Definition
Cholesterol serves important roles in the body but high levels in the blood stream are directly associated with an increased chance of heart attack or stroke. Cholesterol is carried through the blood in little "packages" called lipoproteins, where the cholesterol (a lipid) is encapsulated in a layer of protein. The Mayo Foundation for Medical Education and Research (MFMER) states that there are several types of lipoproteins and each serves a different role. High density lipoproteins (HDLs) are called "good cholesterol" because they carry extra cholesterol back to the liver where it can be removed through bile. Low density lipoproteins (LDLs) and very low density lipoproteins (VLDLs) are "bad cholesterol" because they continue to circulate in the blood. Over time this allows cholesterol fragments to accumulate in the blood vessels and that causes the vessels to become thick and hard.
Lifestyle
A change in lifestyle is the first treatment choice for high cholesterol. Cigarette smokers need to stop smoking. According to physicians at the Mayo Clinic, "cigarette smoking damages the walls of blood vessels, making them likely to accumulate fatty deposits." Controlling blood sugar is important because high blood sugar contributes to higher LDL cholesterol and also damages arteries. Being overweight is another risk factor and losing even five to 10 pounds can significantly affect cholesterol levels. Eating a healthy diet that is low in saturated fats, trans fats and red meat while increasing the amount of fruits, vegetables, whole grains, fish, and lean meats reduces cholesterol intake while helping you lose weight.
The final key is exercise. In addition to the obvious health benefits of losing weight and keeping the body active, information provided by the University of Maryland Medical Center states that physically active people tend to have higher HDL levels and that regular aerobic exercise can help increase the levels of HDL.
Causes for Medication
According to the National Heart, Lung and Blood Institute (NHLBI), cholesterol lowering medication is needed if your LDL cholesterol levels are too high. LDLs should be less than 100 mg/dL. If your LDL is at 130 or higher, or if it's over 100 and you're at a high risk for heart disease, NHBLI states, "you will generally need to take an LDL-lowering medication." Other causes for medication depend on your individual profile. Your doctor will consider your risk factors and determine if treatment can start with lifestyle changes only or if they need to be implemented together with medication. Medication is indicated if high cholesterol levels are added to an underlying health issue that increases your risk of heart disease such as diabetes. Another cause for medication is a prior heart attack or if you have a family history of heart disease.
Types of Medications
Information from the National Heart, Lung and Blood Institute (NHLBI) states that the classes of cholesterol-lowering medications are statins, fibrates, bile acid binders, and niacin. Statins are the most effective medication for reducing LDLs. They also reduce triglycerides and slightly increase HDL cholesterol. Fibrates lower triglycerides and help increase HDL but they don't lower LDLs. Resins lower LDLs but do not help HDLs. MFMER information states the cholesterol absorption inhibitors Zetia and Vytorin reduce LDL cholesterol and triglycerides and raise HDLs.
