Cholesterol is a naturally produced chemical compound in the body. It is basically a waxy substance made of combination of fat (lipid) and steroids. Used to protect the nerves, cholesterol makes cell tissues and produces certain hormones like testosterone and estrogen. The liver produces about 80 per cent of body’s cholesterol while the remaining comes directly from the food one eats. The dietary cholesterol is mainly derived from foods like poultry, fish, meat and dairy products. Organ meats, like liver are very high in cholesterol content, while food items of plant origins do not contain any amount of cholesterol at all. The dietary cholesterol is easily absorbed from one’s intestine to be stored in liver after meals. The liver then regulates the levels of cholesterol in one’s blood stream and secretes it out whenever required by one’s body.
Though a certain amount is important for one’s overall health, excess of cholesterol in the blood stream can have serious negative impacts. It is so because it increases the risk of heart diseases, including heart strokes or attacks.
If one has high cholesterol, the body stores extra amounts in the arteries. The arteries are those blood vessels, which carry blood from the heart to all other parts of the body. The build-up of cholesterol in the arteries is called plaque. Over some period of time, this plaque can harden up, thereby making the arteries narrower. If the deposits are large, this plaque can block the artery completely. This narrowing of the arteries by formation of plaque is called atherosclerosis. Sometimes, these plaques are split open and lead to formation of blood clots that block the blood flow. This is a serious condition because if the artery supplying blood to the heart muscles gets choked, chances of a heart attack become very high. Also, if the artery supplying blood to the brain gets blocked, a heart stroke can take place.
One can’t determine if he/ she has high cholesterol levels unless they get checked. It is recommended by all doctors that adults over the age of 20 years should get their cholesterol levels checked in every five years. Also, if one has already been diagnosed with any risk factors for heart diseases, it becomes all the more pertinent for them to get them checked as soon as possible in order to avert any danger in the later stages. Mostly a blood test called the lipid panel is done to check cholesterol.
Cholesterol travels inside the body via blood in various types of bundles called the lipoproteins. LDL or the low density lipoprotein delivers the cholesterol to one’s body while the HDL or high density lipoprotein removes the excess of it from one’s bloodstream. This is why excess LDL is harmful for the body while HDL is considered good. It is crucial to maintain a balance between both to remain healthy and active and not to disrupt the functioning of lipoproteins inside the body. The liver is responsible for manufacturing and secreting LDL cholesterol in the blood stream. It is also the liver’s job to remove LDL present in the blood using active LDL receptors present on its cell surface.
Both diet and heredity play a significant role in a person’s HDL, LDL and total cholesterol levels. For instance, familial hypercholesterolemia is an inherited disorder in which the patients have almost non- existent or diminished LDL receptors on their liver’s surface cells. People who have this disorder tend to easily develop heart attacks and atherosclerosis during their early adulthood.
In case of high cholesterol levels one may make some simple lifestyle changes. For instance, quitting smoking is one habit (if one smokes) that can help reduce the chances of a heart attack or stroke. Similarly, if one is overweight, it is advised to lose kilograms to improve the cholesterol levels. Intake of plenty of green vegetables and fruits is also recommended besides exercising on a regular basis. This is very beneficial for the heart’s health. Also, one should avoid consuming trans fats and saturated fats that raise the cholesterol levels. Most importantly, one should limit the intake of overall cholesterol to less than 300mg everyday and 200mg if one is already suffering from any heart disease. If there seems to be no improvement even after following the recommended lifestyle changes, it is better to consult the doctor who may prescribe medicines for the same.
Reducing the intake of saturated fats in one’s diet helps lower blood cholesterol levels. NHLBI: National Cholesterol Education Program (NCEP) recommends a low-cholesterol and low-saturated-fat meal plan, which calls for not more than 7 per cent calories from a saturated fat. It also recommends less than 200mg dietary cholesterol every day.
The drug treatment that is used for lowering cholesterol levels along with some dietary changes varies from person to person. There are several kinds of medications available for the purpose in the market, including bile acid sequestrants, statins, fibric acids and niacin. So far, statins have been proven to be best- tolerated and most effective in most of the patients and have been regarded as a common treatment choice for lowering LDL levels. These include the fluvastatin (Lescol), aorvastatin (Lipitor), rosuvastatin calcium (Crestor), lovastatin (Mevacor), simvastatin (Zocor) and pravastatin (Pravachol). The side effects of these medications are generally low in frequency but gas, nausea, abdominal cramping and constipation are common complaints after using them. In some cases, headaches, liver problems and muscle pain may also be reported. Statins work inside the liver to help interrupt cholesterol formation from the blood circulating in the body.
Zetia (Ezetimibe) is a new drug, which lowers LDL cholesterol. It works in the digestive tract and helps reduce cholesterol absorption. It is prescribed along with any of the statins in some cases. The bile acid sequestrants help lower the LDL levels. They are commonly used alone but may be prescribed in combination with one of the statin drugs. These sequestrants may be unpalatable causing gastrointestinal effects (like abdominal pain, bloating, constipation and gas).
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