CHOLESTEROL, HIGH

General Information

DEFINITION--A total blood cholesterol level that is higher than the recommended safe range. When the blood contains too much cholesterol, the risk of heart and blood-vessel disease increases. Cholesterol is a white, fat-related (waxy) substance, manufactured by the liver, and essential for maintaining cells, making hormones and bile salts. Total blood cholesterol is made up of LDL (low-density lipoprotein); HDL (high-density lipoprotein) and VLDL (very low density lipoprotein). Increased levels of LDL are associated with plaque deposits on artery walls that narrow them and restrict blood flow. HDL or "good" helps prevent plaque.

SEX OR AGE MOST AFFECTED--Adults of both sexes, but more common in men.

SIGNS & SYMPTOMS--High cholesterol in itself does not produce symptoms.

CAUSES--The level of blood cholesterol is affected by diet, heredity and some diseases.

RISK INCREASES WITH

• Diet high in saturated fat.
• Hereditary factors.
• Obesity.
• Smoking.
• Sedentary life-style.
• Stress.
• Disorders such as hypothyroidism, diabetes mellitus, nephrotic syndrome, obstructive liver disease.
• Use of some drugs (progestins, anabolic steroids, diuretics, beta-blockers, some immunosuppressants).
• Alcohol excess.
• People with family members who have had a stroke or heart attack before age 50.

HOW TO PREVENT

• Low-fat diet.
• Exercise.
• Weight control.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Laboratory test to measure blood cholesterol levels. In the general population, the results usually range from 100 to 280 milligrams per deciliter (mg/dl). Readings below 200 mg/dl put you at below-average risk, borderline risk level is 200 mg/dl and high-risk level is greater than 240 mg/dl. When results are in risk ranges, further evaluation is suggested to verify the results and to determine the separate levels of LDL, HDL and triglycerides (another kind of blood fat).

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.

POSSIBLE COMPLICATIONS--May lead to atherosclerosis, heart disease and stroke. Smoking increases the risk.

PROBABLE OUTCOME--High cholesterol levels can usually be lowered with a change in diet and life-style modifications. When these are insufficient, medications may be prescribed.

How To Treat

GENERAL MEASURES--

• The diet changes and life-style modifications do not mean you have to give up all the good things you enjoy. Moderation is important.
• Stop smoking. Consult your doctor about recommendations for a cessation program.

MEDICATION--Your doctor may prescribe: cholesterol lowering drugs if self-care measures do not reduce elevated cholesterol levels. Diet restrictions need to be continued, even if you are taking these medications.

ACTIVITY--

• Regular aerobic exercise (30 minutes, 3 times a week) can help increase the level of HDL, the "good" cholesterol.
• Consult your doctor before beginning an exercise program if you have high cholesterol levels and other risk-factors for heart disease.

DIET--

• Restrict your consumption of foods that contain cholesterol and saturated fats (eggs, dairy products, beef, dark meat poultry, poultry skin, and coconut and palm oils).
• Eat a low-fat, high-fiber diet (see both in Appendix).
• Begin a weight reduction diet if you are overweight (see Weight-Loss Diet in Appendix).
• Read food labels carefully. A product may have no cholesterol but still be high in fat content. Reducing your intake of both fat and cholesterol is important.
• Reduce alcohol intake.

Call Your Doctor If

• You want to learn your cholesterol levels.
• Self-care measures do not reduce elevated cholesterol levels.
• New or unexplained symptoms develop. Drugs used in treatment may cause side effects.