Cholesterol

Cholesterol isn't entirely the health villain it's made out to be, its name darkly linked to heart attack, stroke, and other types of cardiovascular disease. Our bodies need cholesterol, which is a type of lipid (another name for fat) to make cell membranes, key hormones like testosterone and estrogen, the bile acids needed to digest and absorb fats, and vitamin D. Cholesterol is so important to the body that the liver and intestines make it from scratch.

What is "bad" about cholesterol isn't the substance itself — in fact, we can't live without it — but how much of it is in the bloodstream.

The body packages cholesterol in two main particles: low-density lipoprotein (LDL), the so-called bad cholesterol, and high-density lipoprotein (HDL), the so-called good cholesterol. Too much LDL in the bloodstream helps create the harmful cholesterol-filled plaques that grow inside arteries. Such plaques are responsible for angina (chest pain with exertion or stress), heart attacks, and most types of stroke.

What causes a person's LDL level to be high? Most of the time diet is the key culprit. Eating foods rich in saturated fats, trans fats, and easily digested carbohydrates boost LDL. Genes are sometimes at the root of high cholesterol, and some medications can boost LDL.

If you have high cholesterol, making changes in your diet can help bring it down into the healthy range. Exercise can help boost the level of protective HDL. Several types of medication, notably the family of drugs known as statins, can powerfully lower LDL. Depending on your cardiovascular health, your doctor may recommend taking a statin.

Cholesterol Articles

Does it matter how you lower your cholesterol?

Certain cholesterol-lowering medications—namely, ezetimibe (Zetia) and drugs known as bile acid binders—also appear to be effective at lowering cholesterol and reducing the risk of serious cardiovascular events.  More »

HDL cholesterol: How much is enough?

When it comes to cholesterol, people want less of the “bad” low-density lipoprotein (LDL) cholesterol and more of the “good” high-density lipoprotein (HDL) kind. This combination is often associated with a lower risk of cardiovascular disease. But while most attention is spent on driving down bad LDL, you still have to keep your eyes on the good HDL, as some research suggests that after a certain threshold, higher levels don’t offer extra protection. (Locked) More »

Fasting before a cholesterol test

Fasting for eight to 12 hours before a cholesterol test doesn’t seem to be necessary. But for now, people should continue to follow their physicians’ advice on this matter. (Locked) More »

Clogged arteries in the gut?

Just like the arteries that supply blood to the heart, arteries in the intestines can become clogged with cholesterol-filled plaque. Known as intestinal angina, the condition is marked by pain that occurs about 30 minutes after eating and lasts one to two hours. This uncommon problem is more prevalent in women, particularly current or former smokers. People with intestinal angina often develop “food fear,” which causes them to lose substantial amounts of weight. Treatment involves restoring blood flow to the intestines, usually by threading a catheter through a vessel to the blockage and inserting a tiny mesh tube (stent) to prop open the artery.  (Locked) More »

Coping with statin side effects

PCKS9 inhibitors lower cholesterol and don’t have the same types of side effects as statins. However, there is no evidence that they decrease heart attacks and strokes the way statins do. PCSK9 inhibitors come with a very high price tag (about $15,000 per year). Some insurance companies, including Medicare, pay for the drug when treatment with statins is either inadequate or causes adverse effects. But it takes time to prove that a statin isn’t effective for an individual. (Locked) More »

New insights about an inherited form of high cholesterol

About one in 250 people has a genetic mutation that leads to dangerously high LDL (bad) cholesterol levels. Known as familial hypercholesterolemia (FH), the condition is the leading cause of early heart attacks (those that occur before age 55 in men and age 65 in women). In a person with FH, the risk of heart disease is 22 times higher than a person with a normal LDL level. But FH—which is caused by a single mutation in one of three different genes—is responsible for very high cholesterol levels in only a small fraction of people. Most people with very high LDL have dozens of different mutations, each of which raises LDL cholesterol a little bit.  (Locked) More »

Your blood work, on the edge of normal

There are several types of routine blood tests. Some are panels or series of tests, such as a comprehensive metabolic panel (CMP), which measures various chemicals in the blood, as well as blood levels of protein, potassium, sodium, and chloride. A complete blood count measures the types of cells in the blood, as well as hematocrit, hemoglobin, and other aspects of blood cells. A lipid panel measures the types of fat in the blood, including “good” HDL cholesterol, “bad” LDL cholesterol, and triglycerides.  (Locked) More »