Cholesterol management tips and treatment options | MediCare Pharmacy
What is Cholesterol?
Cholesterol is a waxy substance that is needed for many functions in the body. Cholesterol is needed to build cells, make vitamins, and other hormones. The presence of cholesterol is not a bad thing, but excessive amounts can cause many complications.
The liver creates all of the cholesterol for the body. The body may receive extra cholesterol through the foods you consume, like meat, poultry, and meat products. These foods are often high in saturated and trans fat, which can contribute to high cholesterol levels.
It is important to get your cholesterol measured at least once every five years if you are over 20. If you are a man over 35 or a woman over 45, more frequent cholesterol tests are recommended.
Measuring Cholesterol Levels
In Canada and European countries, cholesterol is measured in millimoles per litre (mmol/L) in Canada and European countries. In Canada, the following is used as a guideline for cholesterol levels:
- Total cholesterol: less than 5.2 millimoles per litre (mmol/L) is good, and more than 6.2 mmol/L is a high cholesterol
- HDL: anything more than 0.9 mmol/L is desirable
- LDL: less than 3.5 mmol/L is healthy, and a reading over 4.0 mmol/L is high
LDL vs. HDL
LDL (low-density lipoprotein) is considered the “bad” cholesterol. This type can build up in the arteries and increase your risk of heart disease. The lower your LDL reading, the lower your risk. When cholesterol accumulates in the arteries, it can narrow the arteries and cause a lack of blood flow to the heart. LDL is especially dangerous because it often occurs without any symptoms.
HDL or “good” cholesterol protects against heart disease by taking LDL cholesterol out of the blood. HDL picks up LDL and takes it to the liver, where the body breaks it down. If you have a high HDL number, you are less likely to experience health complications like stroke and heart attack.
How to Minimize the Risk of Bad Cholesterol
Reducing high cholesterol levels is fairly simple if you follow a healthy diet and exercise routine. Health Canada recommends at least 30 minutes of exercise a day and abstaining from smoking cigarettes. Reducing excess fat in your diet is also beneficial in keeping your cholesterol at healthy levels. Other tips include:
- Choose leaner meats like poultry and fish
- Eat only one egg yolk a week
- Cook with little to no fat or oil
- Use vegetable oils in small quantities
- Avoid highly processed store-bought baked goods like croissants, muffins, and doughnuts
- Choose skim dairy products
Medication Options for High Cholesterol
Following the above tips is the best line of defence against high cholesterol levels. Some people may not be diagnosed with high cholesterol for a long period and require prescription intervention to lower their levels. Some examples of medications include:
Statins: Statins block a substance in the liver necessary to make cholesterol, causing your liver to remove cholesterol from the blood.
Cholesterol absorption inhibitor: If your cholesterol does not lower with statins, you may be prescribed cholesterol absorption inhibitors. These drugs decrease cholesterol absorption from the digestive tract.
PCSK9 Inhibitors: PCSK9 is a protein made in the liver. These drugs latch onto PCSK9 proteins and block them from acting, allowing liver cells to sweep away excess cholesterol
Niacin: Niacin (also known as vitamin B3) is essential for the overall health of the body. Taking niacin can boost levels of HDL cholesterol and lower triglycerides (a type of fat found in the blood). It is often used in combination with statins.
Complications of High Cholesterol
High cholesterol complications are serious medical events and may be life-threatening if left untreated. Your doctor will calculate your risk of complications by examining your cholesterol levels, age, sex, race, and blood pressure. If your cholesterol and blood pressure continue, you may be at risk for the following complications:
Carotid artery disease: This occurs when waxy substances (cholesterol plaque) build up in the carotid arteries on each side of the neck. This can prevent blood supply to the face, scalp, and neck.
Coronary artery disease: This condition encompasses any problem that affects the heart’s structure and function. The arteries can no longer deliver oxygen-rich blood to the heart.
Heart attack: When blood flow to the heart becomes blocked, the heart muscle can begin to die. Plaque buildup in the coronary arteries can cause this blockage.
Peripheral artery disease (PAD): PAD affects the blood vessels that carry the blood away from the heart to the rest of the body. Lower extremity PAD can reduce blood flow to the legs and feet.
Stroke: When blood to the brain is blocked, brain cells lose oxygen and nutrients and begin to die. A stroke can cause long-term disability or death.
References:
- Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/hdl-cholesterol/art-20046388
- American Heart Association: https://www.heart.org/en/health-topics/cholesterol/about-cholesterol
- Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/symptoms-causes/syc-20350800
- Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/cholesterol-medications/art-20050958