CHOLESTEROL

Cholesterol is a fat-like substance that your body produces naturally. The liver produces most of the cholesterol and its concentration varies greatly depending on your diet.

Your body needs cholesterol to work properly and it uses it to produce hormones, vitamin D and other substances that aid digestion. However, if there is a high cholesterol concentration circulating in your blood, it builds up on the walls of your arteries, causing a disease known as atherosclerosis, which increases risks of cardiovascular disease.

Cholesterol is carried through your bloodstream by particles called lipoproteins. When the level of these particles increases, they deposit on the artery walls, causing the artery to clog and stop blood circulation, thus high cholesterol levels become the number 1 risk factor of cardiovascular disease.

Types of cholesterol

It is important to know that there are two main cholesterol types: high density or HDL cholesterol and low density or LDL cholesterol.

LDL cholesterol

known as ‘bad’, can from plaques on the artery walls and stop circulation of blood through the heart and brain.

HDL cholesterol

known as ‘good’, helps eliminate cholesterol excess in your body.



How do I know what my cholesterol levels are?

The only way to know your cholesterol levels is to get a blood test. This test measures three types of fat in the blood: HDL cholesterol (good), LDL cholesterol (bad) and triglycerides. The latter are a type of fat found in the blood and in fat tissue; they also cause hardening and narrowing in arteries. Frequently, when cholesterol levels increase, triglycerides do too.


HIGH CHOLESTEROL AND TRIGLYCERIDE LEVELS INCREASE RISKS OF CARDIOVASCULAR DISEASE.


It is advisable to get a cholesterol test following the doctor’s recommendations, according to each patient’s current health condition.

These factors might indicate you need a test:

  • Are a 45-year-old or older man
  • Are a 55-year-old woman or are going through post menopause
  • Suffer from any heart disease, diabetes, or high blood pressure, as well as having a family history of any of these diseases
  • Have family history of sudden death before the age of 55 (father or brother) and before the age of 65 (mother or sister)
  • Have a waist measurement of greater than 94 cm for men and 80 cm for women
  • Smoke or have smoked during the last year
  • Have erectile dysfunction
  • Have a family history of cardiovascular diseases or stroke

How do I read my cholesterol test levels?

The test results include the following information:

  • HDL Cholesterol (good cholesterol) – it is good sign to see a high number.
  • LDL Cholesterol (bad cholesterol) – it is a good sign to see a low number.
  • Triglycerides- it is not a good sign to present a high concentration number.

The doctor is the only person responsible for giving the patient a solid interpretation of their results. Usually, they will analyze the results of the blood test along with family history and current health condition of the patient.
*Your doctor will help you reach ideal levels, based on your clinical and health risk profile.

The following information can serve you as guide:

Total Cholesterol:

  • Desirable: Less than 200 mg/dl
  • Borderline high: Between 200-239 mg/dl
  • High: 240 mg/dl or more

LDL Cholesterol (‘the bad one’):

  • Less than 70 mg/dl: Optimal for people at high cardiovascular risk
  • Less than 100 mg/dl: Optimal for people at cardiovascular risk
  • 100-129 mg/dl: Near optimal
  • 130-159 mg/dl: Borderline high
  • 160-189 mg/dl: High
  • 190 mg/dl o more: Very high

HDL Cholesterol (‘the good one’):

  • Less than 40 mg/dl: Levels are considered low, cardiovascular risk increases
  • 40-59 mg/dl: Levels are considered normal
  • 60 mg/dl or more: Better, there is larger cardiovascular protection

Triglycerides:

  • Desirable: Less than 150 mg/dl
  • Borderline high: 150-199 mg/dl
  • High: 200-499 mg/dl
  • Very high: 500 or more

Associated complications



High cholesterol levels do not constitute a disease but are an important factor which can increase the risk of serious cardiovascular diseases such as:


  • Heart attack
  • Stroke

Doing your best to improve your lifestyle will help prevent future heart attacks and control cholesterol levels in your bloodstream.



Treatment

In some cases, diet and regular exercising are enough to decrease and control cholesterol levels; however, not every case is the same. There are certain conditions that demand the use of pharmacological treatments to help reduce high concentrations of cholesterol in the bloodstream.

Facing this situation, there are diverse treatments available and your doctor is the only one who can decide what medication is the most appropriate one, based on each person’s clinical history.

Below there is a list of the most common treatments for cholesterol control:

  • Statins

    Statins inhibit the enzyme the liver employs to produce cholesterol. As a result, the liver produces less LDL cholesterol (bad cholesterol), which is picked up from the blood. The reduced levels of LDL might give rise to lower triglyceride levels and higher HDL cholesterol levels (good cholesterol). This type of treatment is the most widely used for cholesterol reduction and absorption.

  • Cholesterol absorption inhibitors

    These inhibitors help reduce LDL cholesterol and total cholesterol in the blood. They inhibit cholesterol absorption into the digestive system, reducing the amount of cholesterol that is absorbed from food.

  • Bile acid sequestrants (resins)

    They reduce the levels of LDL cholesterol. The body uses cholesterol to produce bile, acid employed during digestion. This medication binds to bile acids to prevent it from being used during the digestive process, and thus the liver produces more bile. The more bile it produces, the more cholesterol it needs, resulting in lower levels of cholesterol in the blood stream.

  • Fibric acid derivatives (fibrates)

    They are used to lower triglyceride levels by disintegrating them so that the body reuses them otherwise. This gives rise to lower triglyceride levels and higher HDL cholesterol levels.

  • Niacin

    It helps increase HDL cholesterol levels (good cholesterol) and lowers LDL levels (bad cholesterol), which also has an impact on triglycerides. It is a form of Vitamin B which must be taken to lower cholesterol levels only when your doctor advises so.

  • PCSK9 inhibitors

    It is prescribed when dieting or when other medications are not enough to control or lower the levels of cholesterol. It helps the liver reduce total cholesterol levels, LDL levels (bad cholesterol) and triglyceride levels in the blood, and also manages to increase good cholesterol levels.

It is important that all patients are under medical supervision and that they only take the medication previously prescribed by their physician, following any dosage or other instructions provided; that they attend each of their medical and medical test appointments; and that they choose a healthier lifestyle including a balanced diet and regular exercising.

What foods have the biggest impact on my health?



Highly processed foods or foods high in saturated fat are also high in calories, sodium, and sugar.


Saturated fat increases C-LDL or bad cholesterol levels in the blood. A balanced diet, not skipping any meals, avoiding long fasting periods, controlling your portions, avoiding excesses and reducing highly processed food intake will contribute to maintaining a healthier lifestyle.



How do I reduce risk?

The Canadian foundation ‘Heart&Stroke’ provided the following tips for people who present high cholesterol levels or who wish to prevent them:

  • Follow a balanced diet plan that includes foods low in saturated fat:
    • Eat your meals with a side of fresh vegetables
    • Eat whole-grain foods such as rice and quinoa
    • Choose lean meats, skinless chicken and incorporate fish into your diet a couple of days a week.
  • • Include more vegetables in your meals and choose, as much as possible, vegetarian dishes and sugar-free foods:
    • Avoid desserts or sugary drinks.
    • Have snacks in between your meals. These can be a combination of fruits, vegetables and low-fat foods such as apples or low-fat cheese.
  • Try to cook and have your meals at home more often since this will allow you to choose foods low in fat or not processed at all. And you will enjoy the additional benefit of sharing time with your family while preparing your meals.
  • When preparing your meals, it is also important to reduce the amount of sugar and salt you ingest.
  • It is important to reduce the number of times you eat out in restaurants or at buffets, and if you plan to go out somewhere, it is advisable that you choose places where they cook with fresher vegetables, avoid processed meats, share large portions or take half of it home to eat the next day.
  • Try to reach and keep a healthy weight. Overweight and obesity cause the body to retain more fat and cholesterol.
  • Exercise regularly since this can increase your HDL cholesterol levels (good cholesterol), contribute to weight loss and reduce cardiac risk.
  • Walk, ride a bike, swim or take long walks for 25 or 30 minutes a day.
  • Avoid smoking as it can increase heart-attack risk and reduce HDL cholesterol levels (good cholesterol). When you stop smoking, within a few weeks those levels stabilize and good cholesterol levels start to increase. Similarly, control your blood pressure, sugar levels in your blood (diabetes) and reduce stress.

Food tips

Tip Type of food
Choose foods rich in Omega 3 and polyunsaturated fats Salmon, sardine, trout
Canola oil
Eat moderate portions Corn, safflower or sunflower oil, peanuts, margarine, nuts, salted dry fruits, oil dressings, avocado
Eat small portions Salt, sugar, trans fats, foods like sausages, liver, salami, baloney, chocolate and sugary drinks
Avoid these foods Trans fats in foods like donuts, cookies, croissants, cake, muffins, fast food and fried foods

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