Elevated cholesterol levels alone usually do not cause any symptoms, but they can indicate an increased risk of cardiovascular diseases such as arteriosclerosis, heart attacks, angina pectoris, strokes and aneurysms. Other risk factors for the heart and circulatory system, such as high blood pressure, diabetes mellitus and lack of exercise, increase this risk. When symptoms occur, the damage is often already advanced. That is why most experts recommend regular preventive measurements from the age of 35.
Elevated Cholesterol Causes And Risk Factors
There are four main reasons for increased cholesterol levels in the blood:
- In about four out of ten sufferers, foods that are too fatty with too many saturated fatty acids are to blame. The amount of fat overwhelms the organism. In addition to the amount of fat, the proportions of saturated and unsaturated fatty acids have a major impact.
- Unfavorable nutrition and unfavorable hereditary factors often come together. In those affected, cholesterol levels rise from amounts of fat, which have no effect in people with more favorable genes. Nevertheless, a healthy lifestyle can compensate for the influence of unfavorable hereditary factors. You are not an inevitable fate.
- Less than 1 in 100 people affected has a purely hereditary lipid metabolism disorder. Even mild manifestations can cause crises such as heart attacks early in life if they go undetected and untreated.
- The "secondary" increase in cholesterol levels is the result of illnesses, the use of certain medications or alcohol addiction. Disorders that increase cholesterol include diabetes, hypothyroidism, inflammation of the pancreas, anorexia, and certain kidney and liver disorders. The values usually return to normal once the diseases are cured. Some medications also cause the levels to rise, such as active ingredients from the family of female sex hormones (oestrogens) and glucocorticoids (e.g. cortisone). After the end of the application, the values usually drop again.
Risk factors
The most important risk factors are listed under "Symptoms" when assessing cholesterol levels. Both there and under “Causes”, unfavorable hereditary factors appear as a risk factor. You can't change them, but their influence can be greatly reduced. An unfavorable diet increases its effect, while a beneficial diet can negate it. Lack of exercise and smoking also have a negative impact on cholesterol levels, especially HDL levels. Alcohol abuse is harmful to health in many ways, not just through elevated cholesterol levels.
Elevated Cholesterol Symptoms
Cholesterol is an important substance. The body needs them as a building block for the cell walls. In the form of bile acids, cholesterol forms the main component of bile and serves as a raw material for sex hormones. However, cholesterol does not dissolve in water and not in the blood. Here it is present as a complex with proteins, the lipoproteins. The two most important are:
- LDL (Low Density Lipoprotein): It is always loaded with cholesterol and delivers it to the cells. When there is too much LDL cholesterol in the blood, it can build up on artery walls. That is why LDL cholesterol is considered “bad” cholesterol.
- HDL (High Density Lipoprotein): It collects excess cholesterol from the cells and transports it to the liver. The organ ensures that the body eliminates cholesterol. That is why HDL cholesterol or a high HDL value is considered "good".
Elevated cholesterol levels alone almost never cause characteristic symptoms. In most cases, the cardiovascular risk increases slowly, which is exacerbated by other risk factors such as lack of exercise, high blood pressure and diabetes.
Experts often recommend regular preventive measurements from the age of 35. In addition to the values for blood fats, these should also determine those of blood pressure and blood sugar. Simple blood tests can prevent unnoticed damage that cannot be reversed.
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| Elevated cholesterol : causes, symptoms, treatment and prevention |
Blood lipid levels
Measurements of blood lipids almost always determine three values: those for total cholesterol and those for LDL and HDL cholesterol. Most of these values are given in milligrams per deciliter (mg/dl), but sometimes also in millimoles per liter (mmol/l). Risk factors for cardiovascular disease are high total cholesterol, high LDL and low HDL. Many international professional organizations recommend that people who are healthy and have no other risk factors should definitely aim for the following values:
- Total cholesterol: ≤ 200 mg/dl (5.2 mmol/l)
- LDL: ≤ 130 mg/dl (3.4 mmol/l)
- HDL: ≥ 50 mg/dl in women (1.3 mmol/l), ≥ 40 mg/dl in men (1.0 mmol/l)
Many experts find that the ratio of LDL to HDL cholesterol (= LDL value divided by the HDL value) says the most about the cardiovascular risk: Values below 3 are considered ideal. Values of more than 4 are considered ideal the risk of cardiovascular diseases is considered to be increased.
However, there are different assessments and guidelines. For some, the cut-off for total cholesterol is lower (190 mg/dL or below) and that for LDL cholesterol is higher (160 mg/dL or below). Other guidelines dispense with recommendations for LDL levels altogether. Some experts are generally critical of the limit values because they can classify people as "sick" even though they are healthy. What is certain is that elevated cholesterol levels and the cardiovascular risk are related (see "History, complications, special features"), even if sometimes something else is to be read.
What do elevated levels mean for health?
The values alone are almost never decisive. Several people with the same cholesterol levels can have very different cardiovascular risks. Cholesterol levels in the majority of those affected only allow a valid statement if they are assessed in connection with other risk factors. The risk assessment follows standardized specifications and usually takes into account factors such as:
- Age: The higher the age, the greater the risk of cardiovascular disease.
- Gender: Men are at higher risk than women.
- Predisposition: If the father or brother had a heart attack or stroke before the age of 55, or if the mother or sister had such an incident before the age of 65, the family predisposition increases the risk.
- Smoking: Smoking is one of the greatest risk factors.
- High blood pressure: High blood pressure increases the risk because it puts strain on the heart and blood vessels.
- Type 2 diabetes mellitus: Blood that is too sweet increases the risk in several ways.
- Coronary heart disease, angina pectoris, previous heart attacks or strokes: These diseases already mean a high risk for the heart and circulatory system, which increases further due to high cholesterol levels.
The more of these risk factors are present, the lower the cholesterol levels should drop. Before treatment, doctors identify all possible of these hazards. Then they name individual target values for each patient.
Elevated Cholesterol Treatment
As already mentioned, the intensity and scope of the therapy mainly depend on how high the cardiovascular risk of the patient is - due to all their risk factors, including the elevated cholesterol levels.
- Experts usually recommend a change or adjustment in diet first: You shouldn't give the body more calories than it actually uses. The diet should be high in fiber (> 20 g/day) and low in fat (< 30% of total energy), low in saturated fat (maximum one third of fat), low in trans fat and low in cholesterol. A high content of monounsaturated fatty acids and omega-3 fatty acids is advantageous. Sea fish, whole grain products, vegetable fats and oils such as those from nuts are considered suitable foods. Studies have also shown that vegetables and fruit reduce the risk of dying from cardiovascular disease.
- Lack of exercise should be avoided. Affected adults should engage in moderate-intensity physical activity for at least 30 minutes five days a week. Daily training is even better. Exercise can often be easily incorporated into everyday life, e.g. on the way to work. If there are other risk factors for the heart and circulatory system, it can be more beneficial to train for endurance and strength under professional supervision.
- Smoking should be stopped. To do this, smokers should take advantage of all reasonable options, such as professionally supervised cessation programs or nicotine preparations.
- Fat-lowering drugs are used when other measures do not have the desired effect. In most cases, these are substances from the families of statins and fibrates or nicotinic acid.
Prevention
Prevention consists in avoiding or at least greatly reducing the risk factors. So it's mainly about eating healthy, not eating too much, getting enough exercise, not smoking and drinking alcohol sparingly.
- Treating high blood pressure, elevated blood lipid levels, diabetes: The diseases should be treated so consistently that the levels normalize as much as possible. A healthy lifestyle should support therapy.
- Healthy nutrition: Balanced, varied meals should be served in quantities that do not lead to obesity. Many industrially processed foods (e.g. ready meals) are problematic: Small bites often contain many calories. In addition, such dishes usually contain many unfavorable unsaturated fatty acids and a lot of hidden sugar or salt. Soft drinks and energy drinks also increase the risk of obesity, diabetes and cardiovascular diseases. It is better to use and eat plenty of fresh foods (e.g. fruits, vegetables, whole grain products, [fatty] fish, lean meat, lean dairy products). Try to replace saturated fats with unsaturated ones. Fat should make up less than 30% of the calories in the diet. For people with high blood pressure, it is advisable to reduce salt intake.
- Enough and regular exercise: regularity brings more than high intensities. It is better for the heart and circulation to train four times a week for 30 minutes at a moderate, even load than once for two hours at full strength. The exertion should match your individual resilience; if in doubt, health checks are advisable. The younger you start training, the better the effect. Regular training is usually easier in clubs, sports, leisure or heart groups. Any movement is better than none! Instead of taking the elevator, you can choose the stairs. Instead of parking directly at the theater, you can park the car further away and walk a few steps. There are many ways to incorporate exercise into everyday life.
- Reduce excess weight: The body weight should be within the normal range; it is more than advisable to lose excess weight. Those who eat healthily and exercise regularly are on the right path.
- Avoiding cigarettes: Nicotine increases the risk of high blood pressure, arteriosclerosis, strokes, heart attacks, cardiac arrhythmia and other diseases. In the smoke from cigarettes, cigars and pipes there are about 4000 other substances that increase many health risks, such as those of lung diseases (e.g. COPD), throat, larynx, esophagus, lung, stomach, kidney, bladder and pancreatic cancer. Quitting smoking is always worthwhile: even after many years, the body can often recover from it. If you want to quit, you should use all sensible tools (e.g. training, nicotine preparations, cessation tablets) to maximize the chances of success.
- Caution with alcohol: With alcohol, restraint is advisable, recent studies have found disadvantages for the heart and blood vessels even with small amounts. That's why some medical societies have lowered the "safe" limit to 25 grams a day for men and 20 grams for women.
- Other diseases: Hypothyroidism, pancreatitis, anorexia and certain kidney and liver diseases can have a negative impact on cholesterol levels. The values usually return to normal once the diseases are cured.
- Caution with some medications: Cholesterol levels can increase as a result of certain medications, such as active ingredients from the family of female sex hormones (oestrogens) and glucocorticoids (e.g. cortisone). After the end of the application, the values usually drop again, but it can also be worthwhile to inquire about alternatives.
- Avoiding or reducing other risk factors for the heart and circulation: Some circumstances do not have a direct negative effect on blood lipids, but on the general cardiovascular risk. These include stress, an irregular rhythm of life, a lack of social contacts, sleep problems and depression.