High Cholesterol

1 What Is High Cholesterol?

Cholesterol is an important component of cell membranes. Cholesterol is a fat-like, waxy substance your body needs to manufacture hormones, vitamin D, and other essential biochemicals. A major portion of cholesterol is produced by the body while the remaining portion is supplied through diet. Although cholesterol is important for the body’s functioning, excess cholesterol beyond the normal range can be harmful. The waxy substance mixes with other components in the blood and clogs the arteries by sticking to the artery walls. This blockage is known as plaque, and it causes various health conditions, such as narrowing of the arteries and blockages.

There are two types of cholesterol, namely, good cholesterol and bad cholesterol. Various factors like age and lifestyle can raise the levels of bad cholesterol in the blood, which can cause fatal conditions like heart disease, as well as put one at a high risk of heart attack. Cholesterol is known as a silent killer, as high cholesterol doesn't have any specific symptoms. The best way to measure cholesterol levels is with a blood test. Various factors, including heredity, poor eating habits, or being overweight, can contribute to high levels of cholesterol in the body. High cholesterol is often a warning sign of future health conditions that could occur at any time. The best way to lower cholesterol levels is to immediately start working out and consuming healthy foods, including fiber-rich fruits and vegetables. In certain extreme cases, the doctor may also suggest medications to improve cholesterol levels.

Why You Need to Measure Your Cholesterol Level

There is a simple, but important relation between your cholesterol level and the risk of heart disease. Higher blood cholesterol levels significantly increase your risk of developing heart disease or having a heart attack.

What Is the Relation Between Cholesterol Level and Heart Disease?

An elevated cholesterol level causes a build-up of fat-like substances in the walls of the arteries. Gradually, the accumulation results in "hardening of the arteries," causing them to narrow (atherosclerosis).

Narrowed arteries cannot transport enough blood to the heart. A reduced blood flow to the heart means it is deprived of oxygen, which can lead to chest pain and worse.

In more serious cases, when certain portions of the heart do not receive blood due to obstruction in the arteries, the result is a heart attack. You may not realize you are carrying more than necessary amounts of cholesterol in your blood since high cholesterol may not cause any symptoms for years.

Remember to have a regular cholesterol check-up to lower your risk of heart disease.

How Can You Interpret Cholesterol Numbers?

Individuals twenty and older are recommended to have cholesterol measurements at least once every five years. You may ask for a blood test called a lipoprotein profile to quantitatively determine your cholesterol numbers.

You need to fast for nine to twelve hours before this test. A lipoprotein profile determines your total cholesterol:

  • LDL (bad) cholesterol, which causes cholesterol buildup and obstruction in the arteries
  • HDL (good) cholesterol, which keeps your arteries safe from depositions of cholesterol
  • Triglycerides, another fatty substance in the blood

Find out what your blood cholesterol means by determining the total cholesterol level category:

  • Less than 200 mg/dL: Desirable
  • 200-239 mg/dL: Borderline-High
  • 240 mg/dL and above: High

Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. The LDL cholesterol level LDL-cholesterol categories are as follows:

  • Less than 100 mg/dL: Optimal
  • 100-129 mg/dL: Near optimal/above optimal
  • 130-159 mg/dL: Borderline-High
  • 160-189 mg/dL: High
  • 190 mg/dL and above: Very high

Note that:

  • Total cholesterol includes the levels of both HDL (good) and LDL (bad) cholesterol.
  • High levels of HDL is good for the heart, whereas high levels of LDL are bad.
  • Triglycerides can also raise heart disease risk. Levels that are borderline-high (150-199 mg/dL) or high (200 mg/dL or more) may need treatment in some people.

What Are the Determinants of Your Cholesterol Levels?

There are various determinants for cholesterol levels, but here are some factors under your control:

  • Diet: Intake of fatty foods can pump up the levels of cholesterol. So, limit your fat intake, especially saturated fat.
  • Weight: More pounds mean higher cholesterol and higher risk for heart disease. Shedding some pounds is good for your heart, too, because it raises your HDL and lowers your triglyceride levels.
  • Physical Activity: Exercise not only helps you reduce your weight, it also raises good cholesterol and lowers bad cholesterol. Aim for at least thirty minutes of exercise on most days of the week.
  • Waist circumference: Your cholesterol levels could have a direct relationship with your waist size. Men with a waist size above forty inches and women with a waist size above thirty-five inches are at a high risk of having increased cholesterol levels.
  • Diabetes: People suffering from diabetes are very likely to have increased cholesterol levels, as higher amount of glucose in the bloodstream naturally interferes with the flow of blood and can cause certain blockages.

Those at risk include:

  • Older women: Getting older is a major risk factor for a rise in cholesterol level. Being a woman is another risk factor.
  • Heredity: High cholesterol levels have been observed to run in families.

What Is Your Risk Score?

Higher LDL levels and other risk factors increase the chances of developing heart disease. To find your risk score, follow these steps:

  • Step 1: Check the table below to see how many of the listed risk factors you have; these factors affect your LDL goal.
    • Major risk factors for elevated LDL level include:
      • Cigarette smoking
      • High blood pressure (140/90 mmHg or higher, or if on blood pressure medication)
      • Low HDL cholesterol (less than 40 mg/dL)
      • Family history of early heart disease (heart disease in the father or brother before age fifty-five; heart disease in the mother or sister before age sixty-five)
      • Age (men forty-five years or older; women fifty-five or older)
      • If your HDL cholesterol is 60 mg/dL or higher, subtract one from your total count.
  • Step 2: If you have two or more risk factors in the table above, use the attached risk scoring tables (which include your cholesterol levels) to find your risk score. Risk score refers to the chance of having a heart attack in the next ten years, given as a percentage. Your risk score is ________%.
  • Step 3: Use your medical history, number of risk factors, and risk score to determine your chances of developing heart disease or having a heart attack.
    • Heart disease, diabetes, or a risk score more than 20%*: I. High Risk
    • Two or more risk factors and a risk score of 10-20%: II. Next-Highest Risk
    • Two or more risk factors and a risk score less than 10%: III. Moderate Risk
    • Zero or one risk factor: IV. Low-to-Moderate Risk

Category one means that more than twenty out of one hundred people will have a heart attack within ten years.

Your risk category is ______________________.

Complications Associated With High Cholesterol Levels

High cholesterol is often a symptom of another major disease that can sometimes be fatal. Many times, high cholesterol can lead to certain conditions like atherosclerosis, which, in simple terms, is the clogging of cholesterol and various other deposits in the artery walls. These deposits eventually affect the blood flow throughout the body and can cause severe complications. Some of the most common complications associated with high cholesterol levels are:

  • Chest pain: When the built-up cholesterol begins to restrict the flow of blood, the arteries start to become clogged, which can sometimes result in severe chest pain, or angina, which is often a symptom of severe cardiac disease.
  • Heart attack: If the plaque starts to tear or rupture, there is a chance of a blood clot developing in the arteries, which eventually causes a blockage in the blood flow. If the blood flow to a particular part of the heart stops, one may be headed towards a heart attack.
  • Stroke: Just like a heart attack, when the flow of blood to a particular part of the brain is restricted, there is a high chance of stroke.


Treatment is aimed primarily at lowering LDL levels. There are two main ways to lower your cholesterol:

  • Lifestyle Modifications: This includes a healthy diet, smoking cessation, physical activity, and weight management.
  • Medications: There are a wide variety of cholesterol-lowering medications. A combination of lifestyle changes and medication is often the best course of action. Your doctor will recommend an appropriate cholesterol-lowering drug based on your cholesterol level, lifestyle, and the expected results. Medicines like statins, bile acid sequestrants, nicotinic acid, fibric acids, and cholesterol-absorption inhibitors may be used.
    • Statins: Statins are a class of medicines which work on blocking the element used by the liver to make cholesterol. With the help of these statins, the body is able to get the cholesterol out of the bloodstream. Statins are also helpful in reabsorbing the cholesterol deposited in the arteries, which aids in diluting the blockages as the build-up deposits are reutilized by the body.
    • Bile-acid-binding resins: The liver utilizes the cholesterol in the body to secrete bile juices that aid digestion. Medicines like cholestyramine (Prevalite), colesevelam (Welchol), and colestipol (Colestid) help reduce cholesterol levels in the body by binding to the bile acids. This in turn helps the liver utilize the excessive cholesterol to secrete more bile juices, which thereby reduces the excessive cholesterol present in the bloodstream.
    • Cholesterol-absorption inhibitors: These medications help restrict the levels of cholesterol absorbed from the diet by the small intestines. Such drugs are usually consumed along with statins for better impact.
    • Injectable medications: People who have a genetic disorder leading to high levels of cholesterol are often recommended these newer classes of drugs which are available in an injectable form. This medication is normally advised for people who have intolerance to statins or other cholesterol medicines.

Alternative Treatments for Reducing Cholesterol

There are several natural and alternative treatments recommended for reducing high cholesterol levels in the body. However, before opting for any supplements, it is extremely important to discuss them with the treating doctor, as certain remedies may not be right for some people with other health issues. Some of the most recommended alternative and natural treatment options are:

  • Garlic: Several studies have proven the health benefits of consuming garlic. It has been observed to reduce cholesterol in the blood to a certain extent, although it may be only a short-term impact. After the garlic treatment, following a proper diet and workout regimen can help return cholesterol levels to normal.
  • Fiber: Consuming fiber supplements in order to meet one’s everyday recommended intake can help reduce cholesterol levels to a large extent, particularly the bad cholesterol present in the blood. Fiber supplements are helpful in maintaining the fiber balance in the body. However, when consuming these supplements, one must consume them slowly and drink adequate amounts of water to prevent gas and cramping in the stomach.
  • Guggulipid: Guggulipid is an extract derived from the gum resin contained in the mukul myrrh tree. It is an age-old remedy that has been often used in the traditional ayurveda. Guggulipid immediately reduces bad cholesterol levels in the blood. However, this remedy could react with various other medications, so a doctor’s consultation is extremely important before consuming this medicine. 

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