Cholesterol Guide: All You Need to Know

What is Cholesterol and Why It Matters

Cholesterol is a type of lipid, a fat-like substance that is found in every cell of the human body. It is essential for basic functions such as producing hormones, vitamin D and substances that help with the digestion. However, too much cholesterol in the blood can cause issues.

Types of Cholesterol

Cholesterol travels through the bloodstream in small packages called lipoproteins. There are two main types of lipoproteins:

High-Density Lipoprotein (HDL): Known as the “good” cholesterol, as HDL helps remove cholesterol from the arteries and transports it back to the liver, where it can be broken down and eliminated from the body.

Low-Density Lipoprotein (LDL): Often referred to as the “bad” cholesterol, LDL can lead to the buildup of plaque in the arteries, making them narrow and less flexible. This condition, known as atherosclerosis, can result in decreased blood flow and increase the risk of heart attack or stroke¹.

Types of Hyperlipidemias

Depending on which lipid is elevated, there are different types of hyperlipidemias; The two most common types are:

Causes and Risk Factors

Hyperlipidemia is often influenced by a combination of genetic and environmental factors. The most common causes and risk factors include:

1. Obesity
2. Cigarette smoking lowers HDL cholesterol and damages the walls of blood vessels⁷.
3. Genetics
4. Excessive alcohol intake can cause higher total cholesterol and triglycerides level⁴.
5. Consuming a diet high in saturated fats, trans fats, and cholesterol can raise LDL levels. Foods like red meat, full-fat dairy products, processed and fried foods are major contributors.
6. Age and Gender: Cholesterol levels tend to increase with age. Women generally have lower LDL levels than men before menopause, but after menopause, LDL levels often rise⁵.
7. Conditions such as diabetes, hypothyroidism, and kidney disease can contribute to high cholesterol levels. 
8. Lack of Physical Activity: A sedentary lifestyle contributes to weight gain, lower HDL cholesterol, and higher triglycerides.

Symptoms and Diagnosis

Unfortunately, hyperlipidemia often presents no symptoms until damage has already occurred. Most people with high cholesterol are unaware of their condition until they have a blood test or experience severe complications like a heart attack or stroke.

Diagnosis requires a blood test known as a lipid panel or lipid profile³. This test measures total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides.

The results are then compared to standard ranges to determine if the levels are within a healthy range or indicative of conditions such as hyperlipidemia, hypercholesterolemia, or hypertriglyceridemia.

Cholesterol Management and Treatment

Managing hyperlipidemia is crucial to preventing the development of cardiovascular diseases, particularly coronary heart disease (CHD).

The treatment approach usually includes lifestyle changes, medications, and regular monitoring.

Lifestyle Changes

Cholesterol Medications

Medicine	Description
Statin	These are the most commonly prescribed medications for loweringLDL cholesterol. They work by inhibiting an enzyme in the liver that is responsible for producing cholesterol.
Bile Acid Sequestrants	These drugs help lower cholesterol by binding to bile acids in theintestines, which prompts the liver to use excess cholesterol toproduce more bile acids, thereby reducing the amount of cholesterol in the bloodstream.
Fibrates	These are used to lower triglyceride levels and can also help increase HDL cholesterol.
PCSK9 Inhibitors	A newer class of drugs that help the liver remove more LDL cholesterol from the blood.
Ezetimibe	This medication works by inhibiting the absorption of cholesterol in the intestines, which reduces the amount of cholesterol delivered to the liver. This results in a decrease in LDL cholesterol levels in the bloodstream8.
Inclisiran	A more recent addition to cholesterol-lowering treatments, approved in 2021. It’s an injectable medication that works by targeting and reducing the production of PCSK9, a protein that contributes to higher LDL cholesterol levels8.

*The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for advice on medication.

Monitoring and Home Testing

Home cholesterol test kits are now available. These devices allow people to check their cholesterol levels at home, providing immediate feedback and helping to track the effectiveness of lifestyle changes or medications¹⁰.

Regular Check-ups: Regular visits to a healthcare provider for blood tests and monitoring are essential. This helps to ensure that the treatment is effective.

Hyperlipidaemia is a significant public health concern due to its strong association with cardiovascular diseases. However, it is a manageable condition.

By understanding the causes, risks, and treatment options, both patients and healthcare providers can take steps to control the cholesterol levels and reduce the risk of serious complications. Through lifestyle changes, appropriate use of medications, and regular monitoring, individuals can significantly lower their risk of coronary heart disease and stroke.

This article written by Medical Writer from Fiverr, 2024.

References:

1. Institute for Quality and Efficiency in Health Care. (2022). ‘In brief: What is cholesterol and how does arteriosclerosis develop ‘, InformedHealth.org. [online]. Available at: https://www.ncbi.nlm.nih.gov/books/NBK279327/ [Accessed: 2 September 2024].
2. Hill, M. F., & Bordoni, B. (2023). Hyperlipidemia. In: StatPearls [online]. Available at: https://www.ncbi.nlm.nih.gov/books/NBK559182/
3. BMJ Best Practice. (2024). Hypercholesterolaemia. [online] Available at: https://bestpractice.bmj.com/topics/en-gb/170 [Accessed 4 September 2024]
4. Minzer S, Losno RA, Casas R. (2022) The Effect of Alcohol on Cardiovascular Risk Factors: Is There New Information? Nutrients. 2020 Mar 27;12(4):912. doi: 10.3390/nu12040912
5. Soriano-Maldonado, C et al. (2021) ‘Gender Differences in the Diagnosis of Dyslipidemia: ESCARVAL-GENERO’ International Journal of Environmental Research and Public Health, 18(23), p. 12419. doi: 10.3390/ijerph182312419
6. Zhang, W., Li, X., Li, Y., et al. (2023) ‘Alcohol intake and dyslipidemia in male patients with hypertension and diabetes enrolled in a China multicenter registry’, Journal of Clinical Hypertension (Greenwich), 25(2), pp. 183-190. doi:10.1111/jch.14638
7. Forey, B. A., et al. (2013). The effect of quitting smoking on HDL-cholesterol – a review based on within-subject changes, Biomarker Research. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4177613/ [Accessed: 2 September 2024].
8. Feingold, K.R. et al. (2000). Cholesterol Lowering Drugs. Endotext [online]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK395573/
9. Ministry of Health (MOH) Singapore. (2016). Lipids: Clinical Practice Guidelines 2/2016. Available at: https://www.moh.gov.sg/docs/librariesprovider4/guidelines/moh-lipids-cpg—booklet.pdf [Accessed: 2 September 2024].