Cholesterol:

Cholesterol is a type of fat which is found throughout the body and carried around it by the blood. Some cholesterol comes from food whilst some is produced in the body by the liver. Perhaps surprising in view of its well-established role in causing heart disease and other problems, a certain small amount of cholesterol is in fact necessary for all of us to live. Unfortunately when present in higher quantities, it tends to cause problems.

The main problem associated with high levels of blood cholesterol is the development of lumps of fatty material, or atheroma, on the inner lining of arteries. These usually enlarge and become more widespread over the years, bulging into the lumen of the blood vessels causing narrowing and an impairment to the flow of blood. When this atheroma develops within the blood vessels supplying the heart (the coronary arteries), angina develops. Other problems from atheroma include heart attacks and strokes both of which typically occur when a blood clot or ‘thrombosis’ forms suddenly over an area of atheroma, causing acute blockage to the blood flow in an artery of the heart or brain, respectively.

Almost everybody will have developed some atheroma by late middle age. Whether this causes them any problem depends on the position and severity of it. Although high levels of cholesterol are associated with atheroma, other "risk factors" also play a part. These include smoking, raised blood pressure, being overweight, lack of exercise, stress, diabetes and a family history of relatives developing angina, heart attacks or strokes in middle age. Men also have a greater risk of developing problems than women.

All of these risk factors, cholesterol included, combine together to increase an individual's chance of developing problems from atheroma. So, although a person's cholesterol level is of importance, whether or not he/she is diabetic, a smoker, overweight, inactive or has raised blood pressure are also just as relevant. We should therefore be careful not to become preoccupied with cholesterol but rather to see it as one part, albeit an important part in the overall 'risk factor equation' that determines a particular person's chance of developing problems from atheroma.

In fact, many of these factors are inter-related and it is possible to give general advice to reduce your chance of developing heart disease, stroke, etc:

Stop smoking

Lose weight if overweight

Do not drink alcohol to excess a maximum of 21 units per week for a man, 14 units for a woman: a unit is one half a pint of beer or lager, a glass of wine or a measure of spirits

Exercise regularly
Eat healthily even if you are not overweight, eating a healthy diet can lessen your chance of developing atheroma. But remember, you need to stick to it!

10 Dietary Tips to Lower Cholesterol:

Avoid frying food grill or roast instead.
Use unsaturated margarine rather than butter.
Eat no more than 2 eggs per week.
If you must fry, use an unsaturated vegetable oil such as sunflower or olive oil.
Drink skimmed or semi-skimmed rather than full-fat milk.
Choose fish or poultry instead of red meat.
Eating an apple (or two) a day helps keep not only the doctor but also heart disease at bay!
Cut down on sweets, biscuits and cakes.
Choose wholegrain rather than white bread.
Cut the fat off meat and remove the skin from chicken before cooking.

In most people high cholesterol levels result from eating too much fat and having a sedentary lifestyle. A small proportion of people, however, may have an underlying medical condition causing high cholesterol such as an underactive thyroid gland and others inherit a genetic tendency for raised levels. The good news is that, for the vast majority of people, altering what they eat whilst increasing the amount of exercise they do significantly reduces their cholesterol and thus the associated risk of heart disease. Some people however, despite eating healthily and keeping active, continue to have a high cholesterol level. In these cases it may be necessary to prescribe medication which, when taken long-term, can help reduce cholesterol.

A common question asked of doctors is "what is a normal cholesterol level?" This is not as straightforward a question to answer as you may think. As the level of cholesterol is merely one risk factor which, together with several others, make it more or less likely to develop problems such as heart disease and strokes, for any one person the significance of a particular cholesterol level will depend to a large extent on these other factors. Indeed, it is now possible to estimate an individual's chance of developing heart disease using specialised computer programmes.

In fact, we now know that a 60 year old diabetic man with a certain cholesterol level who smokes has twice the risk of developing heart disease over the next 10 years as he would have if he didn't smoke and wasn't diabetic. He also is ten times more likely to develop heart problems than a 40 year old lady who doesn't smoke, isn't diabetic but who has the same cholesterol level. It is therefore important to view your cholesterol level in conjunction with these other factors. Your doctor will be able to work out your particular risk and advise you accordingly.

REMEMBER: don't just think 'cholesterol' think how can I reduce my chance of developing a heart attack or stroke ?

For further information see http://www.bhf.org.uk

Disclaimer: This page is for informational purposes only and should not be considered as medical advice or substituted for professional advice. Always consult your doctor with your questions and concerns.