Cholesterol Management

Overview of cholesterol management

Cholesterol is an important element of the body. It regulates several physiological mechanisms and helps maintain a healthy lifestyle. Any abnormalities in the level of blood cholesterol may give rise to multiple complications. This may predispose a person to several diseases. Hence cholesterol management has become an integral part of global health maintenance programs. In the mid 1980s, the National cholesterol Education Program and American Heart Association collaborated and initiated a national campaign to spread the mass awareness related to health risks of cholesterol and effective cholesterol management. A high cholesterol level in different countries has impacted the morbidity and mortality rates.

What is cholesterol?

Cholesterol is a whitish, waxy and fatty material that generates from the liver. Saturated fats present in diet can also generate cholesterol. It is carried by the circulating blood. It performs a few essential functions like-

• Generation and maintenance of cell membrane
• Produce bile (essential for absorption and digestion of consumed fat)
• Prepare Vitamin D and regulate hormones such as oestrogen and testosterone

Cholesterol is naturally generated within the human body. It has a threshold level. A rise in this level of blood cholesterol  is known as “hypercholesterolemia”. It gives rise to serious complications within the body. For an effective cholesterol management, one should avoid a diet rich in trans fats and triglycerides.

What are the causes of high cholesterol?

A high cholesterol level in the body is a primary risk factor for several physiological complications. These conditions are common in men above 45 and women above 55 years of age. The common triggers are as follows-

• Unhealthy diet: Diet rich in saturated and trans fat cause an increase in cholesterol in blood. Poultry, eggs, dairy products and red meat are few examples of fatty diet. High intake of sodium in diet also contributes to the disease.
• Obesity: Increase in weight can increase the level of Low Density Lipoproteins (LDL) and triglycerides in the body.
• Physical activities: Complete lack of physical activities and work-outs is affects health. It inhibits the absorption of fats and triglycerides.
• Age: Different physiological changes occur with age. A few common changes are, weak heart muscles, kidney dysfunctions and the degeneration of the liver cells. This predisposes an individual to several diseases.
• Gender: Men are more susceptible to the disease than women. High blood cholesterol symptoms manifest themselves within men after the age of 40. Women experience similar symtpoms after the age of 55.
• Genes: High cholesterol conditions are hereditary. People who have a family history of the disease are more likely to develop it in future.
• Existing diseases: Chronic diseases like Hypothyroidism, renal dysfunctions, cardiovascular disorders and liver diseases can be responsible.
• Medications: Certain drugs like corticosteroids, diuretics, caffeine and narcotics can trigger high cholesterol (LDL) conditions.
• Addictive habits: Smoking and alcoholism can impede normal liver functions and cause high cholesterol.

What are the different types of cholesterol?

High cholesterol condition mainly arises due to abnormal levels of mainly three types of lipids (fats) and lipoproteins in the body. These are as follows-

• Low-density Lipoproteins (LDL): This type of cholesterol is called “bad cholesterol”. It can combine with other fatty substances which are then carried by blood to the different body tissues. These substances slowly deposit on the walls of arteries (plaque formation) and cause obstruction of arterial passages which leads to coronary heart diseases in future. LDL cholesterol concentration should be kept as low as possible (below 130 mg/dL)
• High-density Lipoproteins (HDL): This is called “good cholesterol”. It usually carries excess cholesterol from the arterial tissues to the liver where they are excreted. Thus risks of heart blockage due to fat deposition are reduced. Higher HDL levels are desirable within the body (above 45 mg/dL). Regular exercise can help achieve this.
• Triglycerides: These belong to the third category of fats and are present in the body of high blood pressure or alcoholic patients. They should be kept below 150 mg/dL).

Clinical complications of high cholesterol

This disease does not have noticeable symptoms. Hence after a certain age (normally 40), people should go for regular check-ups. Progress of the disease can give rise to some serious clinical complications. These are as follows–

• Coronary heart disease: The deposition of excess cholesterol on the inner walls of the coronary artery of the heart can cause this disease.
• Atherosclerosis: In this condition, the heart muscles become thick due to plaque formation.
• Carotid artery disease: It occurs due to the formation of plaque inside carotid artery (supplies blood to brain). It may lead to brain stroke in future.
• Peripheral artery disease: It occurs due to arterial blockage in the limbs.
• Renal failure: Excess cholesterol cannot be excreted and exerts pressure on the walls of kidneys causing renal failure in future.
• Muscular failure: Excess cholesterol might affect the skeletal muscles as well causing muscular dystrophy (muscle stiffening) in advanced stages.

Is there any genetic connection?

According to the reports of British Heart Foundation, 1 in 500 people in UK suffer from Familial Hypercholesterolemia.

It is common in people who have a family history of the disease.

Extensive research proves that the mutations of specific genes like APOB or PCSK9 (determine the amount of cholesterol produced in the body) can cause cholesterol in future generations.

Diagnosis of high cholesterol

Doctors recommend lipid profile tests to determine the levels of –

• Total cholesterol
• LDL cholesterol
• HDL cholesterol
• Triglycerides

Treatment and Prevention

Cholesterol-related health complications are mostly tied closely to lifestyle and diet choices.It is thus important to maintain special care in having a healthy diet, rich in fresh fruits and vegetables that is rich in fibre, essential nutrients, healthy fats etc. Having a physically active routine,  that includes atleast 20-30 minutes of exercise 4-5 days a week.

One should stay away from toxic habits such as drinking and smoking. Nicotine, alcohol, trans-fats, and sugar are the biggest culprits for bad cholesterol management that inevitably lead to heart issues.

WHO reports show that one-third of the ischemic heart diseases worldwide occur due to high levels of cholesterol. Nearly 2.6 million fatalities have been reported globally due to high cholesterol levels. The steadily increasing morbidity rates have made National Stroke Association spread the mass awareness related to heart diseases (especially in low and middle-income countries ) that might arise due to increased cholesterol levels in the body.

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