Risks to your health

A few small changes can save your life

There are usually no signs or symptoms of high blood cholesterol. Many people don't know that their cholesterol level is too high. I for one had no idea I had high cholesterol until I got a test done. Really, if you are over 20 years of age you should have your cholesterol tested by your doctor. It is a simple test - a small amount of blood is taken and usually sent to a laboratory where your cholesterol is measured. Within a week or two your doctor will receive your results and be able to advise you of what they mean (it is not always bad news!), and depending on the result will be able to tell you when you should get it tested again.

Risks

There are a number of risks associated with high Cholesterol, and the main ones are outlined below. Apart from these risks, the pointers on this site are all directly aiming to help you lead a healthier, happier life. This does not mean sitting miserably living on lentils and lettuce. Live life to the full, enjoy all the tasty foods and drinks - just be sure to do it in the right measures.

The effects of high cholesterol tend to develop over the course of many years, and are primarily due to a condition called atherosclerosis, which is the narrowing and hardening of arteries. Common effects of high cholesterol due to atherosclerosis include angina, coronary heart disease, heart attack, and stroke. Lowering cholesterol is the best way to prevent or control the effects of high cholesterol in the blood.

Atherosclerosis

Atherosclerosis is a gradual process whereby hard cholesterol substances (plaques) are deposited in the walls of the arteries. Cholesterol plaques cause hardening of the artery walls and narrowing of the inner channel (lumen) of the artery. Arteries carry blood that is enriched with oxygen and nutrients to the vital organs such as the brain, heart, kidneys, and liver. Arteries also transport blood to other tissues such as the fingers, toes, nerves, bones, skin, and muscles. Healthy arteries can deliver an ample supply of blood to the organs and tissues. In contrast, arteries that are narrowed by atherosclerosis have difficulty delivering blood to the parts of the body they supply. For example, atherosclerosis of the arteries in the legs causes poor circulation in the lower extremities. Poor circulation in the lower extremities can lead to pain while walking or exercising, deficient wound healing, and/or leg ulcers. Atherosclerosis can also cause the complete blockage of an artery from a blood clot. This complete blockage interrupts oxygen supply and results in tissue injury or death. Thus, the blockage of an artery that furnishes blood to the brain can lead to a stroke (death of brain tissue). Likewise, the blockage of the arteries to the heart can result in a heart attack (death of heart muscle), also called myocardial infarction (MI).

Angina Pectoris

Angina pectoris is chest pain or pressure that occurs when the oxygen supply to the heart muscle cannot keep up with oxygen consumption by the heart muscle. (Oxygen consumption by the heart muscle increases with physical exertion or excitement and decreases with rest and relaxation.) Most commonly, the inadequate supply of oxygen is due to narrowing of the coronary arteries by atherosclerosis. When coronary arteries are narrowed by more than 50% to 70%, the arteries cannot increase the supply of blood to the heart muscle during exertion or other periods of high oxygen demand. An insufficient supply of oxygen to the heart muscle causes chest pain (angina). Chest pain that occurs with exercise or exertion is called exertional angina. Please read the MedicineNet Angina article for more information on the different types of angina.

Coronary Heart Diseases (CHD)

Coronary atherosclerosis refers to the hardening and narrowing of the coronary arteries. The coronary arteries supply the blood that carries oxygen and nutrients to the heart muscle. When coronary arteries are narrowed or blocked by atherosclerosis, they cannot deliver an adequate amount of blood to the heart muscle. Disease caused by the lack of blood supply to heart muscle is called coronary heart disease (CHD). Coronary heart diseases include heart attacks, sudden unexpected death, chest pain (angina), abnormal heart rhythms, and heart failure due to weakening of the heart muscle.

Heart Attack

A heart attack (myocardial infarction) is the death of heart muscle due to the sudden and complete blockage of a coronary artery by a blood clot. A coronary artery blockage usually occurs in arteries that contain cholesterol plaques. A plaque can rupture and initiate the formation of a blood clot next to it. A blood clot can completely block blood flow through a coronary artery and deprive the heart muscle of needed nutrients and oxygen. The heart muscle then dies, which produces a heart attack.

Unlike angina, a heart attack results in permanent damage of the heart muscle. After a heart attack, the damaged portion of the heart is left with a scar. If the amount of heart muscle damage and the area of scarring are small, the performance of the heart as a pump will not be significantly impaired. However, repeated heart attacks or a heart attack with extensive heart muscle damage, can weaken the heart and cause heart failure. People with heart failure experience shortness of breath, tolerate exercise poorly, and lack vigor because their weakened heart muscle cannot pump enough blood to keep their bodies healthy and active.

Ventricular Fibrillation

A heart attack can trigger the sudden onset of ventricular fibrillation. Ventricular fibrillation is a chaotic electrical rhythm of the heart that causes cardiac arrest (the heart stands still and ceases to pump blood). Ventricular fibrillation causes permanent brain damage and death unless a normal heartbeat can be restored within five minutes of its onset. Of the 1 million Americans who suffer heart attacks annually, approximately 400,000 of them die suddenly and unexpectedly from ventricular fibrillation before the victims can reach any medical assistance. For these people, the first sign of coronary heart disease is sudden, unexpected death.

Ischemic stroke

An ischemic stroke is the sudden and permanent death of brain cells that occurs when the flow of blood to a part of the brain is blocked and oxygen cannot be delivered to the brain. Depending on the part of the brain that is affected, strokes can result in weakness or paralysis of the arms, legs, and/or facial muscles, loss of vision or speech, and difficulty walking.

Ischemic strokes most commonly occur when clots form in small arteries within the brain (known as thrombosis of the artery) that have been previously narrowed by atherosclerosis. The resulting strokes are called lacunar strokes because they look like small lakes. In some cases, blood clots can obstruct a larger artery going to the brain, such as the carotid artery in the neck, causing more extensive brain damage than lacunar strokes.

A second less common type of ischemic stroke occurs when a piece of a clot breaks loose, for example, from the carotid artery or heart, travels through the arteries, and lodges in an artery within the brain. This type of stroke is referred to as an embolic stroke and occurs commonly as a result of an irregular heart rhythm such as atrial fibrillation, that causes blood clots to form within the heart.

Hemorrhagic stroke

A hemorrhagic stroke occurs when a blood vessel in the brain ruptures, and blood leaks into the surrounding brain tissue. A hemorrhagic stroke, like an ischemic stroke, causes the death of tissue by depriving the brain of blood and oxygen. The accumulation of blood from the hemorrhage also can put pressure on adjacent parts of the brain and damage them as well.

A subarachnoid hemorrhage is a rupture of a blood vessel that is located between the outer surface of the brain and the inside of the skull. The blood vessel at the point of rupture often has been weakened by the development of an aneurysm (an abnormal ballooning of the wall of the blood vessel). Subarachnoid hemorrhages usually cause a sudden, severe headache and often are complicated by additional neurological problems, such as paralysis, coma, and even death.

Transient ischemic attack (TIA)

A transient ischemic attack (TIA) often is referred to as a mini-stroke. TIAs are caused by the temporary reduction in flow of blood (ischemia) to the brain and is most often caused by a clot that spontaneously forms in a carotid artery. Patients with TIA's often have narrowed (or, less often, ulcerated) carotid arteries due to atherosclerosis. TIAs typically last 2 to 30 minutes, although symptoms sometimes can last 24 hours and can produce problems with vision, dizziness, weakness of the arms or legs, and trouble speaking. A TIA is different from a stroke in that it does not cause permanent death of brain tissue. Without treatment, however, patients with TIAs are at high risk for having a stroke with permanent damage to the brain

---

Yikes! I don't like the sound of that!

What can you do to prevent them?

Don't worry, these are only risks, not definite results of high cholesterol. You can prevent atherosclerosis and reduce heart attack and stroke risks by:

• Controlling high blood pressure and diabetes mellitus


• Never smoking or stopping cigarette smoking


• Exercising regularly


• Losing excess weight


• Lowering blood levels of LDL cholesterol


• Increasing blood levels of HDL cholesterol


• Lowering blood levels of lipoprotein A cholesterol and triglycerides


• Increasing LDL cholesterol particle sizes


• Taking anti-platelet medications (such as low dose aspirin) to prevent blood clots


• Consuming antioxidants to prevent blood vessel damage


• Consuming folic acid and other B vitamins to reduce blood levels of homocysteine


• Reducing stress and staying positive

Is lowering LDL cholesterol enough?

Sadly, the prevention and treatment of atherosclerosis, stroke and heart attack/disease are far more complicated than just lowering LDL cholesterol levels. LDL cholesterol reduction is only half the battle.

Individuals who have normal or only mildly elevated LDL cholesterol levels can still develop atherosclerosis and heart attacks even without other risk factors such as smoking, high blood pressure, lack of exercise, excess weight and diabetes. So, we have to accept that lowering elevated LDL cholesterol levels cannot always prevent atherosclerosis and heart attacks. In a number of clinical trials to lower LDL cholesterol, there were patients who adhered to their assigned diets, and even took cholesterol-lowering medications - and in doing so successfully lowered their LDL cholesterol to target levels, yet they still suffered continuing atherosclerosis and heart attacks. We must understand then that while lowering LDL cholesterol below the target levels is an important step, there are other factors involved.

On a more positive note - research suggests that by eating the right foods, getting enough exercise, and generally taking good care of yourself, you could slash your risk of dying from heart disease by an incredible 80 percent. With this in mind it is well worth your time following the simple lifestyle tips provided free of charge on this website.