Cholesterol - What Should You Know About.

Written by sarahalbert
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Cholesterol is oily in nature but is not the same as fat. It is an essential molecule for making cell membranes, steroid hormones, nerve sheaths, and much more. The liver makes most of the cholesterol in the body and the rest comes from the diet. Too much cholesterol in the blood is known as hypercholesterolemia.
This leads to clogged arteries, which causes heart attack, stroke, loss of circulation in the limbs, and kidney failure. This process is called atherosclerosis.
Cholesterol in the blood is carried by protein particles called lipoproteins. The two most important are low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Elevated levels of LDL are usually associated with cholesterol deposits in the blood vessels, so LDL is known as “bad cholesterol.” Elevated levels of
HDL actually protect against heart disease by scavenging cholesterol and removing it from the arteries, so HDL is known as “good cholesterol.” Because of this, total cholesterol is not always the best measure of cholesterol.
High HDL makes the total cholesterol level look too high but is actually a good thing.
Although high LDL is the best known risk factor for heart disease, low HDL is also an important risk factor.
Low HDL occurs in weight gain, inactivity, and smoking.
Triglycerides are often measured along with cholesterol. Triglycerides are fats floating freely in the blood. If blood with a very high triglyceride level is allowed to sit in a tube, after a while a thick whitish layer of fat will rise to the top. Triglycerides are also a risk factor for heart disease, although the reason is not as well understood as it is for cholesterol.
Atherosclerosis can affect any artery of the body.
When the arteries that supply blood to the heart muscle are blocked, a heart attack occurs. When brain arteries are blocked, this causes a stroke. Blockage in arteries in the legs can lead to gangrene, and blockage of arteries to the kidneys leads to kidney failure.
Atherosclerosis in the aorta, the main artery coming from the heart, can cause the aorta to balloon (aortic aneurysm) and eventually rupture.
High cholesterol can be inherited, but it can also develop in people without a family history of high cholesterol.
Two inherited conditions are familial combined hyperlipidemia (occurring in 1 in 100 individuals), and familial hypercholesterolemia (occurring in 1 in 500 people). People with these conditions are at very high risk of premature heart attack and stroke, and need aggressive medical treatment. Family members should be screened for high cholesterol so they can be treated as early as possible.

Diet and Exercise
The initial step in treating high cholesterol is diet, increased physical activity, and weight loss. Reducing dietary intake of saturated fat and cholesterol is beneficial in lowering LDL cholesterol, and regular, sustained aerobic exercise increases HDL cholesterol.
Weight loss in women may cause a decline in HDL cholesterol without much change in LDL cholesterol. Fat tissue in postmenopausal women produces estrogen, and therefore losing this source may reduce HDL cholesterol.

Cholesterol-Lowering Medications
“Statin” drugs (Pravastatin) inhibit the major enzyme responsible for cholesterol production in the liver. These are the most effective medications for lowering LDL cholesterol, reducing it by 25–35%. Statins are proven to reduce the chance of death from heart disease in women. They are comparatively safe and have limited side effects. They also have other benefits like increasing bone density and reducing the risk of fractures.
Because statins occasionally cause liver or muscle inflammation, regular blood test monitoring is required.
Other cholesterol-lowering agents include the bile acid sequestrants: cholestyramine and colestipol. These are older drugs, and work by increasing the conversion of cholesterol to bile acids, which then leave the body in the stool. The newest drug is ezetimibe, which blocks cholesterol absorption in the intestines.

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