High cholesterol and your heart

Figures show that one in four South Africans have cholesterol.

This condition is known to increase your chances of getting a heart attack and needs to be managed by diet, exercise, and in some cases medication.

If you have high cholesterol, you can develop fatty deposits (plaque) in your blood vessels. “Eventually, these deposits grow, making it difficult for enough blood to flow through your arteries,” says Dr Francois Erasmus, a physician at Mediclinic Kloof. “These deposits can break suddenly and form a clot that causes a heart attack or stroke.” This is why it’s important to check your cholesterol levels regularly.

A complete cholesterol test — also called a lipid panel or lipid profile — is a fasting blood test that can measure the amount of cholesterol and triglycerides in your blood.

What is high cholesterol?

Cholesterol is a lipid (type of fat), that forms fat-protein chemicals in your body (lipoproteins). There are known as low-density lipoproteins (LDLs), also known as “bad cholesterol,” and high-density lipoproteins (HDLs) or “good (helpful) cholesterol.”

HDLs carry cholesterol to your liver, the organ that keeps your cholesterol levels balanced. It makes just enough cholesterol to keep your body functioning normally and eliminates the rest. LDLs transports cholesterol to your cells and tissues, and if your LDL levels are too high (hyperlipidaemia), they can clog your arteries. This is associated with an increased risk of coronary heart disease (CHD) and heart attacks.

What are the causes and signs of high cholesterol?

Causes of hyperlipidaemia include a family history, a high-fat diet, smoking, being overweight, and certain illnesses, including diabetes. “The concern is that most people have no symptoms of high cholesterol levels until their blood vessels are nearly closed or become clogged,” says Dr Erasmus. “However, some people with hyperlipidaemia may have small fat deposits under the skin which should act as a warning to get tested.” 

How is high cholesterol diagnosed?

A fasting blood test shows your levels of cholesterol, HDL, LDL, and triglycerides. If your total cholesterol level is high because of a high LDL level, you may be at higher risk of heart disease or stroke. But, if your total cholesterol level is high only because of a high HDL level, you’re probably not at higher risk.

How is high cholesterol treated?

“Diet is the best way to reduce lipid levels,” says Dr Erasmus.  Limit alcohol, eat more fruits, vegetables and high-fibre foods, such as oats and bran. If you’re overweight, lower your daily carbohydrate intake and eat less saturated fats. Read the ingredients on food labels and cook with oils that are high in polyunsaturated fats, e.g., sunflower and grapeseed oils. Weight loss, exercise, and avoiding smoking are also key. When diet and exercise are not enough, your doctor may prescribe lipid-lowering drugs, such as statins. “These effectively reduce cholesterol and LDL production and are usually well tolerated,” says Dr Erasmus.

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