Too much of cholesterol will lead to fat being deposited in blood vessels, subsequently leading to the thickening and blocking of the arteries (arteriosclerosis).
If blood flow to the heart is reduced, it causes angina or heart attack; if the blood vessel affected is in the brain, it causes stroke.
The types
A routine blood test for cholesterol will show the following indicators – LDL, HDL, and triglyceride.
LDL stands for low-density lipoprotein. Lipoprotein, a combination of cholesterol and protein, is how cholesterol is transported in our blood.
LDL is considered ‘bad’ cholesterol because as it transports cholesterol in our body, it causes cholesterol to be deposited in the blood vessel, making it hard.
HLD, or high-density lipoprotein, on the other hand, is good cholesterol as it removes excess cholesterol back to the liver.
Triglyceride is not cholesterol but another type of fat in which its excess is deposited in the arteries causing a narrowing of the passage.
There are many factors that lead to high cholesterol – lack of exercise, diet, smoking, obesity, diabetes and family history.
Lack of exercise increases your blood cholesterol level as exercise helps push the HDL level higher and reduce the LDL level. Diabetes or high blood sugar can lead to higher LDL and lower HDL level while smoking reduces the good cholesterol and damages the blood vessel lining and causes more fat deposition.
If a person has very high cholesterol at a very young age plus strong family history of heart attack or stroke, then the likely reason is hereditary.
The target level
The total cholesterol level should be below 5.2mmol/L (200mg/L) and HDL above 1.3mmol/L (50mg/L). But LDL level is a more important target as LDL is the one that causes deposition of cholesterol and fat in blood vessel.
The target LDL level varies according to your underlying risk factors to develop heart disease or stroke.
If you have risk factors such as diabetes, previous heart attack, hypertension, family history of early heart attack, smoking, over 45 years old for male and 55 for female and low HDL level, then your target LDL level should be below 2.6mmol/L (100mg/L).
If you have a very high risk, your doctor may even aim to reduce your LDL level to less than 1.8mmol/L (70mg/L).
Tackling high level
See your doctor and get a proper assessment first. Your doctor may prescribe medication to lower your cholesterol level if the level is very high or concomitantly, you have many risk factors of heart attack or stroke.
The medications may include statin, cholesterol absorption inhibitor, bile acid binding resin or fibrates. In general, these medications are well tolerated, but some may experience muscle ache, constipation or abnormal liver function.
Keep an optimal weight by exercising regularly, stop smoking if you smoke, and watch your eating habit.
Try to reduce intake of food high in saturated fat, trans fat and cholesterol such as red meat, dairy products, fried food or egg yolks which raise the cholesterol level.
Choose the leaner portion of meat, low fat milk and oil rich in monounsaturated fat such as olive or peanut oil.
Foods that help to reduce cholesterol level are whole grain, fruits, vegetables and omega-3 fatty acid-rich products such as salmon, herring, walnut and almonds.
Alternately, products like barley, fish oil, garlic extract, oat bran found in oatmeal and artichoke extract have been proven to reduce cholesterol level in some.
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