Your Health

Cholesterol

What is cholesterol?

Cholesterol is a normal component of the human body found in every cell. We need small amounts of cholesterol for good health. If blood-cholesterol levels are too high, however, over time cholesterol builds up in the artery walls and restricts blood flow through the arteries. This accumulation of cholesterol in the artery walls is called atherosclerosis. Clogging the arteries that carry blood to the heart muscles and brain is especially dangerous because of increased risk of heart attacks and strokes.

There are two basic types of cholesterol:

  • Low-density lipoprotein (LDL) is sometimes referred to as “bad” cholesterol because it carries cholesterol to the cells in the arteries and contributes to heart disease.
  • High-density lipoprotein (HDL) is considered “good” cholesterol because it cleans cholesterol out of the arteries and moves it to the liver for safe processing. High HDL levels are associated with a reduced risk of heart disease.

Triglycerides, fatty substances in the blood, are measured along with cholesterol levels to help decide the best way to treat high cholesterol. People who eat more fatty foods tend to have higher levels of triglycerides, which could be associated with increased risk of heart disease.

What are the symptoms?

High cholesterol itself rarely has symptoms. It may, however, cause heart attacks and strokes, which do have symptoms.

What are the risk factors?

You may be at risk of high cholesterol if you have a family history of high cholesterol or heart problems before the age of 60. Certain treatable medical conditions such as low thyroid can also cause an increase in cholesterol.

Your lifestyle also affects your cholesterol levels. Your risk for high cholesterol increases if you:

  • eat too many saturated fats, such as higher-fat meats and dairy products
  • drink too much alcohol, which can raise triglycerides
  • smoke
  • do not exercise
  • are 20% heavier than your ideal body weight

Some drugs may affect your cholesterol. If you are on medications and are told your cholesterol is high, check with your Peoples pharmacist.
Diabetic patients should be aggressively treated to achieve very low LDL targets.

How is it diagnosed?

Blood testing can help identify high cholesterol. To ensure that the test is accurate, do not eat or drink anything but water for 8–12 hours before the test. When deciding if cholesterol levels are too high, doctors look more specifically at your total cholesterol, your good (HDL) and your bad (LDL) cholesterol, and triglyceride values. A blood-cholesterol level that is acceptable also depends on how many other risk factors for heart disease you have, such as smoking or high blood pressure.

Canadian guidelines recommend cholesterol screening for:

  • men over 40 and women over 50 who have no health problems that predispose them to high cholesterol (tests no later than every 5 years)
  • adults who have two or more risk factors for coronary artery disease (for example, being overweight, smoking, or having high blood pressure)
  • people diagnosed with diseases attributed to high cholesterol, such as coronary artery disease or peripheral vascular disease (blocked limb arteries)
  • people with diabetes
  • people who show physical evidence of high cholesterol
  • people who have siblings or parents with high cholesterol or early coronary heart disease

Your doctor will help you decide when it is appropriate to repeat cholesterol measurements.

How can I prevent high cholesterol?

Use the following strategies to help prevent high cholesterol:

  • Eat low-fat, high-fibre foods.
  • Exercise regularly.
  • Control your weight.

These preventative lifestyle modifications are also used to treat existing high cholesterol. For more information, see “How Can I Treat High Cholesterol?”

How can I treat high cholesterol?

High cholesterol is usually treated first using lifestyle modifications and, if necessary, medications.

Lifestyle modifications

If you smoke, quitting is crucial because smoking and high cholesterol work together to increase your risk of heart disease and stroke.

If you are overweight, losing weight can help reduce LDL (bad cholesterol), high blood pressure, and your risk for diabetes. You can control your weight using a combination of healthy diet and exercise.

Maintaining a healthy diet may reduce your cholesterol by as much as 10–20%. Follow these guidelines:

  • Reduce saturated fats by cutting down on red meat, dairy fats, and vegetable fats that are hard at room temperature (for example, stick margarine, palm oil, and coconut oil). When it comes to diet, saturated fats are most responsible for raising cholesterol, especially LDL.
  • Substitute unsaturated fats (vegetable oils such as corn, soybean, olive, canola, sunflower, and safflower oil) for saturated fats.
  • Make sure your dietary fat accounts for only 30% of your total calories or less to reduce heart-disease risk. Saturated fats should only account for 10% of your total fat intake.
  • Limit your alcohol intake to 2 or fewer daily drinks (with a weekly limit of 9 drinks for women and 14 for men) to help keep triglycerides levels down.
  • Eat at least 25 g of soy protein daily. Try eating four daily servings of soy-based foods (for example, tofu, soybeans, soy-based meat alternatives, and soy beverages). Soy protein can help reduce cholesterol significantly when combined with a diet low in saturated fat and cholesterol.
  • Choose margarines that contain stanol, a plant sterol that may help reduce cholesterol levels.

Try exercising for 30–60 minutes at a moderate intensity most days of the week. Aerobic physical activity and weight training may increase your HDL (good cholesterol). These activities also reduce other risk factors such as high blood pressure, diabetes, and excess weight. Before starting regular exercise, fill out an exercise safety questionnaire (PAR-Q), available from most fitness centres or your local Peoples Drug Mart or Peoples Pharmacy.

Medications

If lifestyle modifications do not lower your cholesterol enough or you have a serious risk profile, your doctor may recommend one of several types of cholesterol-lowering medications. Ask your Peoples pharmacist about the differences between cholesterol medications. Your doctor may recommend daily ASA to reduce your risk of heart attack and stroke, although ASA does not reduce cholesterol.

Where can I find out more about high cholesterol?

For more information about your medications or other health issues:

  • talk to your Peoples pharmacist
  • read People First, a free health magazine of practical information available from your local Peoples Drug Mart or Peoples Pharmacy

Other resources

Heart and Stroke Foundation of Canada
www.heartandstroke.ca
Regional offices are listed in the phone book.

www.makingtheconnection.ca

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