Managing your cholesterol with a healthy lifestyle

July 2014

We all have cholesterol in our blood, but when it rises above a healthy level, it puts us at increased risk for heart disease, stroke and other dangerous conditions. An estimated 34% of South Africans are at risk for disease due to raised cholesterol levels. Are you one of them?

“There’s a lot you can do to prevent your cholesterol from reaching an unhealthy level,” says Peter Jordan, Principal Officer of Fedhealth. “For starters, get tested regularly and know your numbers, including your blood pressure and blood-glucose levels. It’s also a good idea to brush up on your cholesterol facts,” he adds.

High cholesterol, also known as hypercholesterolaemia, is extremely common. However, an elevated cholesterol level combined with one or more of the following risk factors – a family history of heart disease, your age (males over the age of 45 and females over the age of 55), smoking, high blood pressure and diabetes, means you should be particularly vigilant and be tested regularly.

“South Africa has one of the highest incidences of familial hypercholesterolaemia (Inherited high cholesterol) in the world,” says Jordan. Inherited high cholesterol is a genetic disorder that increases the “bad” LDL cholesterol in the blood and, in most cases, causes premature heart disease. “If you have a family history of heart disease before the age of 55, you should consider the possibility that you may have inherited hypercholesterolaemia.”

Good and Bad cholesterol

Cholesterol is a type of fat that attaches itself to proteins and travels through the blood. These cholesterol-protein packages, called lipoproteins, can be divided into two major types, commonly referred to as “good” and “bad” cholesterol”.

The “bad” kind of cholesterol, called low-density lipoprotein (LDL), refers to lipoprotein with more fat than protein. LDL tends to deposit its cholesterol components onto the artery walls and other body tissues and forms oily masses called plaques. These can tear artery walls and form clots that can impair or stop the blood supply to the organs such as the heart, brain or lungs.

Good cholesterol, or high-density lipoprotein (HDL), is lipoprotein with more protein than fat. This “good” kind of cholesterol actually helps to clear cholesterol from the body by picking up leftover cholesterol from cells and carrying it back to the liver for disposal. High levels of HDL cholesterol appear to help protect against heart disease.

The vast majority of people with high cholesterol are unaware of their condition until they suffer a heart attack or stroke. There is good news however, high cholesterol can be detected during a routine blood test. “Most experts agree that everyone older than 20 years and without risk factors should have their cholesterol tested at least once. If the levels are normal, it’s a good idea to test it at least every five years after the initial test,” says Jordan.

People who should have a cholesterol test at least once a year include: Men over the age of 35, women over the age of 45, or who are menopausal, anyone – including children – with risk factors for heart disease (e.g. hypertension or diabetes).

Treatment for cholesterol is geared towards lowering your cholesterol levels and to minimise your risk for life-threatening diseases. Very high-risk patients (those with genetic disorders, manifest vascular disease or diabetes) will need treatment with medication regardless of other considerations.

“Remember that any medication prescribed by your doctor will be more effective when combined with a low-cholesterol diet and lifestyle changes which include quitting smoking, getting more exercise, losing weight and eating correctly,” says Jordan.

Know your numbers:

When it comes to your cholesterol levels, the following numbers are accepted as normal or ideal:
• Total cholesterol: lower than 5 mmol/L
• LDL: lower than 3 mmol/L when there is no diagnosis of arterial disease, and lower than 2.5 mmol/L when arterial disease is present
• HDL: higher than 1 mmol/L
• Triglycerides: lower than 1.7 mmol/L
• Risk ratio (total cholesterol/HDL cholesterol): higher than 4 constitutes moderate risk; higher than 5 constitutes high risk.

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