Help! My cholesterol levels are high

People with extremely high levels of cholesterol are at risk of getting heart attacks. Cholesterol is a cheesy substance that coats the inner lining of blood vessels. The body needs cholesterol to build healthy cells, but high levels are harmful.

With long-standing high levels of cholesterol, that fatty particle streak into the lining of blood vessels makes them stiff unable to allow enough blood to flow through. Sometimes, those deposits can break suddenly and form a clot that causes a heart attack or stroke.

High cholesterol is often the result of unhealthy lifestyle choices, which makes it preventable and treatable. High cholesterol has no symptoms. A blood test is the only way to detect if one has it. Here are many questions many patients usually present within my clinical practice.

What exposes me to bad cholesterol?

Poor diet associated with consuming saturated fats that are found in animal products and trans fats are commonly found in some commercially baked cookies, crackers and microwave popcorns raise cholesterol level. Consumption of foods that are high in cholesterol such as red meat and full-fat dairy products may also increase cholesterol.

Sedentary lifestyle: Exercise helps in boosting the body's ‘good’ cholesterol while increasing the size of the particles that make up your ‘bad’ cholesterol, which makes it less harmful.

Obesity: Having a Body Mass Index of 30 or more puts you at a risk of high cholesterol.

Age: The body chemistry changes as you age. As you age, the liver becomes less able to remove bad cholesterol.

Diabetes: High blood sugar contributes to higher levels of dangerous cholesterol called very-low-density lipoprotein and lowers good cholesterol. It also damages the lining of the arteries.

Smoking: Tobacco smoking damages the walls of the blood vessels, making them more prone to accumulate fatty deposits. Smoking might also lower the level of good cholesterol. Indeed, stopping tobacco is associated with an increase in good cholesterol.

What foods contain high cholesterol and should be avoided?

Trans fats - They not only increase levels of bad cholesterol but also lower levels of good cholesterol. They are the most harmful fats. Examples of trans-fats include: packaged cookies, cakes, donuts, pastries, potato chips, commercially fried foods, bakery goods that contain shortening, buttered popcorn and any products that contain partially hydrogenated or hydrogenated vegetable oils.

Saturated fats - They mostly occur in meat and dairy products. They instruct the liver to produce more bad cholesterol. Examples of saturated fats include fatty beef, lamb, pork, poultry with skin, lard and shortening, dairy products made from whole or reduced-fat milk, saturated vegetable oils such as coconut oil, palm oil and palm kernel oil.

Other foods that contain cholesterol and may be best avoided include: red meat, sausage, bacon and organ meats such as kidney and liver.

What complications I’m I likely to suffer from high levels of cholesterol?

High cholesterol can cause a dangerous accumulation of cholesterol and other deposits on the walls of the arteries. These deposits can reduce blood flow through the arteries which can cause complications such as:

Chest pain - If the arteries that supply the heart with blood are affected, one may develop chest pain and other symptoms of coronary artery disease.

Heart attack - If blood flow to any part of the heart stops due to cholesterol-induced clots, a heart attack occurs, commonly manifested as severe crushing chest pain.

Stroke - a stroke occurs when a blood clot blocks blood flow to any part of the brain.

What treatment is available for cholesterol-induced heart disease?

The first line of defense against high cholesterol is lifestyle changes such as exercising and eating a healthy diet. If the cholesterol levels remain high after the lifestyle changes then the doctor might recommend medication. The choice of medication or combination of medications depends on various factors which include: personal risk factors, age, health and possible drug side effects.

Dr Ngunga is a consultant interventional cardiologist at Aga Khan University Hospital, Nairobi

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