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What is cholesterol?
Cholesterol is an essential part of the make up of your body and is needed for good health. Most of the cholesterol in your body is made by your liver. Some cholesterol also comes from foods such as eggs, meats and dairy products.
Your body uses cholesterol to protect nerves, make cell tissues and produce certain hormones.
Why is a high cholesterol level unhealthy?
Too much cholesterol in your blood can raise your risk of having a heart attack or stroke because the extra cholesterol in your blood may be stored in your arteries (blood vessels that carry blood from your heart to the rest of your body). The build-up of cholesterol, or "plaque," in your arteries will cause them to narrow. This is called atherosclerosis. Large deposits of cholesterol can completely block an artery, so the blood can't flow through.
If the coronary artery (the blood vessel that supplies blood to the muscles in your heart) becomes blocked, a heart attack can occur. If an artery that supplies blood to your brain becomes blocked, a stroke can occur.
Cholesterol travels through the blood in different types of packages, called lipoproteins.
Low-density lipoproteins (LDL) deliver cholesterol to the body. High-density lipoproteins (HDL) remove cholesterol from the bloodstream.
This explains why too much LDL cholesterol is bad for the body, and why a high level of HDL is good. It's the balance between the types of cholesterol that tells you what your cholesterol level means (see the box below).
For example, if your total cholesterol level is high because of a high LDL level, you may be at higher risk of heart disease or stroke. If your total level is high only because of a high HDL level, you're probably not at higher risk.
Regular cholesterol checks are essential
Men aged 35 and older and women aged 45 and older should have their cholesterol checked periodically. Depending on what your cholesterol level is and what other risk factors for heart disease you have (see the box below), you may need to have it checked more often.
Total cholesterol level:
Less than 200 is best.
Between 200 to 239 is borderline high.
240 or more means you're at increased risk for heart disease.
LDL cholesterol levels
Less than 130 is best.
Between 130 to 159 is borderline high.
160 or more means you're at higher risk for heart disease.
HDL cholesterol levels
Less than 40 means you're at higher risk for heart disease.
60 or higher reduces your risk of heart disease.
Risk factors for heart disease
* Having already had a heart attack
* Being a man 45 years of age or older
* Having a father or brother who had heart disease
* Being a woman who is going through menopause or has completed menopause
* Having a mother or sister who had heart disease
* Smoking cigarettes
* Having high blood pressure or diabetes
* Being very overweight
* Being inactive
How to improve my cholesterol level
If you smoke, stop smoking. Lifestyle changes, such as a healthy diet and regular exercise can also help lower your risk of complications from high cholesterol.
Lifestyle changes
* Avoid smoking cigarettes or using any other tobacco product.
* Get regular physical activity.
* Eat a healthy low-fat diet that includes lots of fruits and vegetables.
* Limit how much alcohol you drink.
Medicine to lower cholesterol
Lowering your "bad" cholesterol (also called LDL, or low-density lipoprotein) can reduce your risk of having a heart attack or stroke. A number of lifestyle changes can help you improve your cholesterol level (see above). However, if these lifestyle changes don't help after about 6 months to 1 year, your doctor may suggest medicine to lower your cholesterol.
Even if you take cholesterol-lowering medicine, it's important to keep up with your lifestyle changes. Eating a healthy diet and being physically active can make your medicine more effective. Your doctor can give you tips on how to make healthy food choices and include physical activity in your daily routine.
Cholesterol-lowering medicines
Several types of medicine are used to treat high cholesterol levels. Your doctor will decide which type of medicine is right for you. He or she may prescribe more than 1 of these drugs at a time because combinations of these medicines can be more effective.
Statins (also called HMG-CoA reductase inhibitors) slow down your body's production of cholesterol. These drugs also remove cholesterol buildup from your arteries (blood vessels). Examples of statins include atorvastatin (brand name: Lipitor), fluvastatin (brand name: Lescol), lovastatin (brand names: Altocor, Mevacor), pravastatin (brand name: Pravachol), rosuvastatin (brand name: Crestor) and simvastatin (brand name: Zocor).
Resins (also called bile acid sequestrants) help lower your LDL cholesterol level. Some examples of bile acid sequestrants include cholestyramine (brand names: Prevalite, Questran), colesevelam (brand name: Welchol) and colestipol (brand name: Colestid).
Fibrates (also called fibric acid derivatives) help lower your cholesterol by reducing the amount of triglycerides (fats) in your body and by increasing your level of "good" cholesterol (also called HDL, or high-density lipoprotein). Some examples of fibrates include fenofibrate (brand names: Antara, Lofibra, Tricor) and gemfibrozil (brand name: Lopid).
Niacin (also called nicotinic acid) is a B vitamin. When given in large doses, it can lower your levels of triglycerides and LDL cholesterol, and increase your HDL cholesterol level. Even though you can buy niacin without a prescription, you should not take it to lower your cholesterol unless your doctor prescribes it for you. It can cause serious side effects.
Cholesterol absorption inhibitors help lower your cholesterol by reducing the amount that is absorbed by your intestines. Ezetimibe (brand name: Zetia) is a cholesterol absorption inhibitor. This type of medicine is often given in combination with a statin. The combination of ezetimibe and simvastatin (brand name: Vytorin) is an example.
Like all medicines, these drugs can cause side effects. However, the side effects usually are not severe and are not experienced very often. Common side effects include:
* Diarrhea or constipation
* Abdominal pain, cramps, bloating or gas
* Nausea and/or vomiting
* Headache
* Drowsiness or dizziness
* Muscle aches or weakness
* Flushing (skin turning red and warm)
*Sleep problems
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