Heart Disease and Cholesterol

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By Ann-Marie Waters, Associate Editor.

What is cholesterol?

Cholesterol is an essential fat (known as a lipid) which is produced by the liver from the fatty foods we consume and is vital for health and normal body functioning. Although they are essential compounds, an excessively high level of lipids in your blood – a condition known as ‘hyperlipidemia’ can be disastrous to your long term heart health. Your risk of  developing heart disease is increased, and it could lead to you suffering a heart attack or stroke.

What is High Cholesterol?

High cholesterol (Hypercholesterolemia) causes fatty deposits (known as plaques) to build up inside your blood vessels. Statistics show that approximately 2 in 3 adults possess cholesterol readings that are higher than the recommended level. High cholesterol causes these plaques to build up inside your blood vessels resulting in narrowing of the arteries, as you can see from the following graphic:

Symptoms of High Cholesterol?

A high cholesterol level may only become apparent if you develop symptoms of heart disease. Some people show physical symptoms such as yellowy patches (known as (xanthomas) which may develop around your eyes or elsewhere on your skin – these yellowy patches are ‘cholesterol deposits’ and indicate that you have higher than normal cholesterol levels in your blood as folllows:

Types of Cholesterol

There are three types of cholesterol – HDL (high-density lipoprotein), LDL (low-density lipoprotein), and VLDL (very low-density lipoprotein).

HDL (high-density lipoprotein 

HDL is often referred to as ‘good cholesterol’, as it is thought to prevent arterial disease. This is because it takes cholesterol away from the cells and back to the liver, it is then either – broken down or is passed from the body as a waste product.

LDL (low-density lipoprotein 

LDL is often referred to as bad cholesterol as it is known to increase arterial disease (build up of plaque in the arteries)) It carries cholesterol from the liver to the cells resulting in a harmful build up – thus causing the cells to have too much to break down – hence resulting in a build up of plaque.

VLDL (very low-density lipoprotein)

VLDL is also referred to as a ‘bad cholesterol’ as it contains the highest amount of ‘triglycerid’ (a blood fat); Triglycerides are found in dairy products, cooking oils, and red meat. Like LDL – VLDL cholesterol is considered as a type of bad cholesterol as elevated levels are also associated with coronary heart disease.

What are considered to be healthy cholesterol levels?

The ‘Joint British Societies’ which consists of a group  of  UK experts in cardiovascular disease recommend the following cholesterol limits for people who have coronary heart disease or who are at risk of developing it:

• Total cholesterol level – should be less than 4.0mmol/l
• LDL cholesterol level – should be less than 2.0mmol/l.

Whereas the United Kingdom National Institute for Health and Clinical Excellence (NICE) publish the following guidance for doctors:

• Total cholesterol level – less than 5.0mmol/l
• LDL cholesterol level – less than3.0mmol/l

However – the average cholesterol level in the UK is above normal, i.e. – 5.5mmol/l for men and 5.6mmol/l for women. Do these levels mean that you will go on to develop heart disease? Not entirely, as cholesterol levels need to be considered in accordance with an individual’s overall risk of heart disease. I.e. whether they have a genetic predisposition (one in 500 people has high cholesterol because of an inherited problem called familial hyperlipidaemia) smoke, have high blood pressure, are overweight, or have diabetes. Also, it is the balance of different types of lipoproteins that are present in the blood rather than the total cholesterol level that is really important.

How can I prevent having high cholesterol levels?

The first vital steps you can take in preventing a high cholesterol level or lowering it is to:

• Eat healthy
• Take regular exercise.

Healthy eating means cutting down on saturated and Trans fats. These should be re placed with unsaturated fats. There are also some foods that may help lower blood cholesterol levels such as – walnuts, oats, garlic, cinnamon, and soya. For more advice on healthy eating you can visit the British Heart Foundation website.