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Hypercholesterolemia,
or high cholesterol, is a high level of cholesterol in the
blood that can cause plaque to form and accumulate leading to
blockages in the arteries (atherosclerosis), increasing the
risk for heart attack, stroke, circulation problems, and
death.
What
Is Cholesterol?
Cholesterol is a soft, waxy fat particle (lipid) that
circulates in the blood. It has several important functions in
the body: it is a building block for all cell membranes and
many sex hormones
(estrogen & testosterone) & steroid hormones, and is the digestive substance released by
the gall bladder.
The body produces cholesterol in the liver. The liver, in
fact, produces almost all of the cholesterol the body needs.
However, many popular foods contain cholesterol and the
substances used to produce cholesterol particles, which can
increase the amount of cholesterol in the blood.
Being insoluble in blood,
cholesterol is circulated around the body with the help of
protein carriers called lipoproteins.
Two of these protein carriers are low-density
lipoproteins (LDL) "bad
cholesterol" & high-density lipoproteins (HDL)
"good cholesterol" . Lipoproteins are
differentiated according to the degree of density.
LDL is responsible for transporting cholesterol from
the liver to various tissues & body cells
while HDL basically delivers any excess or unused cholesterol
back to the liver to have it broken down to bile
acids for excretion.
The measuring unit for cholesterol is milligrams per
deciliter of blood (mg/dl).
Healthy cholesterol levels for LDL should be lower
than 130 mg/dl while HDL should be more
than 50 mg/dl. However, the ratio bewteen the HDL &
LDL is something to pay attention to.
How
Cholesterol Causes blockage in the arteries
When the body has too much of LDL, i.e. above 160 mg/dl,
the LDL or "bad cholesterol" as it's called starts
to accumulate along the the interior walls of arteries (blood
vessels supplying oxygen to the heart & brain), causing a
build-up or forming a plaque &
even then, blood clots could also
appear on the plaque restricting oxygen, blood & nutrients
from getting to the heart & brain. Such a phenomenon could
inevitability cause heart
disease leading to heart attack or stroke.
Causes & symptoms
There are no readily apparent symptoms that indicate high LDL
or triglycerides, or low HDL. The only way to diagnose the
problems is through a simple blood test. However, one general
indication of high cholesterol is obesity. Another is a
high-fat diet.
Diagnosis
High cholesterol is often diagnosed and treated by general
practitioners or family practice physicians. In some cases,
the condition is treated by an endocrinologist or
cardiologist. Total cholesterol, LDL, HDL, and triglyceride
levels as well as the cholesterol to HDL ratio are measured by
a blood test called a lipid panel. Home cholesterol
testing kits are available over the counter but test only for
total cholesterol. The results should only be used as a guide
and if the total cholesterol level is high or low, a lipid
panel should be performed by a physician. In most adults the
recommended levels, measured by milligrams per deciliter (mg/dL)
of blood, are: total cholesterol, less than 200; LDL, less
than 130; HDL, more than 35; triglycerides, 30-200; and
cholesterol to HDL ratio, four to one. However, the
recommended cholesterol levels may vary, depending on other
risk factors such as hypertension, a family history of heart
disease, diabetes, age, alcoholism, and smoking.
Treatment
The primary goal of cholesterol treatment is to lower LDL to
under 160 mg/dL in people without heart disease and who are at
lower risk of developing it. The goal in people with higher
risk factors for heart disease is less than 130 mg/dL. In
patients who already have heart disease, the goal is under 100
mg/dL, according to FDA guidelines. Also, since low HDL levels
increase the risks of heart disease, the goal of all patients
is more than 35 mg/dL.
In both alternative and conventional treatment of high
cholesterol, the first-line treatment options are exercise,
diet, weight loss, and stopping smoking. Other alternative
treatments include high doses of niacin, soy protein, garlic,
algae, and the Chinese medicine supplement Cholestin (a red
yeast fermented with rice).
Remedies
to reduce cholesterol
- Garlic. Studies suggest that garlic may lower
total cholesterol levels by an average of about 9%.
However, some of the recent, more well-designed studies
(in which half of the group was treated with garlic and
the other half with a placebo) have found no beneficial
effect produced by garlic on either total cholesterol or
LDL levels. What can be concluded from this? The best that
can be said, from a scientific point of view, is that
garlic may at most have a modest effect on cholesterol
levels but should not be used instead of other
interventions.
- Oat bran. Oat bran mania swept across the United
States a decade ago. Research (including one report
published in the New England Journal of Medicine)
found that oat bran, per se, had little impact on
cholesterol levels. Rather, any beneficial effects were
attributable to the fact that people were eating more oat
bran and less fat.
- Cholesterol-lowering margarine. The Food and Drug
Administration (FDA) recently approved two of these
products, Benecol® and Take Control®, for marketing.
These margarines contain plant-derived substances that can
decrease the absorption of cholesterol in the digestive
tract. They modestly reduce cholesterol by about 7%-10%.
They should not be used instead of drug therapy but can be
added to a treatment plan for hypercholesterolemia.
High
Blood Pressure / Hypertension
Many people have
high blood pressure for years without knowing it. Uncontrolled
high blood pressure can lead to stroke, heart attack, heart
failure or kidney failure. The only way to tell if you have
high blood pressure is to have your blood pressure checked.
According to recent estimates, one in four U.S. adults has
high blood pressure, but because there are no symptoms, nearly
one-third of these people don't even know they have it. This
is why high blood pressure is often called the "silent
killer."
More...
Coronary
heart disease - CHD
