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High Cholesterol

(Cholesterol, High; Hypercholesterolemia)

by Rosalyn Carson-DeWitt, MD

Understanding Cholesterol Levels

Definition

Cholesterol is a type of lipid in the blood. High cholesterol is an abnormally high level of cholesterol in the blood.

There are different types of cholesterol in your blood including:

  • Low density lipoproteins (LDL)—causes build up of cholesterol and other fats in the blood vessels. Known as bad cholesterol because high levels can cause disease in the arteries and heart disease.
  • High density lipoproteins (HDL)—can remove cholesterol and other fats from the blood. Known as good cholesterol because it may protect against heart disease.

Causes    TOP

Causes of high cholesterol include:

  • Genetics
  • High-fat diet
  • Overweight
  • Sedentary lifestyle

Risk Factors    TOP

Factors that may increase your risk of high cholesterol include:

  • Age: cholesterol levels tend to rise with age
  • Sex:
  • Family members with high cholesterol
  • High-fat diet
  • Obesity, overweight
  • Sedentary lifestyle

Symptoms    TOP

It is rare for high cholesterol to cause symptoms. However, high cholesterol can increase your risk of atherosclerosis. This is a dangerous hardening of the arteries. It can block the flow of blood. Some complications of atherosclerosis include:

Some people with high cholesterol may also have cholesterol deposits in tendons, under the eyes, or in the eye.

Atherosclerosis

atherosclerosis
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Diagnosis    TOP

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor will ask about factors that may increase your risk of heart disease or stroke.

A blood test will also be done. Blood will be sent to a lab to measure lipid levels in your blood. Tests may include:

  • Total cholesterol
  • HDL cholesterol
  • LDL cholesterol
  • Triglycerides

Your doctor may do other tests to look for other conditions that can be associated with high cholesterol levels.

Treatment    TOP

Talk to your doctor about the best treatment plan for you. Treatment is aimed at decreasing your LDL cholesterol levels and decreasing your risk for heart disease and stroke. Options include:

Nutritional Changes

Talk to your doctor about the best meal plan for you. Consider the following changes:

  • Balance the amount of calories you are eating with the amount of calories you use through physical activity and basic body functions. This will help you reach or maintain a healthy weight.
  • Eat a diet that is high in fruits and vegetables.
  • Include foods that are whole grain and high in fiber.
  • Eat fish at least twice per week.
  • Limit foods with saturated fats, trans fats, or cholesterol.
  • Avoid processed and refined sugars and starches. This includes white bread, white potatoes, white rice and simple sugars like soda.
  • Choose and prepare foods with little or no salt.
  • If you drink alcohol, drink in moderation.

Lifestyle Changes

  • Begin a safe exercise program with the advice of your doctor.
  • If you smoke, quit.
  • If you are overweight, lose weight.
  • Make sure other medical conditions such as high blood pressure and diabetes are being treated and controlled.

Cholesterol-Lowering Medication

Your doctor may prescribe medications statins to help lower your cholesterol. Statins have been shown to reduce mortality, heart attacks, and stroke.

These medicines are best used as additions to diet and exercise. They should not be use in place of healthy lifestyle changes.

Prevention    TOP

To help reduce your chance of getting high cholesterol, follow the lifestyle and nutrition changes above.

RESOURCES:

American Heart Association
http://www.heart.org
National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

CANADIAN RESOURCES:

Canadian Cardiovascular Society
http://www.ccs.ca/home/index_e.aspx
Heart and Stroke Foundation of Canada
http://www.heartandstroke.com

References:

Cholesterol. American Heart Association website. Available at: http://www.heart.o.... Accessed March 22, 2013.
Explore high cholesterol. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/hbc/. Updated September 19, 2012. Accessed March 22. 2013.
Hypercholesterolemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated February 7, 2013. Accessed March 22, 2013.
Lipid-lowering pharmacotherapy overview. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated March 3, 2013. Accessed March 22, 2013.
Third report of the expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). National Cholesterol Education Program website. Available at: http://www.nhlbi.nih.gov/guidelines/cholesterol/index.htm. Updated 2004. Accessed March 22, 2013.
12/14/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Ferdowsian HR, Barnard ND. Effects of plant-based diets on plasma lipids. Am J Cardiol. 2009;104(7):947-956.
Last reviewed February 2013 by Brian Randall, MD
Last Updated: 3/22/2013