Why is high cholesterol bad?
Cholesterol is a natural substance found in our diet and
made by our liver. It is necessary for many functions throughout our body. Yet, high levels of cholesterol are linked with atherosclerotic vascular disease, as well as, stroke, heart attacks, heart disease and peripheral vascular disease (arteries of the legs). Over decades, high blood cholesterol levels may result in damage and narrowing of arteries (atherosclerosis) that supply the heart, brain and other organs. In time, the poor blood flow may damage those organs and cause sudden heart attacks and strokes.
What are the “good” and “bad” cholesterols?
Cholesterol (whether from diet or made in the liver) travels through the blood stream in something known as lipoprotein. Think of lipoproteins as little freight trains carrying the cholesterol through the blood. The low-density lipoprotein (LDL) carries cholesterol to the cells. Just like a freight train carrying too much coal dumps coal along its tracks, when there is more LDL
cholesterol than the body can use, some of it tends to get dumped along the blood vessel wall. The cholesterol mixes with 1) calcium, 2) sticky cell fragments called platelets and 3) blood cells forming atherosclerotic plaque which over time blocks the blood vessel

(see the figure). That is why LDL cholesterol is called “bad” cholesterol.
On the other hand, high-density lipoprotein (HDL) cholesterol tends to
be carried away from the arteries and back to the liver, where it is passed from the body. Therefore, HDL cholesterol is referred to as “good cholesterol”.
When should I be checked?
Experts agree that screening for the level of cholesterol and HDL cholesterol is very important for men over 35 and women over 45 years of age. Many doctors support screening all men and women 20 years and older, and all children from families with a high risk of heart disease. People with healthy levels (total cholesterol less than 200 or LDL cholesterol less than 100) should be rechecked every five years.

What should my cholesterol be?

Know your numbers! The table above explains the relative risks depending on your cholesterol level. Your doctor may screen total cholesterol and/or HDL cholesterol non-fasting or a fasting full lipid profile in which the triglycerides and LDL cholesterol are measured. Fasting is no food or drink with calories for 12 hours before testing.
What makes cholesterol high or low?
Family History: Due to genetics, cholesterol levels of many patients will remain high despite doing things right.
Diet: Diets should contain less than 30% calories from fat, less than 8% from saturated fat. Avoid high saturated fats, like diary fats (ice cream, butter) and palm and coconut oils and avoid hard margarines which have trans-fatty acids, and try to use products made from plants( e.g., soybean oil) instead. Limit high cholesterol foods, like eggs and organ meats (liver). Avoid fried foods, while eating higher fiber foods, fruit and vegetables. Eat more fish and skinless chicken breasts.
Weight: Lose weight if overweight. Excess weight is linked with high cholesterol, low HDL cholesterol, high triglycerides, diabetes, and higher risk of heart disease.
Exercise: Even mild regular exercise has been shown to raise HDL cholesterol levels and lower triglycerides. This works even better when a weight loss program is part of the plan.
Quit smoking! Smoking clearly increases your risk of heart attack and stroke. It also lowers your HDL cholesterol.
Alcohol: Although one or two drinks daily has been shown to increase HDL cholesterol, alcohol excess is responsible for damages to other organs, so it is not a good way to prevent heart disease.
Medication: Medications for cholesterol are most often long-term medications. They have to be taken everyday, often for the rest of your life.
More information regarding cholesterol lowering medication can be found in our Dr., Should I be Taking?... article.