High Cholesterol


What is high cholesterol?

Cholesterol is a yellow-colored, waxy and fat-like substance. It is made by your liver from the fats, carbohydrates and proteins in the food that you eat. Most of the cholesterol in your food comes from dairy products, meat, fish and eggs.

Cholesterol in suitable amounts is essential for your body and your body cannot simply function without it. Cholesterol plays a crucial role in the formation of certain hormones (like oestrogen, progesterone, testosterone, cortisol, and aldosterone), Vitamin D and cell membranes in your body. Cholesterol also enables absorption of vitamin A, D, E and K in the body.

When you eat cholesterol-rich or fatty foods, your body makes less cholesterol to keep a balance. But if you eat an unhealthy or excessive diet, consume alcohol, smoke and don’t exercise enough then too much cholesterol can build up in the blood. This extra cholesterol can cause health issues and be dangerous. High cholesterol in the blood is a major cause for the formation of plaque inside the blood vessels resulting in different forms of cardiovascular (heart) diseases. Hence it’s important to understand cholesterol and how it is good or bad for you.

Cholesterol can’t travel in the body by itself because it doesn’t dissolve in water. Instead of that, substances called lipoproteins help transport cholesterol throughout the body.

High-Density Lipoprotein (HDL): This is a good form of cholesterol that helps to return the LDL cholesterol back to the liver for elimination. HDL cleans the vessel walls of the fatty greasy bad cholesterol.

Low-Density Lipoprotein (LDL): This is a bad form of cholesterol and when it is increased excessively in the blood, this condition is called high cholesterol. LDL causes plaque build-up in the arteries (walls of blood vessels) and makes them narrow. This narrowing makes blood flow difficult and may increase the risk of chest pain or angina, heart attack and stroke.

Causes of high cholesterol

The main causes for development of high blood cholesterol levels are as below:

Genetic Factors:   People may inherit a type of cholesterol called familial hypercholesterolemia. People with familial hypercholesterolemia may have heart problems at an early age.

Unhealthy foods:   Eating foods like dairy products, meat, fish, eggs, chocolates, deep fried foods, processed foods, and baked foods can increase lots of saturated fats, trans fats and LDL cholesterol levels in your body.

Inactive lifestyle:   Physical inactivity and lack of exercise in everyday life decreases effects of HDL cholesterol and on the other hand increases LDL cholesterol level in the blood.

Smoking and Alcohol:   Regular alcohol and/or cigarette consumption can harden the blood vessels, raise the blood pressure, increase the oxygen requirement of the heart, and reduce the HDL cholesterol level in the blood.

Diseases:   Some diseases like hypertension, diabetes, hypothyroidism, kidney disease and liver disease can also raise cholesterol level in the blood.

Age and Sex:   Older people are more likely to have this condition than younger people. Similarly males are more likely to have this condition than females.

Symptoms of high cholesterol

High blood cholesterol itself does not show any symptoms but it is the cause of other serious and chronic health conditions such as heart disease and stroke. Because of this silent disease, people with high cholesterol are unaware of the fact that their cholesterol level is too high. The symptoms do not appear until enough plaque deposits in the blood arteries and allow less blood to pass through narrow arteries. Thereafter people may start feeling some symptoms such as shortness of breath, chest pain, pain in different parts of the body etc.

A blood test is the only way to detect high cholesterol levels in the blood. If your blood cholesterol level is above 240 mg/dL, it is too high.

How is high cholesterol diagnosed?

Doctors diagnose high cholesterol by knowing about a person's symptoms, family history, diet, lifestyle and by doing physical examination as well as by studying previous history of high blood pressure, heart attack and stroke. Laboratory tests are also important to diagnose high cholesterol. These tests include:

Lipoprotein profile blood test:   It is helpful to determine the total cholesterol, good (HDL) cholesterol, bad (LDL) cholesterol and triglycerides. The blood test is carried out after 12 hours of fasting.

Healthy Blood Cholesterol Levels

Types of cholesterol
Normal (mg/dL)
Borderline (mg/dL)
High (mg/dL)
Very High (mg/dL)
Total cholesterol
Less than 200
200 - 239
240 or higher
HDL cholesterol
Less than 40
40 - 60
60 or higher
LDL cholesterol
Less than 130
130 - 159
160 - 189
190 or higher

Other rule out tests:   These tests may be advised by doctors and helpful to rule out the diagnosis of other diseases.

   Ultrasound test is helpful to diagnose polycystic ovarian disease.

   Blood tests are helpful to diagnose hypothyroidism, arthritis, psoriasis and more.

Treatment of high cholesterol

The first line of treatment for high cholesterol is to always make diet and lifestyle changes as well as increase physical activity that will lower the risk of cardiovascular disease. When a person has a history of heart attack or stroke or is of old age and these changes are not sufficient, the doctor will prescribe medications and supplements to lower the high cholesterol.


Statins:   These medications block the production of cholesterol in the liver by blocking the enzyme in the liver.

   Atorvastatin   ( Lipitor )

   Simvastatin   ( Zocor )

   Rosuvastatin   ( Crestor )

Bile acid binding resins:   These medications decrease blood cholesterol level by binding to the bile acids.

   Cholestyramine   ( Questran )

   Prevalite   ( Cholestyramine Light,   ( Questran Light )

   Colesevelam   ( Welchol )

   Colestipol   ( Colestid )

Niacin:   These medications decrease LDL (bad) cholesterol and increase HDL (good) cholesterol.

   Nicotinic acid

   Niacin   ( Niacor )

   Niacin ER   ( Niaspan )

Cholesterol absorption inhibitors:   These medications block the absorption of cholesterol from food and bile juices in the intestines into the blood.

   Ezetimibe   ( Zetia )

PCSK9 (Proprotein convertase subtilisin/kexin type 9) inhibitors:   These medications act on the liver and help it to remove LDL from the blood.

   Repatha SureClick

   Praluent Pen



   Soluble fiber rich foods like oats, whole grains, fruits, vegetables etc

   Omega-3 Fatty Acids and Fish Oils


   Nuts and seeds

   Sunflower and olive oil





   Meat and meat products

   Dairy products like cheese, butter etc

   Chocolates, cakes, cookies

   Deep fried foods

   Processed foods

   Carbonated drinks

Lifestyle management:   Person should take the following steps to reduce symptoms as well as risks related to high cholesterol:

   Take your prescribed medications regularly.

   Do regular exercise or walking or jogging or running.

   Stop smoking cigarettes and drinking alcohol completely.

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