Although nearly half of adults in Canada have cholesterol or lipid levels that are higher than recommended and that can contribute to cardiovascular disease, there’s every chance that you don’t know what your own cholesterol level is, and that you won’t know until you actually experience a problem.
The accumulation of cholesterol in blood vessels is referred to as atherosclerosis and it occurs over a long period of time with few symptoms. You feel well, and can’t believe that you have cardiovascular disease.
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Your best bet is to know what your cholesterol level is and take measures to keep it within range, before you have any problems!
You do need some cholesterol in your body in order to manufacture a range of substances including bile acids that aid in digestion, sex hormones, and even vitamin D. It is when your cholesterol levels are elevated that the excess accumulates in blood vessels, along with other substances like collagen, fibrin, and even calcium, contributing to heart and circulation conditions.
As well, cholesterol accumulation can also be a major problem if you have other risk factors like smoking, high blood pressure, diabetes, or obesity.
In general cholesterol or lipids are waxy substances which are not soluble in your blood. Instead they combine with proteins (i. e. lipoproteins) which move readily throughout the body. These lipoprotein complexes are classified according to their size. Low density lipoproteins (LDL) or “bad” cholesterol carry lipids to blood vessels. High-density lipoproteins (HDL) or “good” cholesterol carry lipids away from vessel walls.
When your body has excess lipids or fats, they are stored as triglycerides which are also considered “bad” cholesterol. Very low-density lipoproteins (VLDL) are complexes of triglycerides and cholesterol.
Ideally, you want to have higher levels of HDL and lower levels of LDL and triglycerides, with a total cholesterol less than 5.2 mmol/L. Cholesterol measurements are used along with your other health factors to calculate your risk for cardiovascular disease. One of the most common risk calculators is the Framingham Risk Score, and you can actually calculate your own on the interactive web site, www.framinghamheartstudy.org. However, remember you do need to have your various personal health factors and ideally you want to follow up with your doctor.
A low-fat, high-fibre diet is recommended to reduce cholesterol levels, so Canada’s Food Guide is a great place to start. However, only about 20 per cent of your cholesterol comes from the fats and carbohydrates you eat, such as that hamburger with bacon and extra cheese. (Some cholesterol lowering drugs are aimed at stopping this dietary absorption of fats and carbohydrates, for example bile acid binders and ezetimibe.)
The other 80 per cent is cholesterol that your liver manufactures. This can also be curtailed through the use of prescribed medicines. Statin drugs block the manufacture of cholesterol by inhibiting an enzyme known as HMG-CoA that is essential to the process. Production is reduced and cholesterol levels drop.
The statins get their name from their common suffix, for example lovastatin, pravastatin, simvastatin, atorvastatin, rosuvastatin. Because cholesterol is manufactured overnight, ideally statins are best taken with supper or at bedtime, with the exception of atorvastatin and rosuvastatin, both of which are able to maintain their levels throughout the day.
By knowing your cholesterol level and your cardiovascular risk, you can take steps to improve your health. However, some of the best measures you can take are dietary ones. Read food labels, pay attention to serving and portion sizes, choose low-fat foods, and fill up on fruits, vegetables, nuts and seeds. You want to live a long life, so keep your cholesterol level under control!
Marie Berry is a lawyer/pharmacist interested in health care and education.
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