Rutgers Cancer Institute of New Jersey
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If you have hyperlipidemia, commonly known as “high cholesterol,” you have high levels of lipids in your blood.
Lipids are fats and fat-like substances.
In this condition, the most common types of lipids are cholesterol and triglycerides.
Your body needs cholesterol to function properly. It makes all the cholesterol you need, mostly in your liver.
The cells in your body need cholesterol as part of their cell membrane.
Your skin uses sunlight and cholesterol to make vitamin D.
Certain glands, such as the testicles in men, and the adrenal glands, use cholesterol to make important chemicals, called hormones.
And, your liver uses cholesterol to make bile acids, which help to digest fat in the food you eat.
Your body uses triglycerides for energy. Triglycerides in your blood come from food and your liver.
Foods high in triglycerides include fatty foods, refined carbohydrates, foods high in simple sugars, and alcohol.
From your liver, your lipids are not able to move through your bloodstream without some adjustment.
To enable their movement, your liver wraps certain proteins around the lipids.
The resulting new molecule, called a lipoprotein,
can move through your bloodstream and throughout your body to the cells that need it.
Depending on which type of lipoprotein your cholesterol is part of determines whether your cholesterol is “good” or “bad.”
For example, your liver makes very low-density lipoproteins, or VLDLs, which are the source of “bad” cholesterol, or LDL.
These lipoproteins are stuffed with cholesterol and triglycerides.
VLDL travels through your bloodstream, delivering triglycerides to your cells, which use them for energy.
If your liver makes more VLDL than your body needs for energy, the VLDL stores the extra triglycerides as body fat.
After losing its triglycerides, a VLDL becomes a low-density lipoprotein, or LDL.
LDL travels through your bloodstream, delivering cholesterol to the cells that need it.
If your body makes too much LDL, it can build up in your blood.
LDL can deposit in the walls of your blood vessels, causing a buildup of fatty material, called plaque.
Damage to vessel walls can make it easier for LDL to form plaques.
Over time, this build up can narrow the blood vessel and reduce blood flow. This is why LDL is called the “bad” cholesterol.
A common place this plaque can build up is in your coronary arteries, which are the blood vessels that feed your heart muscle.
This build-up causes coronary artery disease and increases your risk of a heart attack.
Plaque in other arteries, such as the carotid arteries in your neck,
can reduce blood flow to your brain and increase the risk of a stroke.
Your liver also makes high-density lipoprotein, or HDL, also known as the “good” cholesterol.
HDL has more protein and very little cholesterol and triglycerides compared to LDL.
HDL helps remove excess cholesterol from your cells
and from plaque in your blood vessels. This is why HDL is called the “good” cholesterol.
HDL returns the excess cholesterol to your liver, which removes it from your body.
If you are 20 years of age or older, the National Institutes of Health recommends you have a blood test every five years,
called a fasting lipoprotein profile.
It measures your levels of total cholesterol, LDL, HDL, and triglycerides.
During this test, a blood sample will be taken from your arm or finger after you have not eaten for nine to twelve hours.
The total cholesterol goal should be less than 200 milligrams per deciliter.
For most people, an ideal HDL, or “good” cholesterol, should be 60 or higher.
An ideal LDL, or “bad” cholesterol, should be less than 100.
And fasting triglycerides should be less than 150.
Your specific goals may vary depending on your health situation. Ask your doctor what your lipid goals should be.
If your cholesterol levels are too high,
it’s important to eat a heart-healthy diet with lean sources of protein and plenty of fruits and vegetables.
Also, the types of fats you eat can affect your cholesterol level.
For example, saturated fats and trans-fats tend to raise LDL cholesterol in your blood.
These fats are usually solid at room temperature and are found in meat and dairy products,
many processed foods, and tropical oils such as coconut oil, palm oil, and cocoa butter.
Unsaturated fats, including polyunsaturated and monounsaturated fats,
are healthier fats that are usually more liquid at room temperature.
They are found in foods such as fish, nuts, and vegetable oils.
Other lifestyle decisions you can make to help your cholesterol are not smoking,
and getting regular exercise, such as brisk walking or running.
If lifestyle changes can’t reduce your cholesterol levels enough, your doctor may prescribe certain medications to reduce it.
Statins are drugs that reduce the amount of cholesterol made in your liver.
They affect LDL levels more than HDL or triglyceride levels.
Niacin reduces LDL cholesterol and triglycerides, and increases HDL cholesterol made in your liver.
Bile acid-binding resins are drugs that prevent the re-use of bile after helping to digest your food.
As a result, your liver uses more cholesterol to replace the lost bile, which means less cholesterol in your bloodstream.
Fibrates are mainly used to reduce triglyceride levels in your blood, but they can also raise HDL levels.
Cholesterol absorption inhibitors reduce the amount of cholesterol absorbed by your intestines from the food you eat.
In many cases, the same steps can help maintain healthy cholesterol and triglyceride levels, such as:
eating a diet low in saturated fat, trans-fat, and cholesterol, getting regular exercise, managing your weight, and not smoking.