What causes high cholesterol?
Cholesterol is good and bad. It is an essential substance for the body at a natural level. However, it is a silent risk that puts people at risk of heart attack if blood levels are too high.
Cholesterol is present in every cell of the body and performs important natural functions related to food digestion, hormone production and vitamin D production. The body produces cholesterol, but people consume it with food, giving it a waxy, oily appearance.
There are two types of cholesterol.
Low-density lipoprotein (LDL), or “bad” cholesterol.
High-density lipoprotein (HDL), or “good” cholesterol.
This article is about the role of cholesterol. Learn about the causes, symptoms, treatment and prevention of high cholesterol.
What is cholesterol?
- Cholesterol is an oily substance. It does not mix with diluted blood.
- It is a lipoprotein that travels throughout the body.
- Cholesterol mass is transported by two types of lipoproteins.
Low-density lipoprotein (LDL): Cholesterol that undergoes this process is bad or “bad” cholesterol.
High-density lipoprotein (HDL): The cholesterol found in HDL is called “good” cholesterol.
Cholesterol has four main functions that we cannot live without.
- Gastrointestinal bile acid production in the small intestine
- This allows the body to produce vitamin D.
- The body can produce certain hormones.
Causes of hypercholesterolemia
High cholesterol is a major risk factor for coronary heart disease and heart attack.
Cholesterol buildup is part of a process that narrows the arteries called atherosclerosis. In atherosclerosis, plaque builds up and restricts blood flow.
Reducing fat intake in the diet can help manage cholesterol levels. Foods containing in particular:
Cholesterol: Found in animal foods, meat and cheese.
Saturated fat: Found in some meats, dairy products, chocolate, baked goods, fried foods, and processed foods.
Being overweight or obese can also raise blood LDL levels. Genetic factors may play a role in increasing cholesterol. People with familial hereditary hypercholesterolemia have very high LDL levels.
Other conditions that can cause high cholesterol include:
- Liver or kidney disease
- Polycystic ovary syndrome
- Pregnancy and other events increase women’s hormone levels.
- Medicines that raise LDL cholesterol and lower HDL cholesterol, such as progestins, anabolic steroids, and corticosteroids
Symptoms of high cholesterol
People with high cholesterol often have no signs or symptoms, but regular screenings and regular blood tests can help detect high levels.
People who don’t get tested can have heart attacks without warning because they didn’t know they had high cholesterol. Regular testing helps reduce this risk.
Cholesterol in food
Harvard Health Report has identified 11 cholesterol-lowering foods that actively lower cholesterol.
- Oats and grains
- Eggplant and okra
- Vegetable oils (rapeseed, sunflower seeds)
- Fruits (mainly apples, grapes, strawberries, citrus fruits)
- Beans and soy foods
- Fatty fish (especially salmon, tuna and sardines).
- Foods rich in fiber
Adding it to a balanced diet can help control cholesterol.
The same report also contains a list of foods that are harmful to cholesterol levels. It contains:
- Red meat
- with dairy products
- Hydrogenated oil
- it is cooked
Levels and ranges
A cholesterol level of 200 milligrams per deciliter (mg/dL) is considered healthy in adults.
- A reading between 200 and 239 mg/dL is high.
- A level of 240 mg/dL or higher is considered high.
LDL cholesterol levels should be below 100 mg/dL.
- 100-129 mg/dL is acceptable for people without health problems, but may be a concern for anyone with heart disease or risk factors for heart disease.
- 130-159 mg/dL
- increased to 160-189 mg/dL.
- This is considered 190 mg/dL or higher.
HDL levels should be high. The ideal number for an HDL level is 60 mg/dL or higher.
- A reading below 40 mg/dL can be a major risk factor for heart disease.
- A reading of 41 mg/dL to 59 mg/dL is too low.
- Prevention of high cholesterol
There are four key lifestyle decisions people can make to lower or maintain healthy cholesterol levels.
- Like heart healthy foods
- Exercise regularly
- Avoid smoking
- Achieve and maintain a healthy weight
These measures can reduce the risk of heart disease and stroke.
Since 2013, guidelines for reducing or preventing obesity have focused on managing lifestyle risks at an early age.
As of 2018, new evidence-based guidelines published in the Journal of the American College of Cardiology urge doctors to discuss the following factors that may increase a person’s risk:
Family and ethnic history
Certain medical conditions increase the risk of high cholesterol, such as chronic kidney disease or chronic kidney disease.
Taking these factors into account may lead to more innovative approaches to treating and preventing high cholesterol.
How can high cholesterol be treated?
There are many ways to treat high cholesterol; These include:
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If a person has high cholesterol, drug treatment depends on the cholesterol level and other risk factors.
Recommendations usually start with diet and exercise, but people at high risk of heart attack may need to take statins or other drugs.
Statins are the main class of cholesterol-lowering drugs. Prescription statins in the United States:
- Atorvastatin (trade name Lipitor).
- Fluvastatin (Lyscol)
- Lovastatin (Mevacor, Altobrew).
- Provastatin (Pravachol).
- Rosuvastatin calcium (Crestor).
- Simvastatin (Zakor)
In addition to statins, your doctor may prescribe:
- Selective cholesterol absorption inhibitors
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- Fiber retention
- Synthesis of niacin
In 2017, researchers reported that a new drug, ezetimibe, can significantly reduce the risk of such events in people at high risk of heart disease. Etezimibe lowers lipid levels by limiting cholesterol absorption from the gut.
In the update, the authors identified another new class of drugs: protein convertase subtilisin/kixin 9 (PCSK9) inhibitors. There is some evidence that these drugs are effective in lowering cholesterol, especially when used with ezetimibe.
New screening guidelines for 2018 recommend a tiered approach based on how high a person’s risk is.
If a person already has heart disease, the doctor may prescribe ezetimibe and a statin. The guidelines recommend adding a PCSK9 inhibitor, especially for high-risk individuals.
However, the guidelines state that PCSK9 inhibitors are expensive and insurance companies do not cover the cost. Therefore, this option is only available to high-risk individuals.
The safety of statins
The use of statins, like all drugs, has caused some controversy because they can have side effects.
- Statin-induced myopathy (muscle tissue disease)
There is a slightly higher risk of developing diabetes and its complications, but this is still controversial
Do not stop taking statins without first talking to your doctor, as this may increase your risk of developing cardiovascular disease.
The doctor may advise:
- Switching to another drug
- Increased cholesterol-lowering efforts due to lifestyle changes
Complications of high cholesterol
Previously, the goal was to reduce the cholesterol level to the target level, say below 100 mg/dl, but this is not the case.
Randomized controlled clinical trials have not provided sufficient evidence to support targeted therapy.
However, some doctors may still use goals to guide treatment.
10-year risk of heart attack
Cholesterol levels will have a significant impact on heart attack risk over the next decade.
The National Heart, Lung and Blood Institute offers an online cardiovascular risk calculator.
Weigh the risks of these factors using research evidence.
- cholesterol level
- smoking status
- blood pressure
Guidelines published in 2018 consider this calculator an important tool in assessing cholesterol levels and risks.