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

Experts urge intensive lifestyle measures for lowering triglycerides

In recent years, scientists have learned more about how triglycerides contribute to atherosclerosis, the clogged arteries that raise the risk of heart attack, stroke, and other cardiovascular problems. High triglyceride levels are often correlated with low HDL and a type of LDL cholesterol that is particularly likely to produce harmful deposits in the arteries. High triglyceride levels are also a component of another heart disease risk factor — metabolic syndrome, a condition that occurs in most people with type 2 diabetes and includes high blood pressure and a large waist size. The American Heart Association (AHA) issued a scientific statement about triglycerides and cardiovascular disease that sets a new, lower optimal level of triglycerides and recommends intensive lifestyle measures for reducing elevated triglycerides. (Locked) More »

Health by the numbers

Statistics on statin use show a decrease in LDL cholesterol levels in those who take the medications, but for people who don't want to or who cannot handle the possible side effects, dietary changes can have similar benefits. For example, you can fill your meals with foods that contain a lot of soluble fiber, which binds to cholesterol in the digestive system before it has a chance to get into the blood. You can also steer away from foods that contain saturated fat and trans fat, which are known to increase LDL cholesterol. Many people take red yeast rice supplements to lower their LDL. Researchers have shown that red yeast rice, in combination with fish oil and lifestyle changes, can be just as effective as a statin at lowering LDL cholesterol.  (Locked) More »

In Brief

Brief reports on hypertension statistics, a theory about why some people show more of an HDL cholesterol benefit from exercise than others, and more about the connection between depression and heart disease. (Locked) More »

Medical memo: Cholesterol and prostate cancer

Ask men about their top health worries, and most will put cholesterol and prostate cancer high on the list. That's understandable, since unfavorable cholesterol levels contribute to heart attack and stroke, the first and fourth leading causes of death in America, and prostate cancer takes about 32,000 lives a year. Still, while most men understand the link between cholesterol and cardiovascular disease, few suspect a link between cholesterol and cancer. Research is beginning to change that. (Locked) More »

April 2011 references and further reading

Patel M, Kim M, Karajgikar R, et al. Outcomes of patients discharged the same day following percutaneous coronary intervention. JACC Cardiovascular Interventions 2010; 3:851-8. Chambers CE, Dehmer GJ, Cox DA, et al. Defining the length of stay following percutaneous coronary intervention: an expert consensus document from the Society for Cardiovascular Angiography and Interventions. Endorsed by the American College of Cardiology Foundation. Catheterization and Cardiovascular Interventions 2009; 73:847-58. Schermerhorn ML, O'Malley AJ, Jhaveri A, Cotterill P, Pomposelli F, Landon BE. Endovascular vs. open repair of abdominal aortic aneurysms in the Medicare population. New England Journal of Medicine 2008; 358:464-74. (Locked) More »

Fish oil questioned as treatment for heart disease

Results of several studies suggest that taking fish oil does not benefit people who already have some form of heart disease, but eating fish is still likely to offer health benefits to most people. It could fight other types of cardiovascular disease or problems like depression. And it is a good treatment for high triglycerides. More »