Cholesterol is a substance that is found in the blood. It is needed for good health. Cholesterol helps build cell membranes and synthesise certain hormones for normal body function.
If you get a cholesterol test, you might hear your cardiologist talk about the different types of cholesterol:
- Total cholesterol
- LDL cholesterol – Some people call this the “bad” cholesterol. That’s because having high LDL levels raises your risk of heart attacks, strokes, and other health problems.
- HDL cholesterol – Some people call this the “good” cholesterol. That’s because people with high HDL levels tend to have a lower risk of heart attacks, strokes, and other health problems.
- Triglycerides – Triglycerides are not cholesterol. They are another type of fat. But they often get measured when cholesterol is measured. (Having high triglycerides also seems to increase the risk of heart attacks and strokes.)
Hyperlipidemia is a condition whereby abnormally high levels of fats, or lipids, are found in the blood. Although this includes triglycerides, cholesterol, and other types of fats, many people use the terms hyperlipidemia and high cholesterol interchangeably.
Compared with people with normal cholesterol, people with high cholesterol have a higher risk of heart attacks, strokes, and other health problems. The higher your cholesterol, the higher your risk of these problems.
Hyperlipidemia can significantly increase a person’s risk of developing cardiovascular disease, including disease of blood vessels supplying the heart (coronary artery disease), brain (cerebrovascular disease), and limbs (peripheral artery disease). These conditions happen when the blood vessels get blocked with fatty deposits, restricting blood flow. Left untreated, hyperlipidemia can result in several serious complications such as heart attack, and stroke.
High levels of cholesterol in the blood often result in the build-up of fatty deposits along the walls of the blood vessels, also known as atherosclerotic plaque. Over time, the deposits may increase and cause blockages within the blood vessels. The blockages cause decreased blood flow to the heart muscles and may eventually lead to damage. This is known as coronary artery disease.
Coronary artery disease can sometimes present as a heart attack when there is a sudden break in the cholesterol plaque, causing a blood clot to form.
The cholesterol deposits may also cause vessel stiffness leading to hypertension, or high blood pressure. Together, hyperlipidemia and hypertension increase a person’s risk of heart disease.
Hyperlipidemia can sometimes be caused by genetic factors but is more likely to be caused by various unhealthy lifestyle factors. These include:
- Excessive alcohol consumption
- Smoking
- Lack of physical activity
- Excessive consumption of trans fats and saturated fats
- Excessive consumption of animal proteins
Hyperlipidemia is diagnosed by a blood test known as a lipid profile. This measures:
- Total cholesterol
- Low-density lipoprotein cholesterol
- High-density lipoprotein cholesterol
- Triglycerides
The lipid profile test is usually taken when you are in a fasted state.
Healthy lifestyle choices are key to managing your cholesterol levels, even in cases of inherited hyperlipidemia.
One of the most important factors to consider is diet. A heart-healthy diet is low in fat (especially trans and saturated fat) and cholesterol, and high in fibre. Common ways of achieving a heart-healthy diet include limiting consumption of red meat and introducing more fruits and vegetables into your diet.
Regular physical activity and maintaining a healthy weight is also important when it comes to managing your cholesterol levels. It boosts HDL cholesterol and helps to lower LDL cholesterol as well.
Smoking is known to lower HDL cholesterol, and also amplifies the risk of heart disease, hypertension, and other illnesses by causing damage to the blood vessels. If you are a smoker, quitting smoking can be a big step in reaching healthy levels of blood cholesterol.
Outside of these lifestyle changes, hyperlipidemia can also be treated with lipid-lowering medications. Even if you already have established cardiovascular disease, it’s not too late to lower your risk. In fact, in this case, lipid-lowering treatment can be lifesaving.
- Diet
One of the most important factors to consider is diet. A heart-healthy diet is low in fat (especially trans and saturated fat) and cholesterol, and high in fibre. Common ways of achieving a heart-healthy diet include limiting consumption of red meat and introducing more fruits and vegetables into your diet. - Lifestyle
Regular physical activity and maintaining a healthy weight is also important when it comes to managing your cholesterol levels. It boosts HDL cholesterol and helps to lower LDL cholesterol as well. - Quit smoking
Smoking is known to lower HDL cholesterol, and also amplifies the risk of heart disease, hypertension, and other illnesses by causing damage to the blood vessels. If you are a smoker, quitting smoking can be a big step in reaching healthy levels of blood cholesterol. - Medication
Outside of these lifestyle changes, hyperlipidemia can also be treated with lipid-lowering medications. Even if you already have established cardiovascular disease, it’s not too late to lower your risk. In fact, in this case, lipid-lowering treatment can be lifesaving.
Not everyone who has high cholesterol needs medicines. Your cardiologist will decide if you need them based on your age, family history, cardiovascular risk factors and the presence of cardiovascular disease.
You should take a cholesterol-lowering medicine called a statin if you:
- Already had a heart attack or stroke
- Have known coronary artery disease
- Have diabetes
- Have a condition called peripheral artery disease, which makes it painful to walk, and happens when the arteries in your legs get blocked with fatty deposits
- Have an abdominal aortic aneurysm, which is a widening of the main artery in the belly
Most people with any of the conditions listed above should take a statin no matter what their cholesterol level is.
Many studies have shown that good treatment with statins can prevent further cardiovascular events from occurring. If your cardiologist prescribes you a statin, stay on it. The vast majority of people feel well when taking statins, and it can help prevent heart attacks, strokes, and death.
A small minority feel mainly muscle pain, aches, or weakness. Your cardiologist will be able to monitor these and make adjustments to your treatment. Sometimes, other types of medications may be added on top of statins to further control the cholesterol levels effectively.
Since hyperlipidemia itself does not present with symptoms, it is important to visit a cardiologist to assess your cardiovascular risk and to prevent serious complications. It is important to go for regular lipid profile checks and follow-up. If required, there are very effective treatment choices available.
The long-term cardiovascular risks of untreated hyperlipidemia mean that you should be vigilant in maintaining this aspect of your health. Regular monitoring of your cholesterol level with your cardiologist and healthy lifestyle choices are key to preventing complications.
