The amount of cholesterol in your blood has a lot to do with your chances of getting cardiovascular disease (CVD). High blood cholesterol is one of the major risk factors for this illness. In fact, the higher your blood cholesterol level, the greater your risk of developing CVD or having a heart attack.
Cholesterol is a fat-like substance produced by your liver; it is necessary for building cell walls and in the production of hormones. Cholesterol is also found in some foods.
When you have too much cholesterol in your blood, it builds up in the walls of your arteries. Over time, this buildup causes "hardening of the arteries," meaning that the lining of the arteries becomes narrow, affecting blood flow to the heart. Blood carries oxygen to your heart and other vital organs. If enough blood and oxygen cannot reach your heart, you may feel chest pain. If the blood supply to an area of the heart is completely blocked, the result is a heart attack.
High blood cholesterol does not cause symptoms, so many people are unaware that their cholesterol level is too high until it has caused symptoms of cardiovascular disease. That's why it's important to find out what your cholesterol level is. If your level is high, you can take steps to reduce it, and thus reduce your risk of developing CVD, or of dying of a heart attack if you already have heart disease.
Keeping your cholesterol within healthy limits is important for you no matter what your age or gender, whether you have CVD or not. Everyone age 20 and older should have a blood cholesterol test at least once every five years. The most accurate test is the "lipoprotein profile," which is done after fasting.
A lipoprotein profile measures:
LDL ("bad") cholesterol, which is the main source of cholesterol buildup and blockage in the arteries
HDL ("good") cholesterol, which helps keep LDL cholesterol from building up in the arteries
Triglycerides, which are another form of fat in your blood
VLDL (very low-density lipoproteins) and a cholesterol/HDL ratio may also be included in the profile
If it's not possible to get a lipoprotein profile done, knowing your total cholesterol and HDL cholesterol can give you a general idea about your cholesterol level.
Understanding treatment guidelines
Current guidelines for treatment of high cholesterol come from the National Cholesterol Education Program III, overseen by the National Heart, Lung, and Blood Institute. The guidelines are used to determine a person's risk of experiencing a heart attack within 10 years by considering factors such as age, gender, and whether he or she smokes and has hypertension or diabetes.
A person's cholesterol level is one part of the equation for determining risk for CVD. Other risks for CVD include smoking, obesity, high blood pressure, family history of heart disease, and age (older than 45 for men and older than 55 for women).
Treatment for high cholesterol depends on how many other risk factors are present.
If you have high cholesterol, your goal is to reduce your LDL level enough to cut your risk of developing heart disease or having a heart attack. The higher your risk of these illnesses, the lower your LDL should be.
You can lower your LDL level through lifestyle changes, such as a low-fat diet, exercise, and weight management. A low-saturated-fat, low-cholesterol diet has less than 7 percent of calories from saturated fat and less than 200 mg of cholesterol. If this diet doesn't lower your LDL enough, you can add soluble fiber to your diet. It's important to control your weight in order to control your LDL, especially if your HDL level is low, your triglycerides are high, or your waist circumference is too great (more than 40 inches if you're a man or more than 35 inches if you're a woman). To get enough exercise, aim for 30 to 60 minutes of moderate physical activity most, if not all, days. In some people, there are genetic reasons that the LDL level can't be lowered by these methods. In others, these methods just don't work well. In both of these cases, medications may have to be added.