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If you have hyperlipidemia, commonly known as "high cholesterol," you have high levels
of lipids in your blood. Lipids are fats and fat-like substances.
In this condition, the most common types of lipids are cholesterol and triglycerides.
Your body needs cholesterol to function properly.
It makes all the cholesterol you need, mostly in your liver.
The cells in your body need cholesterol as part of their cell membrane.
Your skin uses sunlight and cholesterol to make vitamin D.
Certain glands, such as the testicles in men, and the adrenal glands,
use cholesterol to make important chemicals, called hormones.
And, your liver uses cholesterol to make bile acids, which help to digest fat in the food you eat.
Your body uses triglycerides for energy. Triglycerides
in your blood come from food and your liver. Foods high in triglycerides include fatty
foods, refined carbohydrates, foods high in simple sugars, and alcohol.
From your liver, your lipids are not able to move through your bloodstream without some
adjustment. To enable their movement, your liver wraps
certain proteins around the lipids. The resulting new molecule, called a lipoprotein,
can move through your bloodstream and throughout your body to the cells that need it.
Depending on which type of lipoprotein your cholesterol is part of determines whether
your cholesterol is "good" or "bad." For example, your liver makes very low-density
lipoproteins, or VLDLs, which are the source of "bad" cholesterol, or LDL.
These lipoproteins are stuffed with cholesterol and triglycerides.
VLDL travels through your bloodstream, delivering triglycerides to your cells, which use them
for energy. If your liver makes more VLDL than your body
needs for energy, the VLDL stores the extra triglycerides as body fat.
After losing its triglycerides, a VLDL becomes a low-density lipoprotein, or LDL.
LDL travels through your bloodstream, delivering cholesterol to the cells that need it.
If your body makes too much LDL, it can build up in your blood.
LDL can deposit in the walls of your blood vessels, causing a buildup of fatty material,
called plaque. Damage to vessel walls can make it easier
for LDL to form plaques. Over time, this build up can narrow the blood
vessel and reduce blood flow. This is why LDL is called the "bad" cholesterol.
A common place this plaque can build up is in your coronary arteries, which are the blood
vessels that feed your heart muscle. This build-up causes coronary artery disease
and increases your risk of a heart attack. Plaque in other arteries, such as the carotid
arteries in your neck, can reduce blood flow to your brain and increase
the risk of a stroke. Your liver also makes high-density lipoprotein,
or HDL, also known as the "good" cholesterol. HDL has more protein and very little cholesterol
and triglycerides compared to LDL. HDL helps remove excess cholesterol from your
cells and from plaque in your blood vessels. This
is why HDL is called the "good" cholesterol. HDL returns the excess cholesterol to your
liver, which removes it from your body. If you are 20 years of age or older, the National
Institutes of Health recommends you have a blood test every five years,
called a fasting lipoprotein profile. It measures your levels of total cholesterol,
LDL, HDL, and triglycerides. During this test, a blood sample will be taken
from your arm or finger after you have not eaten for nine to twelve hours.
The total cholesterol goal should be less than 200 milligrams per deciliter.
For most people, an ideal HDL, or "good" cholesterol, should be 60 or higher.
An ideal LDL, or "bad" cholesterol, should be less than 100.
And fasting triglycerides should be less than 150.
Your specific goals may vary depending on your health situation. Ask your doctor what
your lipid goals should be. If your cholesterol levels are too high,
it's important to eat a heart-healthy diet with lean sources of protein and plenty of
fruits and vegetables. Also, the types of fats you eat can affect
your cholesterol level. For example, saturated fats and trans-fats
tend to raise LDL cholesterol in your blood. These fats are usually solid at room temperature
and are found in meat and dairy products, many processed foods, and tropical oils such
as coconut oil, palm oil, and cocoa butter. Unsaturated fats, including polyunsaturated
and monounsaturated fats, are healthier fats that are usually more liquid
at room temperature. They are found in foods such as fish, nuts,
and vegetable oils. Other lifestyle decisions you can make to
help your cholesterol are not smoking, and getting regular exercise, such as brisk
walking or running. If lifestyle changes can't reduce your cholesterol
levels enough, your doctor may prescribe certain medications to reduce it.
Statins are drugs that reduce the amount of cholesterol made in your liver.
They affect LDL levels more than HDL or triglyceride levels.
Niacin reduces LDL cholesterol and triglycerides, and increases HDL cholesterol made in your
liver. Bile acid-binding resins are drugs that prevent
the re-use of bile after helping to digest your food.
As a result, your liver uses more cholesterol to replace the lost bile, which means less
cholesterol in your bloodstream. Fibrates are mainly used to reduce triglyceride
levels in your blood, but they can also raise HDL levels.
Cholesterol absorption inhibitors reduce the amount of cholesterol absorbed by your intestines
from the food you eat. In many cases, the same steps can help maintain
healthy cholesterol and triglyceride levels, such as:
eating a diet low in saturated fat, trans-fat, and cholesterol, getting regular exercise,
managing your weight, and not smoking.