Your Health: Understanding cholesterol

Cholesterol is a natural wax-like substance circulating through our blood vessels that helps create healthy cells and hormones. A certain amount of cholesterol is definitely good for us, but an excess amount can cause fatty deposits in the lining of blood vessels. This makes it harder for blood to flow through the vessels carrying life-sustaining oxygen and may lead to either a heart attack or a stroke.
High cholesterol per se has no symptoms and can be detected only by a blood test. Men should have a baseline cholesterol blood test at age 35, women at age 45, and both sexes every five years thereafter — or sooner, if a doctor so determines because of risk factors. Even children should be tested if they are obese, have high blood pressure or diabetes, or have a strong family history of high cholesterol.
Most of the cholesterol in our bodies is manufactured right in the liver. A lesser amount comes from certain foods, such as fatty meats, dairy products and eggs. Therefore, a high cholesterol count can be due to either heredity or diet.
Cholesterol is carried through the blood attached to certain proteins. This combination of cholesterol and protein is called a lipoprotein, of which there are three types:
– Low-density lipoproteins (LDL). Referred to as “bad cholesterol,” these are what cause damage to blood vessels.
– Very low-density lipoproteins (VLDL). These carry another type of fat, called triglycerides, which can also damage blood vessels.
– High-density lipoproteins (HDL). Referred to as “good cholesterol,” these actually pick up excess cholesterol and take it back to the liver.
Risk factors for developing high levels of cholesterol are smoking, diabetes, obesity, poor diet, lack of exercise and family history of heart disease.
The first thing to do to control high cholesterol is to change one’s lifestyle with an emphasis on exercising and eating a healthy diet.
If your total cholesterol, particularly LDL cholesterol, remains high, your doctor will probably recommend medication. The choice of medication depends on several factors, such as your age, your state of health and possible side effects.
There are a variety of medications which help to lower cholesterol and triglycerides. They all do their work differently and have specific side effects. This is where your doctor will have to fine-tune the medications to your specific needs and set up regular visits to monitor your progress.
The bottom line is to have your cholesterol checked and, if it’s high, get it lowered to a more normal level. The results are in on this one: Lowering an elevated cholesterol level will help promote a longer and healthier life.
– Terry Hollenbeck, M.D., is an urgent-care physician at Palo Alto Medical Foundation Santa Cruz in Scotts Valley. Readers can view his previous columns on his website, http://valleydoctor.wordpress.com, or email him at va**********@*******al.net. Information in this column is not intended to replace advice from your own health care professional. For any medical concern, consult your own doctor.