High Cholesterol

(Hypercholesterolemia)

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Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention | Organizations

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Definition

High cholesterol is excess levels of cholesterol in the blood. Cholesterol in the blood consists of three main components:

Low Density Lipoproteins (LDL) – involved in depositing cholesterol and other fats throughout the body. High levels of LDL put you at risk for hardening of the arteries and heart disease.

High Density Lipoproteins (HDL) – involved in eliminating cholesterol and other fats from the body. High levels of HDL are protective against heart disease.

Triglycerides – a common form of fat in the body

Causes

Causes of high cholesterol include:

• Inherited tendency to have high cholesterol
• High-fat diet
• Overweight
• Sedentary lifestyle
• Excess alcohol intake

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

• Age: Cholesterol levels tend to rise as you get older
• Sex:
  • Males
  • Females after menopause
• Family members with high cholesterol
• High-fat diet
• Obesity, overweight
• Sedentary lifestyle

Symptoms

High cholesterol rarely causes symptoms.

Eventually, symptoms may include:

• Angina (chest pain)
• In people with an inherited form of high cholesterol, cholesterol deposits:
  • In the tendons
  • Under the eyes
  • Around the cornea

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. High cholesterol is diagnosed through blood tests that measure:

• The total level of cholesterol in your blood
• The level of HDL-cholesterol in your blood
• The level of LDL-cholesterol in your blood
• The level of triglycerides in your blood

Treatment

Treatment may include:

Lifestyle Changes

• Limit the amount of fat and cholesterol you eat.
• Eat a diet high in fiber.
• Begin a safe exercise program recommended by your doctor.
• Increase physical activity in your daily life, as recommended by your doctor.
• If you smoke, quit.
• If you are overweight, lose weight.
• Limit the amount of alcohol you drink. Moderate alcohol intake is no more than 2 drinks per day for men and 1 drink per day for women.

Cholesterol-lowering Medication

If diet and exercise don't lower your blood cholesterol in a reasonable period of time, you may need cholesterol-lowering medication. These include:

• Cholestyramine
• Cholestipol
• Nicotinic acid
• Lovastatin
• Pravastatin
• Simvastatin

Hormone Replacement Therapy

If you're a post-menopausal woman, your doctor may recommend estrogen replacement therapy.

Prevention

To reduce your chance of having high cholesterol:

• Eat a healthful diet, one that is low in saturated fat and rich in whole grains, fruits, and vegetables.
• Exercise regularly.
• Maintain a healthy weight.
• Don't smoke. If you smoke, quit.
• Drink alcohol in moderation. Moderate alcohol intake is no more than 2 drinks per day for men and 1 drink per day for women.

Organizations

American Heart Association
http://www.americanheart.org/

SOURCES:

Primary Care Medicine, 4th ed. Lippincott Williams & Wilkins, 2000.

National Heart, Lung, and Blood Institute

American Heart Association

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Last reviewed June 2001 by Medical Review Board