High Cholesterol (Hypercholesterolemia)
Key points
- Cholesterol is a fatty substance that occurs naturally in the body.
- Most people with high cholesterol don't have any symptoms until cholesterol related atherosclerosis causes significant narrowing of the arteries leading totheir hearts or brains.
- Your doctor will ask if anyone in your family had or has coronary artery disease, high cholesterol or diabetes.
- You can significantly decrease your cholesterol levels within six weeks by switching to a diet that is low in saturated fats, high in fruits and vegetables, and by substituting monounsaturated fats for saturated fats.
What Is It?
Cholesterol is a fatty substance that occurs naturally in the body. It performs several vital functions. It is needed to make the walls surrounding the body's cells and is the basic material that is converted to certain hormones. Your body makes all the cholesterol you need. You require only a small amount of fat in your diet to make enough cholesterol to stay healthy.
The fat and cholesterol you eat are absorbed in the intestine and transported to the liver. The liver converts fat into cholesterol, and releases cholesterol into the bloodstream as low density lipoprotein (LDL) cholesterol (the "bad" cholesterol) and high density lipoprotein (HDL) cholesterol (the "good" cholesterol).
High levels of LDL cholesterol are linked to atherosclerosis, which is the accumulation of cholesterol rich fatty deposits in arteries. This can cause arteries to narrow or become blocked, slowing or stopping the flow of blood to vital organs, especially the heart and brain. Atherosclerosis affecting the heart is called coronary artery disease, and it can cause a heart attack (myocardial infarction). When atherosclerosis blocks arteries that supply blood to the brain, it can cause a stroke (cerebral infarction).
High levels of HDL cholesterol actually protect against heart attacks and strokes by removing cholesterol from the arteries and bringing it back to the liver.
Because high cholesterol levels can cause atherosclerosis, doctors recommend that people keep their cholesterol levels within a specific range. In general, adults older than 20 should try to keep their total cholesterol level below 200 milligrams per deciliter.
For a more precise assessment of the risk of atherosclerosis, your LDL cholesterol should be checked. According to guidelines established by the National Cholesterol Education Program, the desirable level for LDL cholesterol depends on whether or not a person already has a disease caused by atherosclerosis or diabetes or other risk factors for coronary artery disease. Risk factors for coronary artery disease include:
- Being a male older than 45
- Being a female older than 55
- Being a female with premature menopause
- Having a family history of premature coronary artery disease (a father or brother younger than 55 with coronary artery disease or a mother or sister younger than 65 with coronary artery disease)
- Smoking cigarettes
- Having high blood pressure
- Not having enough good cholesterol (high density lipoprotein or HDL)
If you have coronary artery disease, diabetes, peripheral vascular disease or have had a stroke from atherosclerosis, your LDL cholesterol should be less than 100 milligrams per deciliter.
Frequently asked questions
What is high cholesterol (hypercholesterolemia)?
Cholesterol is a fatty substance that occurs naturally in the body. It performs several vital functions. It is needed to make the walls surrounding the body's cells and is the basic material that is converted to certain hormones. Your body makes all the cholesterol you need. You require only a small amount of fat in your diet to make enough cholesterol to stay healthy. The fat and cholesterol you eat are absorbed in the intestine and transported to the liver. The liver converts fat into cholesterol, and releases cholesterol into the bloodstream as low density lipoprotein (LDL) cholesterol (the "bad" cholesterol) and high density lipoprotein (HDL) cholesterol (the "good" cholesterol).
What are the symptoms of high cholesterol (hypercholesterolemia)?
Most people with high cholesterol don't have any symptoms until cholesterol related atherosclerosis causes significant narrowing of the arteries leading totheir hearts or brains. The result can be heart related chest pain (angina) or other symptoms of coronary artery disease, as well as symptoms of decreased blood supply to the brain (transient ischemic attacks or stroke). About one out of every 500 people has an inherited disorder called familial hypercholesterolemia, which can cause extremely high cholesterol levels (above 300 milligrams per deciliter).
How is high cholesterol (hypercholesterolemia) diagnosed?
Your doctor will ask if anyone in your family had or has coronary artery disease, high cholesterol or diabetes. The doctor will ask about your diet and if you have ever smoked. He or she will check your blood pressure and look for xanthomas and xanthelasmas. Your doctor can confirm a diagnosis of high cholesterol with a simple blood test.
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.