Cholesterol is a waxy substance found in your blood. Your body needs cholesterol to build healthy cells, but high levels of cholesterol can increase your risk of heart disease. With high cholesterol, you can develop fatty deposits in your blood vessels. Eventually, these deposits grow, making it difficult for enough blood to flow through your arteries. Sometimes, those deposits can break suddenly and form a clot that causes a heart attack or stroke.
High cholesterol can be inherited, but it’s often the result of unhealthy lifestyle choices, which make it preventable and treatable. A healthy diet, regular exercise, and sometimes medication can help reduce high cholesterol.
Cholesterol is carried through your blood, attached to proteins. This combination of proteins and cholesterol is called a lipoprotein. There are different types of cholesterol, based on what 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.
- High-density lipoprotein (HDL). HDL, or “good” cholesterol, picks up excess cholesterol and takes it back to your liver.
A lipid profile also typically measures triglycerides, a type of fat in the blood. Having a high triglyceride level can also increase your risk of heart disease.
Factors you can control — such as inactivity, obesity, and an unhealthy diet — contribute to high cholesterol and low HDL cholesterol. Factors beyond your control might play a role, too. For example, your genetic makeup might keep cells from removing LDL cholesterol from your blood efficiently or cause your liver to produce too much cholesterol (www.mayoclinic.org).
Factors that can increase your risk of bad cholesterol include:
- Poor diet. Eating saturated fat, found in animal products, and trans fats, found in some commercially baked cookies and crackers and microwave popcorn, can raise your cholesterol level. Foods that are high in cholesterol, such as red meat and full-fat dairy products, will also increase your cholesterol.
- Obesity. Having a body mass index (BMI) of 30 or greater puts you at risk of high cholesterol.
- Lack of exercise. Exercise helps boost your body’s HDL, or “good,” cholesterol while increasing the size of the particles that make up your LDL, or “bad,” cholesterol, which makes it less harmful.
- Smoking. Cigarette smoking damages the walls of your blood vessels, making them more prone to accumulate fatty deposits. Smoking might also lower your level of HDL, or “good,” cholesterol.
- Age. Because your body’s chemistry changes as you age, your risk of high cholesterol climbs. For instance, as you age, your liver becomes less able to remove LDL cholesterol.
- Diabetes. High blood sugar contributes to higher levels of dangerous cholesterol called very-low-density lipoprotein (VLDL) and lower HDL cholesterol. High blood sugar also damages the lining of your arteries (www.mayoclinic.org).
High cholesterol has no symptoms. A blood test is the only way to detect if you have it.
To keep blood cholesterol numbers in a desirable range, it helps to follow these practices:
- Know your numbers. Adults over age 20 should have their cholesterol measured at least every five years. That gives you and your doctor a chance to intervene early if your numbers start to rise.
- Stick to a healthy diet. Saturated fats, trans fats, and dietary cholesterol can all raise cholesterol levels. Foods thought to keep cholesterol low include monounsaturated fats (such as nuts and olive oil), polyunsaturated fats (such as fish and canola oil), and water-soluble fiber (such as oats, beans, and lentils).
- Exercise and manage your weight. Along with a healthy diet, staying fit and maintaining a normal weight for your height lower your cardiovascular risks by minimizing the odds of other contributing health problems like obesity and diabetes. If you’re overweight, losing as little as 5 to 10 percent of your weight can significantly lower your risk of cardiovascular disease (www.hopkinsmedicine.org).
Lifestyle changes such as exercising and eating a healthy diet are the first line of defense against high cholesterol. But, if you’ve made these important lifestyle changes and your cholesterol levels remain high, your doctor might recommend medication.
The choice of medication or combination of medications depends on various factors, including your personal risk factors, your age, your health, and possible drug side effects. Common choices include:
- Statins. Statins block a substance your liver needs to make cholesterol. This causes your liver to remove cholesterol from your blood. Statins can also help your body reabsorb cholesterol from built-up deposits on your artery walls, potentially reversing coronary artery disease.
- Bile-acid-binding resins. Your liver uses cholesterol to make bile acids, a substance needed for digestion. The medications cholestyramine (Prevalite), colesevelam (Welchol) and colestipol (Colestid) lower cholesterol indirectly by binding to bile acids. This prompts your liver to use excess cholesterol to make more bile acids, which reduces the level of cholesterol in your blood.
- Cholesterol absorption inhibitors. Your small intestine absorbs the cholesterol from your diet and releases it into your bloodstream. The drug ezetimibe (Zetia) helps reduce blood cholesterol by limiting the absorption of dietary cholesterol. Ezetimibe can be used with a statin drug.
- Injectable medications. A newer class of drugs, known as PCSK9 inhibitors, can help the liver absorb more LDL cholesterol — which lowers the amount of cholesterol circulating in your blood. Alirocumab (Praluent) and evolocumab (Repatha) might be used for people who have a genetic condition that causes very high levels of LDL or in people with a history of the coronary disease who have an intolerance to statins or other cholesterol medications (www.mayoclinic.org).
Natural and home remedies for managing high cholesterol
- Lose extra pounds: Losing even 5 to 10 pounds can help lower cholesterol levels.
- Omega-3 fatty acids: Eating foods rich in omega-3 fatty acids may also help reduce heart disease and lower triglycerides. Omega-3 fatty acids decrease the rate at which the liver produces triglycerides. Omega-3 fatty acids also have an anti-inflammatory effect on the body, decrease the growth of plaque in the arteries, and aid in thinning blood. Aim for at least two servings of fatty fish like salmon, mackerel, herring, tuna, and sardines per week. Other dietary sources of omega-3 fatty acids include flaxseed and walnuts (www.mdpi.com).
- Fenugreek: Fenugreek can help in reducing the body’s production of cholesterol, especially low-density lipoprotein (LDL or bad cholesterol) (pubs.acs.org).
- Exercise regularly. With your doctor’s OK, work up to at least 30 minutes of moderate-intensity exercise five times a week or vigorous exercise five times a week (www.mayoclinic.org).
- Pu-erh green tea: There is interest in using pu-erh tea for lowering cholesterol because, unlike other teas, it contains small amounts of a chemical called lovastatin. Lovastatin is a prescription medicine used for lowering cholesterol (www.sciencedirect.com).
Eat a heart-healthy diet: Focus on plant-based foods, including fruits, vegetables, and whole grains. Limit saturated fats, found in red meat and full-fat dairy products, and trans fats, found in many processed foods. Monounsaturated fat — found in olive and canola oils — is a healthier option. Avocados, nuts, and oily fish are other sources of healthy fat.
Don’t smoke. If you smoke, find a way to quit. Smoking appears to increase bad lipoproteins, decrease “good” HDL and hinder the body’s ability to send cholesterol back to the liver to be stored or broken down. Quitting smoking can reverse these effects.
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“Report of the National Cholesterol Education Program Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults.” Archives of Internal Medicine 148.1 (1988): 36-69.
“The place of HDL in cholesterol management: a perspective from the National Cholesterol Education Program.” Archives of Internal Medicine 149.3 (1989): 505-510.
Note: “Western Pharmaceutical” is defined as a system in which medical doctors and other healthcare professionals (such as nurses, pharmacists, and therapists) treat symptoms and diseases using drugs, radiation, or surgery. Quote from National Cancer Institute: http://www.cancer.gov
Holistic Health: is mindfulness of one’s mind, body, emotions, spirit, environment & social group.