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Hypercholesterolemia

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Medical Care

Hypercholesterolemia

High Cholesterol (Lipid) or Hypercholesterolemia can be explained as a condition whereby one’s
blood cholesterol levels are above the cut off for a normal healthy individual.

It is a common thing to see people without any current information about their blood cholesterol
level. Most people are inclined to checking their blood pressure, blood sugar, cancer risk factors
than lipid profile.

High cholesterol is a leading risk factor for cardiovascular (heart) disease which is one the
leading causes of sudden death.

What is Cholesterol?
Cholesterol is a kind of fat called a lipid. . Almost 80% of all the cholesterol you need is
produced by your liver and is circulated throughout the body in the blood

Why do we need Cholesterol?
It is essential for maintaining the proper functioning of cell membranes and is used by the body
to produce hormones like estrogen and progesterone in women and testosterone in men
It is also used in the production of Vitamin D and bile
Cholesterol also helps in the formation of your memories and is vital for neurological function.
Your liver makes about three-quarters or more of your body’s cholesterol

Types of Cholesterol, the Good and the Bad

Cholesterol like all fats does not dissolve in water and since it is not water soluble, it cannot be
carried in the blood. For it to get transported from the liver where it is produced, to the tissues
and organs where it is needed, it combines with a protein to form a compound known as
Lipoprotein (fat+protein). Lipoproteins are like vehicles that help to transport cholesterol around
the body.

There are two major types of cholesterol containing lipoproteins and they are called Low
Density Lipoprotein- LDL (which is the bigger and the bad guy), and High Density
Lipoprotein- HDL (which is smaller and safe guy). This is the “good” cholesterol that helps
keep cholesterol away from your arteries and remove any excess from arterial plaque, which may
help to prevent heart disease.

An interesting way to describe the way cholesterol is transported in the body is to compare it to a
busy dual carriage way. On one side of the express is the LDL which is carrying cholesterol
from the liver on its way to the body’s cells. Imagine LDL as a big long-distance mega coach
bus, packed full of passengers and goods on its way from the farm to the City.
On the other side is the HDL which is taking used or excess cholesterol away from the cells and
back to the liver to be reprocessed. Imagine HDL as a small bus returning half empty from the
city to the farm. One could describe HDL as the clean-up crew driving behind the tipper
described above.

When there are too many “Coach Buses” travelling on the road there will be lots of traffic on the
express way and there is a higher chance of serious road traffic accidents. In the same way, when
there is too much LDL cholesterol in the blood, it can make the blood sluggish, forming plaques
in your arteries, making it narrow and stiff, (a condition called atherosclerosis). This plaques can
dislodge and occlude arteries leading to one,s heart or brain and a stroke will occur!

.
Why is High Cholesterol a problem?
Have you ever seen a tipper truck full of sand or gravel speeding past and noticed how some of
the contents in the back can fall off and get scattered along the way as the vehicle goes down the
road? In the same way, when there are high levels of LDL cholesterol in the blood some of the
cholesterol can get deposited in the walls of arteries. If LDL cholesterol levels remain high then
the plaques will continue to grow and over a period of time will begin to narrow the blood
vessels. This is known as Atherosclerosis. When blood vessels are narrowed the tissues and

organs they supply are slowly starved of oxygen rich blood. If the narrowing persists, blood flow
can be cut off completely leading to tissue and organ death.

But that’s not all. Normal blood, for as long as it is in the veins and arteries will not clot and will
remain a free flowing fluid. However, when cholesterol levels in the blood are too high it can
cause blood to become sluggish as it flows through the vessels. Sluggish blood coupled with
narrowed arteries makes it more likely for the blood to clot inside vessels. When a clot forms it
can completely block blood flow to vital organs (thrombus) and if the clot breaks up, small
chunks can detach (embolus) and be carried to distant organs where they block blood vessels
and lead to blood starvation known as ischemia. When blood flow is cut off in the arteries of the
heart, we call this a heart attack and when it happens in the brain it is called a stroke.
This is why LDL is known as Bad Cholesterol.

 

What can I do to prevent Hypercholesterolemia?
There are two ways of treating hypercholesterolemia. One is by changing your diet and adjusting
your lifestyle and the other is by taking a cholesterol lowering drug.

A radical dietary and lifestyle change is very effective in lowering cholesterol levels and it has the
added benefit of also reducing other health related problems like obesity, arthritis, cancer and heart
disease. This will include:

Reducing LDL
With 80% of the cholesterol being produced in the liver and the other 20% from dietary sources,
trans-fats and polyunsaturated fats are the main dietary sources of cholesterol. Foods that contain
trans-fat include:
– Fatty meats such as corned beef, hot dogs, sausage, bacon, and processed meats are high in trans
fats and poly unsaturated fats. These can be replaced with chicken or turkey, lean beef, lamb, and
fish.

– Pastry and flour based foods such as meat pies, bread, cakes, and other snacks made with
saturated or hydrogenated fat, whole eggs, or whole milk. Try low-fat baked goods, and avoid
ketchup or mayonnaise or use only sparingly.

– Fast foods like hamburgers, fries, fried chicken are very high in both total fat and saturated fat.
Try instead vegetable salads or fruit salads or smoothies.

Increasing HDL
HDL is your good cholesterol and eating foods high in HDL will help keep your arteries healthy.
HDL is able to pick up any free cholesterol it finds in the arteries and take it back to the liver.
Foods that contain or increase HDL include:
– Beans
– Oats
– Garlic and onions
– Oily fish
– Olive oil
– Avocados
– Seafood

Reducing exposure to Free Radicals
The real culprit in atherosclerosis is not cholesterol itself but cholesterol that has been damaged
by free radicals. Free radicals are substances in the environment or in our food that can destroy the
chemical structure of our body’s cells and are a leading cause of atherosclerosis, cancer and many
other diseases. Examples of sources of free radicals include:
– Barbequed food: e.g. Kebab
– Smoked food: e.g. Smoked fish
– Ultraviolet rays from the sun
– Industrial chemicals
– Smoking: e.g. Cigarettes, Cannabis, Shisha
– Processed foods: e.g. canned or tinned food

– Fizzy drinks

Increasing Anti-Oxidants
Antioxidants are powerful compounds that help neutralize the effects of free radicals and these
are present in our food. Good sources of antioxidants include:
– Fruit and vegetables: e.g. Cranberry
– Vitamin C and E stop bad cholesterol from sticking to the body’s artery walls. Vitamin C
diminishes as it is cooked or if it is stored for too long so raw fruit and vegetables containing
vitamin C such as oranges, strawberries, cauliflower, broccoli and grapefruit are ideal. You can
also blend these into a healthy smoothie and mix with organic fat free yoghurt.

Exercise
You mentioned that you consider yourself fit and healthy and that you go to the gym regularly.
Even if a person is slim or looks fit, they may still have dangerously high levels of LDL

cholesterol in their blood because of what they eat. That said however, exercise especially cardio
and moderate weighed exercises are proven to reduce LDL and increase HDL levels in the blood

Lipid Lowering Food and Drugs
In some people, the cholesterol levels are dangerously high and lifestyle modifications alone may
not be quick enough to reduce the LDL to safe levels, or they may have other conditions like
Diabetes which may then make it necessary for their doctor to prescribe a medication to lower
their cholesterol.

Statins are a group of drugs used to reduce the cholesterol levels in the blood and have been proven
effective in reducing the risk of death from stroke and heart attacks in patients who take them. As
with all medicines you will need to talk with your doctor who will discuss with you the potential
side effects and the dose required.

Summary
In a nutshell, Cholesterol is a lipid produced in the liver and is a key part of your body’s cells
and is transported in the blood in form of lipoproteins. LDL cholesterol is known as bad
cholesterol because high levels can lead to stroke or heart attack and is generally associated with
unhealthy eating. HDL is known as good cholesterol and can help reduce the risk of
cardiovascular disease. HDL is generally associated with healthy eating.

Eating healthy, including antioxidants in our food, exercising regularly, and avoiding or reducing
exposure to free radicals will help to keep LDL levels low and reduce the risk of serious diseases.

If you follow the suggestions above meticulously I have no doubts that you should be able to
successfully reduce your cholesterol by the time you have your next occupational health check.

Warm regards,

Dr Adesola

Disclaimer: This column is written for patient education. It is not intended to diagnose or
prescribe treatment and does not replace the advice of your physician. Also, It does not cover the
full medical scope of this condition.

References
Mercola Journal, The Importance of Vitamin D for normalizing your cholesterol level.
Ask Dr Craig about bad Cholesterol.
Photo Credit: WikiMedia Commons

Adesola Ajiboye is a UK based medical practitioner and a public health researcher. She holds a
Bachelor of Medicine, Bachelor of Surgery from Unilorin,College of Medicine, and a Master of
Science with a major in Public Health from the Lund University ,Sweden. She is passionate

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