High Cholesterol

What is cholesterol?

Cholesterol is a waxy substance that's found in the fats (lipids) in your blood. While your body needs cholesterol to continue building healthy cells, having high cholesterol can increase your risk of heart disease.

When you have high cholesterol, you may develop fatty deposits in your blood vessels. Eventually, these deposits make it difficult for enough blood to flow through your arteries. Your heart may not get as much oxygen-rich blood as it needs, which increases the risk of a heart attack. Decreased blood flow to your brain can cause a stroke.

High cholesterol (hypercholesterolemia) can be inherited, but it's often the result of unhealthy lifestyle choices, and thus preventable and treatable. A healthy diet, regular exercise and sometimes medication can go a long way toward reducing high cholesterol.

What Are the Symptoms of High Cholesterol?

High cholesterol has no symptoms. A blood test is the only way to detect high cholesterol.

In most cases, high cholesterol is a silent problem that typically doesn't cause any symptoms. For most people, if they have not had regular checkups and followed their cholesterol levels, their first symptoms are events like a heart attack or a stroke. In rare cases, there are familial syndromes where the cholesterol levels are extremely high (familial hypercholesterolemia). These people have cholesterol levels of 300 milligrams per deciliter (mg/dL) or higher. Such people may show symptoms from high cholesterol that are due to deposits of cholesterol (xanthomas) over their tendons or under their eyelids (xanthalasmas). While high cholesterol affects a large portion of the United States, familial hypercholesterolemia affects only about one in 500 people.

What Causes High Cholesterol?

Cholesterol is carried through your blood, attached to proteins. This combination of proteins and cholesterol is called a lipoprotein. You may have heard of different types of cholesterol, based on what type of cholesterol the lipoprotein carries. They are:

  • Low-density lipoprotein (LDL). LDL, or "bad," cholesterol transports cholesterol particles throughout your body. LDL cholesterol builds up in the walls of your arteries, making them hard and narrow.
  • Very-low-density lipoprotein (VLDL). This type of lipoprotein contains the most triglycerides, a type of fat, attached to the proteins in your blood. VLDL cholesterol makes LDL cholesterol larger in size, causing your blood vessels to narrow. If you're taking cholesterol-lowering medication but have a high VLDL level, you may need additional medication to lower your triglycerides.
  • High-density lipoprotein (HDL). HDL, or "good," cholesterol picks up excess cholesterol and takes it back to your liver.

Factors within your control — such as inactivity, obesity and an unhealthy diet — contribute to high LDL cholesterol and low HDL cholesterol. Factors beyond your control may play a role, too. For example, your genetic makeup may keep cells from removing LDL cholesterol from your blood efficiently or cause your liver to produce too much cholesterol.

High cholesterol is usually made worse by eating too many unhealthy foods that are high in cholesterol, saturated fats, and trans fats. Examples of foods that contribute to high cholesterol include:

  • red meat
  • liver and other organ meats
  • full fat dairy products like cheese, milk, ice cream, and butter
  • eggs (the yolk)
  • deep fried foods, like potato chips, french fries, fried chicken, and onion rings
  • peanut butter
  • some baked goods, like muffins
  • processed foods made with cocoa butter, palm oil, or coconut oil
  • chocolate

High cholesterol can also be genetic in many cases. This means that it’s not simply caused by food, but by the way in which your genes instruct your body to process cholesterol and fats. Genes are passed down from parents to children.

Other conditions like diabetes and hypothyroidism may also contribute to high cholesterol. Smoking can also increase cholesterol problems..

Who Is at Risk for High Cholesterol?

Over one-third of American adults have raised levels of LDL or "bad" cholesterol, according to the Centers for Disease Control and Prevention (CDC). People of all ages, ethnicities, and genders can have high cholesterol.

You may be at a higher risk of high cholesterol if you:

  • have a family history of high cholesterol
  • eat a diet containing an excessive amount of saturated fat
  • are overweight or obese
  • have diabetes, kidney disease, or hypothyroidism

You're more likely to have high cholesterol that can lead to heart disease if you have any of these risk factors:

  • Smoking. Cigarette smoking damages the walls of your blood vessels, making them likely to accumulate fatty deposits. Smoking may also lower your level of HDL, or "good," cholesterol.
  • Obesity. Having a body mass index (BMI) of 30 or greater puts you at risk of high cholesterol.
  • Large waist circumference. Your risk increases if you are a man with a waist circumference of at least 40 inches (102 centimeters) or a woman with a waist circumference of at least 35 inches (89 centimeters).
  • Poor diet. Foods that are high in cholesterol, such as red meat and full-fat dairy products, will increase your total cholesterol. Eating saturated fat, found in animal products, and trans fats, found in some commercially baked cookies and crackers, also can raise your cholesterol level.
  • Lack of exercise. Exercise helps boost your body's HDL "good" cholesterol while lowering your LDL "bad" cholesterol. Not getting enough exercise puts you at risk of high cholesterol.
  • Diabetes. High blood sugar contributes to higher LDL cholesterol and lower HDL cholesterol. High blood sugar also damages the lining of your arteries.

Complications

High cholesterol can cause atherosclerosis, a dangerous accumulation of cholesterol and other deposits on the walls of your arteries. These deposits (plaques) can reduce blood flow through your arteries, which can cause complications, such as:

  • Chest pain. If the arteries that supply your heart with blood (coronary arteries) are affected, you may have chest pain (angina) and other symptoms of coronary artery disease.
  • Heart attack. If plaques tear or rupture, a blood clot may form at the plaque-rupture site — blocking the flow of blood or breaking free and plugging an artery downstream. If blood flow to part of your heart stops, you'll have a heart attack.
  • Stroke. Similar to a heart attack, if blood flow to part of your brain is blocked by a blood clot, a stroke occurs.

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