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Cholesterol is a waxy substance that helps the body make hormones, Vitamin D, bile acids and cell membranes. It is carried through the blood in lipoproteins, which are protein orbs filled with fat. Our bodies naturally produce cholesterol in the liver. We also ingest cholesterol through our diets.
Not all cholesterol is the same. When physicians talk about high cholesterol, also known as hypercholesterolemia, they are typically describing high levels of the kind carried in low-density lipoproteins (LDL). This cholesterol combines with fat, fibrin, calcium and cell debris to form plaque in the arteries. Over time, the plaque causes atherosclerosis, a narrowing and hardening of the arteries that deliver oxygen-rich blood to the heart and the brain. Restriction of the blood flow to the heart may result in angina, or chest pain. A complete blockage occurs when plaque buildup is severe or when the thin top layer of the plaque ruptures, releasing material that clots the blood in an already restricted artery. If such a blockage deprives the heart of oxygen, a heart attack occurs. If it deprives the brain of oxygen, a stroke occurs. If it deprives the extremities of oxygen, gangrene can occur. Pieces of plaque or clots also can travel through the arteries, ultimately causing a heart attack, stroke or pulmonary embolism.
Good cholesterol is found in high-density lipoproteins (HDL). Research suggests that HDL may carry cholesterol to the liver to be discarded by the body. HDL also may collect excess cholesterol from arterial plaque, slowing buildup of the dangerous substance.
When your Wellstar physician measures the LDL and the HDL in your bloodstream, he or she will also look for triglycerides, blood fats that are common in people with diabetes or heart disease. A high count of triglycerides is sometimes genetically determined, but is often seen in people who smoke, eat a high-carbohydrate diet (60% or more of total calories), are overweight, are sedentary or consume excessive alcohol. People with high triglycerides usually have lower HDL (good cholesterol) and are at a higher risk of heart attack or stroke.
Wellstar recommends a lipoprotein profile to measure the amount of HDL, LDL and triglycerides in the blood every five years starting at age 20. Men should be screened more frequently after age 35. Women should be screened more frequently after age 45. Children at risk of developing premature heart disease may be tested as early as 2 years of age. Your Wellstar physician may increase the frequency of screenings anytime your total cholesterol measurement is 200 mg/dL or your HDL level is less than 40 mg/dL. You will also be screened if you develop diabetes, high blood pressure or heart disease.
Just how much LDL and HDL you have in your blood depends on your gender, your age, your family history, your lifestyle and your health. If high cholesterol or heart disease was an issue for a parent or grandparent, it’s a good idea to tell your Wellstar physician so he or she can watch your cholesterol levels more closely. Being honest about your diet, exposure to cigarette smoke, alcohol consumption and exercise habits is also critical. Some people can make changes in their lifestyle to lower bad cholesterol, raise good cholesterol and lower triglycerides. Others require medication, in combination with dietary or other changes. Your Wellstar physician can tailor a plan specifically for you.
People with high cholesterol typically show no symptoms at all. However, your Wellstar physician typically will screen for cholesterol readings if you show symptoms of atherosclerosis, once these more serious conditions are stabilized:
Are you at risk for high cholesterol? Risk factors include:
Except where genetics plays a role, many types of high cholesterol can be prevented and controlled with healthy lifestyle choices.
You can lower your levels of good cholesterol (HDL), lower your levels of bad cholesterol (LDL) and lower your triglycerides with these lifestyle changes:
Your Wellstar physician can run a lipoprotein profile using a small blood sample from your arm. If your physician is screening for your total cholesterol, HDL, LDL and triglyceride levels, you will need to fast—no food, liquid or pills—for nine to 12 hours before the test. Otherwise, the test will only indicate total cholesterol and your HDL (good cholesterol) level. (If results indicate total cholesterol of more than 200 mg/dL or HDL before 40 mg/dL, your physician will ask you to fast and take blood test again, yielding the full lipoprotein profile). Optimum results include:
These numbers do not take into account your age, gender, risk factors, diet or other health concerns. If you take a home test or participate in a health screening that includes a cholesterol panel, be sure to have your Wellstar physician interpret your results. Your physician will determine the frequency of follow-up screenings, prescribe any necessary medications and recommend changes you can make to improve your cholesterol counts.
If screening tests or check-ups reveal high cholesterol, your Wellstar physician may perform further evaluations regarding atherosclerosis and related diseases.
To determine whether you have high cholesterol (LDL, or bad cholesterol), your Wellstar physician will take a sample of your blood and test it for levels of your total cholesterol, LDL, HDL (good cholesterol) and triglycerides. Your physician can create a plan for you to achieve the levels listed below:
If you have high cholesterol and your Wellstar physician suspects you may have atherosclerosis, he or she may order tests to determine the extent of any plaque buildup and any effect it may have on heart function. Among the tests:
Your Wellstar physician may prescribe lifestyle changes, medication or a combination of both to get your cholesterol levels within the optimum ranges.
Your physician may ask you to adjust your lifestyle to include the following, if they are not already part of your daily habits:
Your physician may prescribe one or more of the following medications to increase your HDL (good cholesterol), lower your LDL (bad cholesterol) or lower your triglycerides:
In every case, your Wellstar physician will help you weigh the benefits of each treatment approach and make an experienced recommendation for the best outcome. You can feel confident your decision will be based on both your input and the expertise and recommendations of your experienced physician.
Wellstar offers world-class, community-based physicians based in state-of-the-art medical centers and hospitals with access to the latest technologies and other medical resources. They are dedicated to:
Wellstar’s Cardiovascular Network provides top-flight Cardiac Care throughout its physicians’ offices, urgent care centers and emergency rooms. Emergency departments at Wellstar Cobb, Wellstar Douglas, Wellstar Kennestone, and Wellstar Paulding hospitals provide comprehensive cardiac services. Wellstar Cobb and Wellstar Kennestone hospital’s cardiac diagnostic and treatment services provide the next level of defense against heart disease. The technologically advanced Cardiac Center at Wellstar Kennestone Hospital raises the bar on world-class cardiac care. Wellstar’s Cardiac Rehabilitation Services’ medically supervised programs focus on helping heart disease patients maintain a healthier heart through education and support groups.
Though genetics may not be on your side, there are a number of ways to lower LDL (bad cholesterol) and triglycerides, while increasing your HDL (good cholesterol). Among them:
Additionally, maintain any regimen recommended by your Wellstar physician.