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What is cholesterol?

Cholesterol is a lipid that is produced in the liver, and circulates in the bloodstream. It is important to the function of cell membranes, and contributes to the formation of many of the body’s hormones. The body synthesizes some cholesterol; we ingest some in our diets.

Why are high cholesterol levels dangerous?

High levels of total cholesterol and LDL (low-density lipoprotein) contribute to the formation of atherosclerotic plaque build-up on the inside walls of blood vessels. If the build-up blocks an artery, or breaks loose and forms a clot “downstream” in a smaller blood vessel, the result can be a heart attack or a stroke.

There is a direct and exponential relationship between elevated cholesterol levels and the incidence of coronary heart disease. Coronary heart disease is the leading cause of death for both men and women of all races and ethnicities in the United States. In the U.S., more people die of heart attacks every year than die of all the forms of cancers combined.

How often should I be tested?

It is recommended by the American Heart Association to test cholesterol every five years for people aged 20 years or older. It is recommended to have cholesterol tested more frequently than five years if a person has total cholesterol of 200 or more, is a man over age 45 or a woman over age 50, has HDL (good) cholesterol less than 40, or other risk factors for heart disease and stroke.

What are the recommended levels of cholesterol?

The acceptable levels will vary from individual to individual depending upon age and other risk factors. As a rule, total cholesterol should be less than 200 and triglyceride levels less than 150. LDL (“bad” cholesterol) levels are optimally less than 100. Near optimal is 100 to 129, borderline high is 130 to 159, high is greater than 160, and very high is over 190. High-density lipoprotein (HDL or “good” cholesterol) should be greater than 40 in men and 50 in women.

What treatments are available?

A low-cholesterol, low-fat diet is the most important intervention. Regular aerobic exercise can help to raise HDL levels. Over-the-counter supplements such as flax seed, fish oil capsules and red yeast rice tablets have been shown to be beneficial.

For those requiring medications, there are several families of medicines: statins such as simvastatin (Zocor®) or atorvastatin (Lipitor®); cholesterol absorption inhibitors such as ezetimibe (Zetia®); bile acid sequestrants such as cholestyramine (Questran®); Nicotinic acid such as Niacin (immediate, sustained, and extended release, Niaspan®); and the fibrates such as gemfibrozil (Lopid®) or fenofibrate (Tricor®).

What new therapies are being tested?

Newer medications that work by inhibiting cholesterol absorption or production are being developed. If you have high cholesterol and would like to participate in a study, please contact us. If you do not know your cholesterol levels, Baptist Health Center for Clinical Research offers a free cholesterol-screening visit that only requires a drop of blood from the fingertip.

For additional, general information on cholesterol:

MedlinePlus: Cholesterol
NIH National Heart, Lung, and Blood Institute: High Cholesterol
American Heart Association: Cholesterol