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Coping with High Cholesterol

Cholesterol itself is not a bad thing: it is an essential nutrient in the body and is present in every single cell. Cholesterol aids digestion of food, generation of vitamin D, and production of hormones. However, if cholesterol levels become too concentrated within the blood, this puts us at risk of serious health problems - high cholesterol is a cause of heart attacks.

Management of high cholesterol

High cholesterol needs to be carefully managed because it is a significant risk factor towards coronary heart disease. As cholesterol travels around the blood, it can build up and narrow the arteries in a process called atherosclerosis. This then causes restrictions to blood flow in the body, which can lead to a heart attack.

There are several causes of high cholesterol, including obesity or excess weight, which can also lead to high cholesterol in the blood. Genetic factors and inherited conditions can also have a significant impact, as can the presence of liver or kidney disease, an underactive thyroid gland, certain drugs (including anabolic steroids), and diabetes.

Over 240 milligrams of cholesterol per deciliter of blood is considered high, with some doctors setting a target number to guide therapy.

Tips for lowering your cholesterol

Limiting foods that contain cholesterol, including animal products such as meat and cheese, is an integral part of managing cholesterol levels in the body. It is also important to control the intake of certain fats; just like cholesterol, not all fats have a negative impact on health, and some are an essential part of our diets. However, trans fats that occur in some processed or fried foods, and saturated fats, which are present in many meat, dairy, or convenience foods, need to be limited to successfully manage cholesterol levels.

Similarly, some foods actively lower cholesterol levels in the body, including nuts, fruits, fatty fish, foods rich in fiber, barley, oats and other wholegrains, beans, vegetable oil, aubergines and okra. Using vegetable oils, such as sunflower or canola oil, can also effectively reduce cholesterol if used in line with a balanced diet.

It is also vital for those who wish to reduce their cholesterol levels, or maintain them at a suitable level, to regularly exercise, avoid smoking, eat a heart-healthy diet, and to achieve - and maintain - a healthy weight. These can have a significant impact, especially when begun at a young age.

Monitoring and medication of high cholesterol

Lipid-lowering therapy

Lipid-lowering therapy with drug treatment may be offered, depending on a person's cholesterol level and other risk factors. Recommendations will usually begin with changes to diet and exercise. However, statins or other medications may be recommended for those at increased risk of a heart attack.

Statins are the leading group of cholesterol-lowering drugs, but a doctor may instead prescribe resins, fibrates, or niacin.

A stepped or graduated approach has been recommended since 2018, depending on the individual's level of risk. For example, a patient who has already had a cardiovascular event may also be prescribed other medication alongside a statin.

Statin safety

There has been some debate over the use of statins in recent years due to their side effects; this is a common factor of almost all drugs, where there are some unintended symptoms which present in some patients, alongside their effective use.

These can include fatigue, a slightly increased risk of diabetes or complications associated with diabetes (though this is a topic of significant debate), or myopathy, a disease associated with muscle tissue. However, statins are in wide use because they reduce the risk of serious cardiovascular problems, alongside lifestyle changes like exercise and improved diet.

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