What Is High Cholesterol?

Cholesterol is a lipid, a fatty substance produced by your liver. In small amounts it plays a positive role in your health, helping to synthesize cell membranes, bile acid, certain hormones, and vitamin D. When joined with proteins, it passes into the bloodstream and circulates through the body in two forms, low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol. LDL is sometimes called “bad cholesterol,” while HDL is known as “good cholesterol.”

Cholesterol is only a problem when there’s more than your body can properly use. Excess LDL cholesterol combines with fats and calcium to create plaque, which builds up in the blood vessels, leading to narrowing of the arteries, hypertension, and a heightened chance of heart disease and stroke. It is partly offset by HDL cholesterol, which helps return excess LDL cholesterol to the liver, where it is removed from the body. 

According to the Centers for Disease Control, about 95 million American adults have total cholesterol levels in the borderline to high range (above 200 mg/dL), which correlates to an elevated risk for major illness. To learn your cholesterol levels, as well as steps you can take to reduce your risk of heart disease and stroke, see your Baptist Health primary care physician. 

Symptoms

One of the difficulties in managing cholesterol is that high cholesterol has no obvious early symptoms. The only way that most people know that they have too much LDL cholesterol is by having their physician perform a blood test to measure the levels.

Complications

If over time plaque buildup becomes extensive, it can trigger serious medical conditions with emergent symptoms, such as:

• Acute coronary syndrome: The loss of blood flow to the heart directly results in angina or chest pain, as well as myocardial infarctions (heart attacks).
• Heart attack: Heart attacks are marked by a variety of symptoms, including chest pressure or pain, nausea, cold sweats, difficulty breathing, and sudden dizziness.
• Stroke: A stroke is a loss of blood flow to the brain – a “brain attack” that parallels a heart attack. Symptoms include numbness in the face or limbs, partial paralysis, blurred vision, difficulty speaking, and loss of balance or coordination. 

Causes

The human body requires small amounts of cholesterol but is typically capable of producing all that it needs. This means that cholesterol introduced through food consumption may be excessive, especially if your diet is high in bad cholesterol, along with saturated and trans fats. Smoking, immoderate alcohol consumption (more than two drinks daily), and sedentary living (lack of exercise) can contribute to cholesterol levels as well. 

Genes also play a role in high cholesterol. There is gene-influenced variation in how bodies manufacture and absorb cholesterol, and some of that variation is heritable. Medical conditions, such as diabetes and hyperthyroidism, can also impact your cholesterol levels. 

The following are generally regarded as risk factors for high cholesterol:

• Unhealthy diet
• Physical inactivity
• Obesity
• Use of tobacco products
• Excessive alcohol consumption
• Genetic factors inherited from your parents
• Hyperthyroidism, diabetes, and kidney disease
• Stress

Diagnosis

High cholesterol is diagnosed with a kind of blood test called a lipid panel. A lipid panel documents the amount of cholesterol in your bloodstream – good, bad, and overall. The chart below shows acceptable, borderline, and high levels of bad and total cholesterol. The unit of measure is milligrams of cholesterol per deciliter of blood (mg/dL). 

These are only rough guidelines. Your physician will interpret them in light of other factors that apply to your personal health (for example, whether your family medical history shows evidence for heart disease and stroke):
 

Lipid panels also measure the amount of HDL or good cholesterol in your bloodstream. As a rule of thumb, you want a reading of at least 50 mg/dL of good cholesterol, and 60 mg/dL or more is even better. Women generally require more HDL cholesterol than men. 

Another health factor measured in a lipid panel is the triglyceride. Triglycerides are an energy source that have negative effects in too-high numbers.

Treatment

Lifestyle changes – better diet, more exercise, weight loss, and elimination of tobacco products – are the preferred methods for lowering cholesterol. Though good for your overall health, these changes don’t always have the desired effect of reducing cholesterol enough. In those cases, your physician may prescribe one or more of the following medications. 

Bile-Acid-Binding Resins

Bile-acid-binding resins offer an indirect approach to decreasing your cholesterol count. These medications bind with bile acids made by your liver, which are necessary for digestion. When this happens, the liver turns to your body’s excess cholesterol to increase production of the acids. Converted cholesterol is not a health threat.

Cholesterol Absorption Inhibitors  

Cholesterol absorption inhibitors block the small intestines from processing dietary cholesterol for use. 

PCSK9 Inhibitors

A new category of injectable medications, called PCSK9 inhibitors, increases the liver’s capacity for absorbing excess LDL cholesterol. PCSK9 inhibitors are most frequently used with persons who have unusually high cholesterol readings, possibly due to an inherited medical condition. 

Statins  

Statins cause the reabsorption of cholesterol from circulation by blocking the liver’s ability to produce additional quantities. Some of the reabsorbed cholesterol may originate in plaque deposits found in the blood vessels. There are a variety of statins available as prescription medications.