High cholesterol causes and symptoms - and how to lower it
Many people are completely unaware that they have high cholesterol, which is why it’s known as the silent killer.
“There are no symptoms of high cholesterol,” says Dr Dermot Neely, who runs a specialist lipid clinic in Newcastle upon Tyne.
“The only real symptom is a blocked artery, which causes a stroke or heart attack. In severe cases, you can get cholesterol deposits in the tendons or around the clear part of the eye, but a doctor would rarely notice these during an examination.”
So what is it?
Cardiovascular diseases are responsible for 38% of male and 37% of female deaths before the age of 75, with high cholesterol a serious risk factor. But it’s not all bad.
“It’s a fatty substance carried in the blood attached to proteins called lipoproteins and is mainly made by the liver, with only about a fifth coming from food. We need it to make hormones, vitamin D and to repair cells.”
Why is too much cholesterol bad for us?
“There are two main forms, LDL, low density lipoprotein, and HDL, high density,’” says Dr Neely.
LDL is often known as the bad cholesterol because too much is unhealthy.
It carries cholesterol to the cells that need it, but if there’s too much for them to use, it can build up on the wall of the arteries.
HDL is protective and carries cholesterol away from the cells and back to the liver, where it’s broken down or passed out of the body as waste.
Dr Neely says many of us associate having high cholesterol with a fatty diet, smoking or being overweight.
High cholesterol usually develops in men in their 50s and women in their 60s, after the menopause.
“This is when people often become aware of their cholesterol and can help reduce it by changing their diet and exercising” says Dr Neely.
We’ve seen an increase in fad diets too,” he says, which on the surface look healthy, but are actually increasing chances of high cholesterol.
“For example, lots of people have started using coconut oil in their diet. We’ve seen patients’ cholesterol double after using this.
“But while poor diet and lifestyle is a reason for high cholesterol, there is also an inherited condition called familial hypercholesterolemia or FH, which can cause high cholesterol even in someone who eats healthily, is slim and exercises regularly,” he adds.
Around one in 250 people has this condition, and it’s passed on by a “faulty” gene.
“In FH, cholesterol is double the normal from soon after birth, and if left untreated, can lead to early heart disease. Unfortunately, those with inherited high cholesterol only find out if a family member suffered early heart disease. For those with this type, they need early treatment with a high potency statin, which can reduce the LDL by at least half.”
What are the tests for it?
“In people with early heart disease, around 75% of them will have high cholesterol,” says Dr Neely.
“My suggestion would be that if you have family members who’ve had early heart disease or similar, go and get yourself tested. Some pharmacies, like Boots can do it, but if you think you are at risk, ask your GP.
“The work Heart UK does to raise awareness about this is vital – and the fundraising people do into research is too,” he says.
“This might be known as the silent killer, but we want to shout about it from the rooftops.”
How to treat it
If you have been diagnosed with high cholesterol, the best way to try and lower the levels is to eat a healthy diet and do regular exercise.
There are two main types of fat, saturated and unsaturated. Eating too many foods containing saturated fat can raise the level of cholesterol in your blood.
Try swapping these for foods that contain unsaturated fats, including oily fish like mackerel and salmon, nuts, sunflower and pumpkin seeds and avocados. Heart UK calls these foods “cholesterol busters”.
Grilling, poaching and steaming your foods instead of roasting or frying can also help.
Adults should also aim for at least 30g of fibre a day, as high-fibre foods, such as wholemeal bread, fruit and vegetables, and potatoes with their skins on, can help lower cholesterol.
An active lifestyle can also help. Doing just 150 minutes of moderate aerobic activity every week can improve your cholesterol levels. Moderate aerobic activity means you’re working hard enough to raise your heart rate and break a sweat.
Another way to tell if you’re reaching this goal, is if you can still talk, but cannot sing the words to a song.
If, however, diet and exercise will not improve cholesterol levels due to it being inherited, statins will be prescribed by a GP.
Maintaining a healthy lifestyle is still encouraged, but statins are offered to people who have been or are likely to be diagnosed within 10 years, with coronary heart disease or cardiovascular disease.
Stopping smoking and reducing your alcohol intake can also help lower cholesterol levels.
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