high cholesterol (hypercholesterolemia) can cause the​ formation and​ accumulation of​ plaque deposits in​ the​ arteries. Plaque is​ composed of​ cholesterol, other fatty substances, fibrous tissue, and​ calcium. When it​ builds up in​ the​ arteries, it​ results in​ the​ hardening and​ narrowing of​ the​ arteries (atherosclerosis) in​ the​ major vascular systems.

Narrowing of​ the​ arteries around the​ heart (coronary heart disease) can prevent the​ heart from getting as​ much oxygen-rich blood as​ it​ needs, increasing the​ risk of​ a​ heart attack. Decreased blood flow to​ the​ brain can cause a​ stroke, and​ less blood flowing to​ the​ lower limbs may result in​ exercise-related pain or​ even gangrene.

Having a​ high cholesterol level does not cause symptoms and​ does not make you feel sick. if​ there is​ a​ huge excess, some people develop soft, yellowish skin growths called xanthomas, usually in​ the​ area near the​ eyes. Most people find out they have high cholesterol when they have their blood cholesterol measured as​ part of​ a​ medical check-up.

Types of​ Cholesterol

Cholesterol is​ not soluble in​ water and​ doesn't mix easily with blood. in​ order to​ be able to​ travel in​ the​ bloodstream, the​ cholesterol made in​ the​ liver is​ combined with protein and​ other substances. This cholesterol-protein package is​ called a​ lipoprotein. Lipoprotein then carries the​ cholesterol through the​ bloodstream.

Lipoproteins can be high density (HDL), low density (LDL) or​ very low density (VLDL), depending on how much protein there is​ in​ relation to​ fat.

LDL (low density lipoprotein)

Low-density lipoprotein (LDL) is​ called the​ "bad" cholesterol. About 70% of​ cholesterol is​ transported as​ LDL. This is​ mostly fat and​ not much protein. LDL causes cholesterol to​ be deposited in​ the​ arteries. High levels of​ LDL are associated with an​ increased risk of​ coronary heart disease.

HDL (high density lipoprotein)

High-density lipoprotein (HDL) is​ called the​ "good" cholesterol. it​ carries cholesterol from the​ body's tissues back to​ the​ liver. About 20% of​ cholesterol is​ transported as​ HDL, which is​ mostly protein and​ not much fat. HDL cholesterol may help protect against atherosclerosis by preventing cholesterol from depositing on arterial walls as​ it​ circulates in​ the​ bloodstream.

Risks factors

There are several factors that may contribute to​ high cholesterol level in​ the​ blood:

  • Genetic predisposition. People are at​ a​ higher risk of​ high cholesterol if​ they have a​ direct male relative aged under 55 or​ female relative aged under 65 affected by coronary heart disease.

  • Diet high in​ saturated fat. Saturated fat and​ cholesterol come from animal foods such as​ beef, pork, veal, milk, eggs, butter, and​ cheese.

  • Sedentary lifestyle. Lack of​ exercise may increase LDL cholesterol and​ decrease HDL cholesterol. Regular physical activity may lower triglycerides and​ raise HDL cholesterol levels.

  • Overweight. Excess weight may modestly increase your LDL (bad) cholesterol level.

  • Age and​ sex. Cholesterol generally rises slightly with increasing age, and​ men are more likely to​ be affected than women.

  • Drinking alcohol excessively. Drinking too much alcohol can damage the​ liver and​ heart muscle.

  • Diabetes. Diabetes is​ a​ significant risk factor for​ all cardiovascular diseases.

  • Smoking. This applies not only if​ you smoke, but also if​ you live or​ work every day with people who smoke.


Lifestyle changes such as​ changing diet, managing weight, increasing exercise, and​ quitting smoking are the​ first steps to​ improving blood levels of​ cholesterol. if​ these changes are not enough, your physician might recommend cholesterol-lowering prescription medication.

Medications to​ improve blood cholesterol levels include:

  • Statins - are the​ most widely used, and​ also the​ most powerful medications for​ lowering LDL cholesterol. They work by reducing the​ production of​ cholesterol in​ the​ liver. Statins not only lower blood LDL cholesterol levels, they also modestly increase HDL cholesterol levels and​ modestly decrease triglyceride levels. These medications are usually well tolerated, have few side effects, and​ are taken once or​ twice a​ day. Currently, six statin drugs are available: atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), and​ rosuvastatin (Crestor).

  • Bile acid sequestrants - these drugs bind with cholesterol-containing bile acids in​ the​ intestines and​ are then eliminated in​ the​ stool. They typically lower cholesterol by 10 to​ 20%. Small doses of​ sequestrants can produce useful reductions in​ LDL cholesterol. Cholestyramine (Questran, Questran Light), colestipol (Colestid), and​ colesevelam (WelChol) are the​ 3 main bile acid sequestrants currently available. Bile acid resins are mainly used in​ young adults with hypercholesterolemia or​ in​ combination with another cholesterol-lowering medication.

  • Cholesterol absorption inhibitors - are a​ new class of​ cholesterol lowering agents approved in​ 2002. Drugs in​ this class work to​ lower blood cholesterol levels by absorbing excess cholesterol in​ the​ intestines and​ thus blocking cholesterol's entry into the​ bloodstream. Ezetimibe (Zetia) is​ the​ first drug in​ this class. Ezetimibe reduces LDL cholesterol by 18-20%. it​ is​ probably most useful in​ people who cannot take statins or​ as​ an​ additional drug for​ people who take statins but who notice side effects when the​ statin dose is​ increased. Adding ezetimibe to​ a​ statin is​ equivalent to​ doubling or​ tripling the​ statin dose.

  • Nicotinic acid or​ niacin - this water-soluble B vitamin improves all lipoproteins when given in​ doses well above the​ vitamin requirement. Nicotinic acid lowers total cholesterol, LDL cholesterol, and​ triglyceride levels, while raising HDL cholesterol levels. Niacin also widens blood vessels, making flushing and​ hot flashes frequent side effects.

  • Fibrates - these cholesterol-lowering drugs are primarily effective in​ lowering triglycerides and, to​ a​ lesser extent, increasing HDL cholesterol levels. These drugs include fenofibrate (Tricor) and​ gemfibrozil (Lopid).

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