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High Cholesterol and Your Risk for Heart Disease

Published on May 08, 2020
Medically reviewed by Lisa Tarasenko, PharmD, MBA

Did you know that our bodies actually need cholesterol to keep us healthy? Your body creates and uses cholesterol to make things our bodies need, such as hormones, vitamin D, and bile acids to help break down food for digestion.

Cholesterol is a waxy substance that is found in body tissue and circulates in the blood. It’s made in your body, specifically in the liver, and is also absorbed from cholesterol-containing foods that you eat. If cholesterol levels in the blood become too high, it becomes a problem because it puts us at risk for heart attack and stroke.

The good, the bad, and the healthy

There are two types of cholesterol; you’ve probably heard them referred to as “bad cholesterol” and “good cholesterol.” Here’s why they are referred to that way.

LDL (or low-density lipoprotein) cholesterol is known as the "bad cholesterol". When LDL levels are too high, it can build up in the walls of your blood vessels as thick, hard deposits called plaque that can clog arteries. This condition is known as atherosclerosis.

Plaque can build up for several years, and then harden over time. Hardened plaque narrows the artery which then reduces blood flow through the artery. The plaque can also break off and form a blood clot which can also block blood flow through an artery. If blood flow to the brain is reduced or blocked, it can result in a stroke. When blood flow is decreased or cut off to the heart, it can cause a heart attack.

HDL (or high-density lipoprotein) cholesterol is sometimes referred to as the “good cholesterol” because it carries the excess cholesterol you no longer need back to your liver where it is removed from the body.

Basically, too much of the bad cholesterol (LDL) or not enough of the good cholesterol (HDL) can put you at risk for coronary heart disease, heart attack or stroke.

Knowing your risk

There are a number of risk factors that can cause high cholesterol, some of which you cannot do anything about, such as your family history. Your genes partly determine how much cholesterol your body makes. Some people inherit genes from their mother and or father that cause them to make too much cholesterol.

Here are some other risk factors for high cholesterol and/or heart disease in general:

  • Being overweight or obese.
  • Lack of physical activity.
  • Smoking.
  • Poor diet.
  • Diabetes.
  • High blood pressure.

What you can do to lower your risk

It’s important to know that high cholesterol does not have any signs and symptoms. The first step to prevention or management of high cholesterol is to talk with your doctor about checking your cholesterol levels (done with a blood test) and assessing your risk for a heart attack or stroke.

There are a number of things that you can do to help lower your risk for heart disease. One way is through lifestyle habits—these include the following:

  • Eat a healthy and balanced diet. Eating foods with certain fats such as saturated fat or trans fats also increases the amount of LDL cholesterol in your blood. Reducing the amount of saturated fat and cholesterol in your diet can help lower your blood cholesterol level.
  • Lose weight. Being overweight is a risk factor for heart disease. Losing weight can help lower your LDL and total cholesterol levels, as well as raise your HDL levels.
  • Exercise regularly. Regular physical activity can help lower LDL cholesterol and raise HDL cholesterol levels. Be sure to speak with your health care provider before starting any new exercise programs.
  • Don’t smoke. Smoking is a factor that increases the risk of heart disease in people who have high cholesterol.

Medication treatment is usually recommended for people who are at increased risk of having a heart attack or stroke such as those who currently have heart disease, have very high levels of LDL or have diabetes.

If your doctor decides that cholesterol-lowering medicines are needed, keep in mind they are meant to be used together with diet and exercise. Current treatment guidelines for high cholesterol focus on lowering your overall risk of heart disease and stroke rather than on “chasing” cholesterol numbers.

References

  • 1. American Heart Association. HDL (Good), LDL (Bad) Cholesterol and Triglycerides.
  • 2. Centers for Disease Control and Prevention. High Cholesterol Facts.
  • 3. Couillard V, Deprés JP, Lamarche B, et al. Effects of endurance training on plasma HDL cholesterol levels depend on levels of triglycerides: evidence from men of the Health Risk Factors, Exercise Training and Genetics (HERITAGE) Family Study. Arterioscler Thromb Vasc Biol. 2001;21(7):1226-1232.
  • 4. Guyton AC, Hall JE. Lipid metabolism. In: Textbook of Medical Physiology. 11thed. Philadelphia, PA: Elsevier; 2006:840-851.
  • 5. Lichtenstein AH, Appel LJ, Brands M, et al; for American Heart Association Nutrition Committee. Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association. Circulation. 2006;114(1):82-96.
  • 6. National Heart, Lung, and Blood Institute.High Blood Cholesterol.
  • 7. National Heart, Lung, and Blood Institute. High blood cholesterol: what you need to know.
  • 8. Stone NJ, Robinson JG, Lichtenstein AH, et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report on the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2889-2934. doi: 10.1016/.jacc.2013.11.002.
  • 9. US Department of Agriculture. Dietary Guidelines for Americans, 2015-2020, 8th ed. Washington, DC: US Department of Agriculture, US Department of Health and Human Services; 2018.

 

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