• High Cholesterol

    (Cholesterol, High; Hypercholesterolemia)

    Definition

    Cholesterol is a type of lipid in the blood. High cholesterol is an abnormally high level of cholesterol in the blood.
    There are different types of cholesterol in your blood including:
    • Low density lipoproteins (LDL)—causes build up of cholesterol and other fats in the blood vessels. Known as bad cholesterol because high levels can cause disease in the arteries and heart disease.
    • High density lipoproteins (HDL)—can remove cholesterol and other fats from the blood. Known as good cholesterol because it may protect against heart disease.

    Causes

    Causes of high cholesterol include:
    • Genetics
    • High-fat diet
    • Overweight
    • Sedentary lifestyle

    Risk Factors

    These factors may increase your chance of high cholesterol:
    • Age: cholesterol levels tend to rise with age
    • Sex:
    • Family members with high cholesterol
    • High-fat diet
    • Obesity, overweight
    • Sedentary lifestyle

    Symptoms

    It is rare for high cholesterol to cause symptoms. However, high cholesterol can increase your risk of atherosclerosis. This is a dangerous hardening of the arteries. It can block the flow of blood. In some cases, a blocked or slowed blood flow may cause:
    Some people with high cholesterol may also have cholesterol deposits in tendons, under the eyes, or in the eye.
    Atherosclerosis
    atherosclerosis
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    Diagnosis

    The doctor will ask about your symptoms and medical history. Your doctor will ask about factors that may increase your risk of heart disease or stroke. A physical exam will be done.
    A blood test will also be done. Blood will be sent to a lab to measure lipid levels in your blood including:
    • Total cholesterol
    • HDL cholesterol
    • LDL cholesterol
    • Triglycerides
    Your doctor may do other tests to look for other conditions that can be associated with high cholesterol levels.

    Treatment

    Treatment is aimed at decreasing your cholesterol levels. Your doctor will also make recommendations to help you manage other risk factors for heart disease and stroke.

    Nutritional Changes

    Talk to your doctor about the best meal plan for you. Consider the following changes:
    • Balance the amount of calories you are eating with the amount of calories you use through physical activity and basic body functions. This will help you reach or maintain a healthy weight.
    • Eat a diet that is high in fruits and vegetables.
    • Include foods that are whole grain and high in fiber.
    • Eat fish at least twice per week.
    • Limit foods with saturated fats, trans fats, or cholesterol.
    • Avoid processed and refined sugars and starches. This includes white bread, white potatoes, white rice and simple sugars like soda.
    • Choose and prepare foods with little or no salt.
    • If you drink alcohol, drink in moderation. This means two drinks per day for men and one drink per day for women.

    Lifestyle Changes

    • Begin a safe exercise program with the advice of your doctor.
    • If you smoke, quit.
    • If you are overweight, lose weight.
    • Make sure other medical conditions such as high blood pressure and diabetes are being treated and controlled.

    Cholesterol-Lowering Medication

    Your doctor may prescribe medication. They will help lower your cholesterol. Examples include:
      Statins—have been shown to reduce mortality (death), heart attacks, and stroke. Examples include:
      • Lovastatin (Mevacor)
      • Pravastatin (Pravachol)
      • Atorvastatin (Lipitor)
      • Simvastatin (Zocor)
      • Rosuvastatin (Crestor)
    • Gemfibrozil (Lopid)
    • Fenofibrate (Tricor)
    • Cholestyramine (Questran)
    • Colestipol (Colestid)
    • Niacin (Niacor)
    • Ezetimibe (Zetia)
    These medicines are best used as additions to diet and exercise. They should not be use in place of healthy lifestyle changes.

    Prevention

    To help reduce your chance of getting high cholesterol, follow the lifestyle and nutrition changes above.

    RESOURCES

    American Heart Association http://www.americanheart.org

    National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov

    CANADIAN RESOURCES

    Canadian Cardiovascular Society http://www.ccs.ca

    Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca

    References

    Cholesterol. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/Cholesterol/Cholesterol%5FUCM%5F001089%5FSubHomePage.jsp. Accessed September 12, 2012.

    Prevention and treatment of high cholesterol. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/Cholesterol/PreventionTreatmentofHighCholesterol/Prevention-and-Treatment-of-High-Cholesterol%5FUCM%5F001215%5FArticle.jsp. Published August 2012. Accessed September 12, 2012.

    Lipid-lowering pharmacotherapy overview. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated July 3, 2012. Accessed September 12, 2012.

    Third report of the expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). National Cholesterol Education Program website. Available at: http://www.nhlbi.nih.gov/guidelines/cholesterol/index.htm. Updated 2004. Accessed September 12, 2012.

    What is cholesterol? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/hbc/. Accessed September 12, 2012.

    12/14/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Ferdowsian HR, Barnard ND. Effects of plant-based diets on plasma lipids. Am J Cardiol. 2009;104(7):947-956.

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