MHVI Owners Manual . Conditions . High Blood Cholesterol

What Is It?
High blood cholesterol, or hypercholesterolemia, is one of the major risk factors for cardio-vascular disease. Cholesterol, a type of lipid or fat, is a soft, wax-like substance that the body needs to work properly. It is an essential part of our cells. The body produces all the cholesterol it needs in the liver. But in some people the body makes more cholesterol than it can use. The excess cholesterol then circulates in the blood stream waiting to be carried back to the liver for removal.

In many cases, the liver is not able to dispose of all the extra cholesterol. It may be that there is simply too much cholesterol to be eliminated, or it may be that the liver's cholesterol clearing process is not functioning efficiently. At times, both problems are present. Because of cholesterol's waxy makeup, it does not dissolve in the bloodstream, but travels through the blood as microscopic particles called lipoproteins. These excess particles of cholesterol in the blood contribute significantly to the formation of plaque, the substance that builds up on artery walls when you have atherosclerosis.

Blood cholesterol levels can also be increased by the foods you eat. Cholesterol in your diet comes from animal proteins such as meats, dairy products, and poultry. But the main dietary culprit for increased cholesterol in your blood system is the amount of fat in your diet. If you eat a diet that is high in cholesterol and fat, you will increase the excess cholesterol in your blood. If you have a family history of high cholesterol, it may be even harder for you to keep your levels low.

Elevated blood cholesterol does not cause any symptoms you would notice. Therefore, the only way to know if your cholesterol level is high is to have it tested. The blood test used to measure your cholesterol levels is called a lipid profile. This profile provides the total blood cholesterol level, but also includes information on two important components, LDL (low density lipoproteins), and HDL (high density lipoproteins).

Cholesterol is a substance that your body needs to work properly, but your liver produces all the cholesterol your body requires. Eating foods that are high in fat, especially saturated fat, slows down the elimination of cholesterol and helps keep blood levels of cholesterol high. Elevated blood cholesterol is a major risk factor for heart disease.

In evaluating your lipid profile, your doctor or nutritionist will look at several numbers. The first is your total cholesterol. The desirable range for your total cholesterol is less than 200 mg/dl. The next level your doctor will check is your LDL. LDL is known as the "bad" cholesterol. LDL is the part of cholesterol that becomes plaque in your arteries. This plaque gradually builds up and leads to blockages. Your LDL level should be below 130 mg/dl if you do not have cardiovascular disease, and below 100 mg/dl if you already have been shown to have a cardiovascular condition.

HDL or high density lipoprotein, is usually called the "good" cholesterol. HDL helps carry excess cholesterol in your blood back to the liver for disposal. Your HDL levels should be above 40 mg/dl in men and 50 mg/dl in women. HDL levels below 35 mg/dl indicate increased risk for cardiovascular disease. Finally, when you compare the amount of HDL to your total cholesterol, HDL should be about one quarter (or more) of your total cholesterol. The cholesterol ratio (total cholesterol divided by HDL) should therefore be less than or equal to four.

Triglycerides are another type of fat substance measured in a lipid profile. While the link between high triglyceride levels and cardiovascular disease has not been as clearly defined, we know that if you have high triglycerides you are also more likely to have less HDL, or good cholesterol, and more likely to develop diabetes. Triglyceride levels are raised by fats and sugars in the diet. Alcohol intake can also cause elevations in triglycerides.


Type	Desirable Range
Total Cholesterol	Less than 200 mg/dl
HDL	Greater than 35 mg/dl
LDL	Less than 130 mg/dl (Less than 100 mg/dl with heart or vessel disease)
Triglycerides	Less then 150 mg/dl

If you do not know what your cholesterol levels are, ask to have them measured. Elevated blood cholesterol can be successfully treated so that the risk associated with levels outside their desirable range can be minimized.

Treatment
Treatment for abnormal blood cholesterol levels always begins with lifestyle changes, especially in the area of nutrition. For mild elevations, these changes alone may bring cholesterol levels to desirable ranges. For more serious elevations, a combination of medications and lifestyle change is usually prescribed.

Nutrition for abnormal cholesterol levels centers on a diet that is low in fat and sugar, and high in fiber. Your doctor and nurses can help you get started. Sometimes, nutritional counseling with a registered dietitian is the best way to learn about how to change your eating habits.
A regular exercise program is another key part of treatment. Exercise will help to lower high levels of total cholesterol and LDL, and raise HDL levels.
Smoking cessation will also help, especially to raise HDL levels.
If changing your lifestyle does not sufficiently lower your cholesterol levels to the desirable range, or your cholesterol levels are very high, your doctor may order medications that will treat your particular cholesterol problem. There are several safe and effective medications currently available that can be prescribed.
If you have already been told you have heart or vascular disease, control of your blood lipids becomes even more important. Many studies have shown the chance of a second heart attack, for example, is significantly lowered if blood cholesterol is controlled well.

The Cardiovascular Medications and Lifestyle sections of this manual provide excellent information on all of these areas.