High Cholesterol: Causes, Risks, and Prevention

High cholesterol is a common but serious condition that can increase the risk of heart disease and stroke. Understanding its causes, risk factors, and prevention methods can help maintain heart health and overall well-being.

What is Cholesterol?

Cholesterol is a fatty substance that your body both produces and obtains from your diet. It plays a vital role in:

• Cell renewal
• Transporting substances throughout the body
• Hormone synthesis

While cholesterol is essential for these functions, excessive amounts can be harmful. The body naturally produces all the cholesterol it needs, so dietary intake should be moderated.

Types of Cholesterol

Cholesterol travels through the bloodstream in particles called lipoproteins, the two most notable being:

• LDL (Low-Density Lipoprotein) – “Bad” Cholesterol
  • Transports cholesterol to blood vessels
  • Can form atherosclerotic plaques, narrowing arteries and increasing the risk of blood clots, heart attacks, and strokes
• HDL (High-Density Lipoprotein) – “Good” Cholesterol
  • Removes cholesterol from blood vessels
  • Transports it back to the liver for elimination

Causes and Risk Factors for High Cholesterol

While some risk factors—such as genetics and family history of hypercholesterolemia—cannot be controlled, several lifestyle factors contribute to high cholesterol:

• Being overweight (BMI over 30), especially with excess fat around the waist
• Smoking, which negatively impacts cholesterol levels
• Lack of physical activity, leading to poor metabolism
• Unhealthy diet, particularly one high in saturated and trans fats
• Type 2 diabetes, which is linked to abnormal cholesterol levels

Familial Hypercholesterolemia (FH)

This genetic condition results in extremely high cholesterol levels due to a mutation affecting cholesterol metabolism. If a family member was diagnosed with high cholesterol at a young age, consult a healthcare provider for screening.

Symptoms of High Cholesterol

High cholesterol, also known as hypercholesterolemia, is often called a “silent condition” because it does not cause noticeable symptoms. The only way to detect it is through a blood test.

Unfortunately, the first sign of high cholesterol for many individuals is a heart attack or stroke, making regular screening crucial.

Diagnosing High Cholesterol

A lipid panel blood test measures:

• Total cholesterol
• LDL cholesterol (“bad” cholesterol)
• HDL cholesterol (“good” cholesterol)
• Triglycerides (a type of fat in the blood)

Normal Cholesterol Levels (According to the U.S. National Library of Medicine)

• Total cholesterol: Below 200 mg/dL
• LDL cholesterol: Below 130 mg/dL
• HDL cholesterol: Above 60 mg/dL (for heart protection)
• Borderline high total cholesterol: 200-239 mg/dL
• High total cholesterol: Above 240 mg/dL

For accurate results, fasting for 12 hours before the test is recommended.

Treating High Cholesterol

Lifestyle Changes (First Line of Defense)

• Weight loss: Losing 10 pounds can lower LDL cholesterol by up to 8%.
• Dietary changes: Reduce trans fats (found in fried and baked goods) and increase fiber, nuts, and fish.
• Exercise: At least 150 minutes per week (such as a 30-minute walk, five times a week).

Medications for High Cholesterol (If Lifestyle Changes Are Not Enough)

• Statins: Block an enzyme required for cholesterol production.
• Bile acid-binding resins: Help remove cholesterol from the body.
• Fibrates: Lower LDL and increase HDL cholesterol levels.

Preventing High Cholesterol

• Eat a heart-healthy diet: Reduce saturated and trans fats, commonly found in:
  • Red meat
  • Cheese and dairy products
  • Fried and processed foods
  • Baked goods (cakes, cookies, pastries)
• Increase fiber and healthy fats: Whole grains, fruits, vegetables, nuts, and fish.
• Limit cholesterol intake:
  • Healthy individuals: Below 300 mg/day
  • Those with high cholesterol: Below 200 mg/day (American Heart Association recommendation)
• Maintain a healthy weight: Helps prevent diabetes, heart disease, and even cancer.
• Exercise regularly: At least 2.5 hours per week of moderate activity.

When to See a Doctor

• Get your cholesterol checked regularly, especially if you have risk factors.
• If lifestyle changes are not effective, discuss medications with your doctor.

By managing cholesterol levels through healthy habits and medical guidance, you can reduce the risk of heart disease and live a longer, healthier life.