Cholesterol: managing its levels to prevent the risks of heart attack or stroke!

What is cholesterol? 

Cholesterol is a lipid, a fat that is essential to the human body. Each of our cells needs it to function correctly because it structures the membrane, and enables the synthesis of numerous hormones.

Cholesterol is produced by the liver or is brought into our body through our food.

There are two types of cholesterol: the good and the bad cholesterol. This classification actually comes from two families of proteins that constitute cholesterol:

• HDL, High Density Lipoprotein, or the "good cholesterol", which has the role of capturing the cholesterol molecules that are deposited in the arteries, then transporting them to the liver. The liver then eliminates them through the digestive tract using bile,
  
• LDL, Low Density Lipoprotein, or the "bad cholesterol", which deposits cholesterol on the walls of the arteries, causing fatty plaques called atheromas, or atheromatous plaques.
  

Thus, HDL helps to reduce the level of cholesterol in the blood, while the levels of LDL should be particularly monitored, especially in the case of a family history of cardiovascular disease.

What are the normal levels of cholesterol? 

High cholesterol, or hypercholesterolemia, does not initially cause any symptoms. However, it is a major risk factor in the long term, that can lead to cardiovascular diseases (CVD) such as heart attack, stroke or arteritis of the lower limbs.

For people at risk, regular lipid testing is recommended to monitor cholesterol levels. For healthy people without a family history of high cholesterol or CVD, this test should be done every 5 years starting from the age of 40.

The way to find out your cholesterol level is to take a blood sample (on an empty stomach), which will then be sent off for biological analysis. This lipid assessment will allow the evaluation of HDL cholesterol, LDL cholesterol, total cholesterol and triglyceride levels. Normal levels vary from person to person.

Different laboratories may have different reference values, but on average, your levels of :

• HDL cholesterol should be above 0.4 g/L, or 1 mmol/L, and of
• LDL cholesterol - less than 1.6 g/L, or 4.1 mmol/L.
  

Triglycerides are also important: they constitute all the fats in the blood that are not in the form of cholesterol. Their level must be between 1.6 and 2.0 g/L (or between 0.40 and 1.70 mmol/L).

We should also mention total cholesterol, which corresponds to the level of both HDL and LDL cholesterol, as well as 1/5 of the triglyceride level. It should be between 1.6 and 2.0 g/L (or between 0.40 and 1.70 mmol/L).

These values should be analysed together, and the person's general state of health, as well as the presence of any underlying conditions or risk factors for developing cardiovascular diseases, should also be taken into consideration.

What are the symptoms of high cholesterol? 

When symptoms of high cholesterol appear, it is often too late, as they are actually signs of medical complications.

As mentioned above, the consequences of the damage to the arteries due to high cholesterol levels are long-term.

This is why pain in the calves, in the chest, feelings of tightness, nausea and dizziness, fever, headaches, shortness of breath, palpitations, muscular weakness on one side only, difficulty speaking and visual problems may indicate an already established cardiovascular disease.

How to manage your cholesterol levels and prevent the development of heart disease or stroke?

Every year, about 85,000 Americans have a heart attack, and stroke is one of the leading causes of death and disability worldwide.

In both cases, it is likely that cholesterol, in the form of atherosclerotic plaques, has caused atherosclerosis (hardening) and blocked the arteries, preventing the blood from flowing normally. High cholesterol is a major risk factor, together with other factors such as smoking, type I or type II diabetes, high blood pressure, obesity and stress. That is why its levels, especially those of LDL cholesterol, should be kept within reasonable limits.

Most of the time, our cholesterol levels depend on our diet and our level of physical activity. Therefore, the first step in reducing bad cholesterol should be changing your lifestyle: switching to a more balanced diet and starting a regular physical activity. The decision whether or not to start treatment depends on the risk level of each patient.

Here are some tips on how you can reduce your cholesterol levels:

• Increase the amount of fiber in your diet,
  
• Increase the intake of foods containing omega-3, anti-oxidants,
  
• Avoid certain foods high in saturated and trans fats,
  
• Use low-fat cooking methods,
  
• Have a regular physical activity,
  
• Lose weight if you are overweight,
  
• Do not smoke,
  
• Reduce or stop alcohol consumption,
  
• Limit stress.
  

If cholesterol levels cannot be regulated by lifestyle changes, doctors may decide to start treatment, which also depends on the patient's risk level.

Drug treatment may include cholesterol-lowering medication, such as:

• Statins: these drugs interfere with the action of an enzyme used by the liver to produce cholesterol (Atorvastatin),
  
• Fibrates: they are used to increase the elimination of cholesterol through the bile ducts (Fenofibrate, Ciprofibrate),
  
• Bile acid chelators: they bind bile acids in the intestines, preventing the absorption of cholesterol into the body (Cholestyramine).
  

Other methods may also be used to reduce bad cholesterol, such as phytotherapy (e.g. fruit and vegetable cures), or aromatherapy (e.g. essential oils of carrot, lemon, etc.).

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