Today, few people have not heard of cholesterol (abbreviated as cholesterol) and are not interested in what rate of this organic compound should be in the blood of a person. And this is an important aspect for maintaining the elasticity of blood vessels, because some types of cholesterol have an atherogenic property - they contribute to the development of atherosclerosis. To avoid this and other pathologies, doctors recommend periodically checking blood for cholesterol levels and, if abnormalities are found, strive to bring it back to normal.
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The concept of cholesterol is inextricably linked with its components such as lipoproteins, or lipoproteins (LP) - protein-fat complexes of different densities, and triglycerides. Lipoproteins carry out a transport function, since pure cholesterol is not able to move. As part of lipoproteins, cholesterol is transferred to the tissues and again to the liver, being in continuous renewal.
Triglycerides are one of the main forms of fat storage in the body. These fats are neutral, they are found in the fatty tissues of humans and animals. Triglycerides consist of glycerol and fatty acid ethers, their presence in the blood undergoes significant fluctuations throughout the day. For example, after 15-30 minutes, triglycerides react to food intake, returning to their original value only after 9-12 hours.
low density lipoproteins
Physiologists often compare cholesterol with bile due to the similarity of functions, composition and consistency of these substances. And the name "cholesterol" from the Greek language is translated as "solid bile." But one French scientist managed to prove that cholesterol is a fatty alcohol, which is why the French began to call it cholesterol. The official medicine of most countries believes that one does not contradict the other, and uses both names.
The correlation of cholesterol levels with a person's age, although it seems obvious, does not necessarily manifest itself, which indicates an individual norm for different situations within the reference values.
Age metamorphosis concerns both metabolism in general and lipid metabolism. Cholesterol outgrowths on the inner surface of the vessels gradually appear in all people, and it seems logical that the rate of cholesterol in the plasma of the elderly is close to the maximum. But this is not true.
The norm of cholesterol in the blood plasma does not depend on the number of years, its optimal limits in any age group are between 3.5 and 6.5 mmol / l. As a result of metabolic disorders in the elderly, there may be just a lack of some plasma cholesterol fractions, which is reflected in the overall indicator.
Fluctuations in blood cholesterol levels are mostly influenced by:
And in itself, age is considered an insignificant factor influencing the amount of cholesterol.
As the results of recent medical studies show, the level of cholesterol in the blood determines the amount of this compound produced by the liver. When fat-rich foods are supplied to the body, the production of cholesterol by the liver decreases.
Normally, the harmony of cholesterol metabolism is observed in healthy people, and during the day fluctuations in the level of cholesterol in the blood are insignificant.
In pathological conditions such as metabolic syndrome, problems of the liver, gallbladder and other organs of the digestive system, the level of cholesterol will exceed the norm due to any stress, overeating or eating too fatty foods.
The results of studies on cholesterol are compared both with the norm of total cholesterol, and for each fraction separately. This is necessary to determine the possible risks in case of discrepancy with the norm for each type of cholesterol. For example, it is believed that atherogenic hazard increases with:
Differences from the norm should be compared with the values of the normal cholesterol level set out in the tables by age.
Table of norms of cholesterol in the plasma of adults by fractions in millimoles per liter
Reference points for blood cholesterol in children in millimoles per liter
The pathological effect of low-density cholesterol on the cardiovascular system of women is somewhat held back by the counteraction of female sex hormones - estrogens. This explains the fact that reproductive women have a lower risk of myocardial infarction and other acute manifestations of coronary artery disease. However, the norm for them has the same limits as for all adults - from 3.5 to 6.5 mmol per liter of blood according to total cholesterol.
Upon reaching the age of 50, for most women, a new stage of sexual development begins - menopause, when the effect of estrogens on fat metabolism and other benefits of the body are sharply weakened.
In this regard, the impact of low-density lipoproteins can be manifested by atherosclerotic deposits in the arteries, poor blood circulation, and increased blood pressure.
By the age of 60, most women experience a deterioration in metabolic processes, which affects the work of all organs that produce healthy cholesterol - the liver, adrenal glands, and intestines. How much cholesterol will be in a woman's blood can be affected by cholelithiasis, which women over 60 are more prone to.
Violation of the functionality of the digestive organs can provoke a dangerous imbalance of cholesterol fractions in the blood with a predominance of low-density (VLDL, LDL).
If timely attention is not paid to this problem, then even with normal total cholesterol, hyperlipoproteinemia is expected with further damage to the vessels, pancreas and other organs. The reference value of cholesterol in this age group is considered to be the amount that is normally observed in the blood of adults before and after 60 years of age - no more than 6.5 mmol / l.
The so-called lipid profile of an adult can be determined by a simple laboratory test - a blood test for cholesterol with deciphering deviations by fractions.
In the presence of a general norm, health disorders are often noted - if, against the background of optimal total cholesterol, there is an increased low-density or deficiency of high-density cholesterol.
High numbers of total cholesterol can indicate:
Reduced by a general indicator cholesterol is no less dangerous, as it can be provoked by:
Deciphering any discrepancies with the norm of cholesterol in blood tests is the prerogative of a specialist.
Let's return to the types of cholesterol and consider them in more detail. There are several fractions, but adult blood test decoding tables usually deal with the varieties listed below.
As is already clear, cholesterol is not present in tissues in its pure form, but in the form of fat-protein and other compounds:
All these fractions make up the concept of total cholesterol.
Cholesterol fraction size ratio
Low-density lipoproteins tend to attach to the inner walls of the arteries, creating a precedent for narrowing and atherosclerotic damage to the vessels with all the ensuing consequences. Because of this property, they are conditionally called “bad” cholesterol, although when this type is normal, it does not pose a danger to the body.
High molecular weight lipoproteins are produced mainly by the liver and perform a transport function, contributing to normal lipid metabolism. Normally, with the help of HDL, the outflow of lipid deposits from the lumen of the vessels is also carried out. Because of this, they are considered "good" cholesterol, although it, like "bad", is useful within the normal range of blood levels.
Despite the widespread fame of a harmful compound, cholesterol is required by our body to provide:
The main share of cholesterol is produced in the liver, kidneys, intestines, and only about 20% enters the body with food. The norm of cholesterol that comes with meals is considered to be 200-300 mg of this organic compound consumed per day as part of various products.
Functions of cholesterol in the body
Since low-density cholesterol is the most atherogenic, maintaining it normal serves to prevent the dangerous consequences of atherogenesis. Discrepancies with the norm for this fraction are provoked by both external and internal reasons:
There are isolated cases when, with the norm of total cholesterol in the blood, pathological abnormalities are observed, for example, atherosclerosis, but this is rather an exception to the rule. The disorders are usually associated with elevated LDL.
When hypercholesterolemia is detected (a risk factor caused by excess cholesterol in the blood). Based on how much the cholesterol norm is exceeded and what is the risk of manifestation of undesirable consequences (CHD, hypertension, etc.), he will be offered a complex or phased treatment of this atherogenic condition.
The appointment of such drugs and monitoring the results of the treatment should be carried out by a doctor.
It is believed that the approximation of cholesterol levels in the blood to the norm by 1% reduces the likelihood of coronary heart disease by 2%. However, according to the latest data from medical studies, the risk of atherosclerotic vascular disease and related heart disease during statin therapy remains quite high (up to 60%). Therefore, the search for an effective therapy for hypercholesterol conditions continues today.
In order to correctly decipher the blood test, one should take into account what is the norm of cholesterol in the blood of a person. There is a special table of cholesterol norms:
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Everyone has heard that high cholesterol increases the risk of cardiovascular disease. But what kind of cholesterol is considered high? It is not difficult to take a cholesterol test - but it turns out that not every doctor can correctly determine the level of cholesterol by it. If you or your loved ones are worried about "bad" cholesterol, cardiologist Anton Rodionov will help you understand the norms of cholesterol.
Do you want to earn some money? I give you a great idea. You make a bet (for a small amount so that no one is offended) that cholesterol is alcohol. Your interlocutor, of course, does not believe you and is ready to argue. You open any serious reference book... And to your great joy, you are convinced of my (and now yours) rightness. The win is yours.
Cholesterol was isolated at the end of the 18th century, it got its name from two words: "chole" - bile and "sterol" - fatty. And in the middle of the 19th century, chemists proved that in its chemical structure it belongs to the class of alcohols. Therefore, in some countries it is called "cholesterol". You remember from school chemistry that all alcohols end in "ol": ethanol, methanol, etc.
Some laboratories use English transcription - cholesterol. Cholesterol and cholesterol are synonyms.
Cholesterol is completely different from those alcohols that cause intoxication and intoxication, but its excess is not at all useful for the body. However, it is also impossible to live without cholesterol at all. Cholesterol is a building material for the cell wall, it is the precursor of all steroid hormones (cortisol, aldosterone, sex hormones).
There is a common belief that high cholesterol occurs only in people who eat a lot of fatty foods. Nothing like this. 80% of cholesterol is produced in the body (in the liver, in other tissues) and only 20% of cholesterol comes from food. But the amount of cholesterol that is produced by the body depends ... right, on heredity.
Therefore, a completely herbivorous person, a staunch vegetarian who has seen meat only in the picture, may have high cholesterol. Consequence number two: if your next of kin have high cholesterol, then you need to control it more often. Finally, consequence number three: it is often impossible to lower high cholesterol through diet alone.
As you know, gasoline does not burn on its own. It needs a spark to ignite. In the same way, cholesterol itself does not stick to absolutely healthy vessels. In order for its deposition in the vessels to begin, some kind of “match” is needed. Other risk factors become such a match: smoking, diabetes, hypertension, overweight, that is, everything that in itself damages blood vessels, making them more vulnerable to the development of atherosclerosis.
Alas, many people carry such matches with them ... That is why, by the way, atherosclerosis often develops in people with relatively low cholesterol - there is not much gasoline, but there are a whole box of matches.
Facts about cholesterol
Everyone has heard of “good” and “bad” cholesterol. The fact is that cholesterol itself is an insoluble molecule and cannot just get into tissues. He needs a special "transport". In the role of "cabbers" of cholesterol are special carrier proteins. Moreover, among them there are those that “deliver” cholesterol to the tissues, where it will be deposited, contributing to the development of atherosclerosis, and there are proteins, with the help of which cholesterol, on the contrary, is removed from the body.
In medical parlance, "bad" cholesterol is called "low density lipoproteins" (LDL, LDL, LDL). It is this indicator that we will look for in a biochemical blood test in order to determine the degree of risk. "Good" cholesterol is "high-density lipoproteins" (HDL, HDL, HDL). The higher its level, the better the excess cholesterol is excreted from the body.
With the deposition of cholesterol in the vessel wall, an atherosclerotic plaque begins to form. It grows, begins to narrow the vessel. While the narrowing is 20-30%, the person does not feel anything. When it blocks the lumen by 50-60%, the remaining 40% is not enough to pass the required amount of blood, ischemia develops. Cardiac ischemia is called - the heart needs more blood, and a narrowed (stenotic) vessel cannot give it.
If the plaque is loose, fragile, inflamed, it can collapse, rupture. Damage to the plaque is perceived by the body as an injury, and platelets come to the site of damage - blood cells that are responsible for stopping bleeding. A blood clot forms in the vessel, which means that the blood flow suddenly stops and part of the tissue of the heart, brain or other organ is suddenly left without blood and dies.
This process is called a "heart attack". If a catastrophe occurs in the heart - this is, in the brain -, in the artery of the leg - gangrene.
In order to determine the exchange of cholesterol and estimate the amount of "good" and "bad" cholesterol, a blood test is performed, which is called lipid spectrum(lipid profile, lipidogram). It includes:
Triglycerides- This is another indicator of fat metabolism, one of the main sources of energy in humans. It is believed that the increase in triglyceride levels in itself is not as dangerous in terms of cardiovascular risk as the increase in cholesterol. High triglycerides are primarily a risk factor for pancreatitis.
Unlike cholesterol, triglycerides are practically not produced in the body, but mainly come from food. Therefore, I can sometimes believe that a patient with high cholesterol really complies with the recommended one, but if he has elevated triglycerides, this means that he eats much more animal fats than he needs.
So, we got the results of the blood lipid test. The next thing we need to do is to cross out the “norm” column in this analysis. Yes, don't be surprised. Exactly. Not a single laboratory in the country knows the norms of cholesterol. This indicator is constantly reviewed by the world medical community, but for some reason this secret knowledge does not reach the laboratories.
First of all, let's agree that there is only high cholesterol, but there is no low cholesterol. There is no lower limit of normal for cholesterol. The lower the cholesterol, the better. To meet the vital needs of the body (cell building, hormone synthesis), cholesterol is needed quite a bit, and none of the modern methods of treatment allows you to lower cholesterol so much that these functions suffer.
After we crossed out (or smeared) the “norm” on the form, let's write in there what is actually considered today blood lipid targets.
But the target value of "bad" cholesterol (LDL) depends either on the presence of concomitant diseases.
Target values of low density lipoproteins (cholesterol-LDL)
After we have decided on the target LDL values, the operation "Cholesterol" enters its final phase. We have to understand whether it is necessary to lower cholesterol with drugs or whether it is enough to change the diet to affect those same 20%.
Let's look at this table. At first glance, it looks intricate, but in reality everything is not so complicated. Horizontally we find our level of "bad" cholesterol (LDL), vertically - the category of cardiovascular risk.
What to do depending on the level of cholesterol and the calculated risk
| Risk SCORE (%) | Level of LDL-C | ||||
| 1.8 to | 2.5 to | 4.0 to | > 5.0 mmol/l | ||
| No lipid lowering required | Healthy lifestyle | Healthy lifestyle | |||
| > 1% up to | Healthy lifestyle | Healthy lifestyle | Improvement of lifestyle, possibly prescribing medications if the target level is not reached | Improvement of lifestyle, possibly prescribing medications if the target level is not reached | Improvement of lifestyle, possibly prescribing medications if the target level is not reached |
| > 5% up to | Improving lifestyle, possibly prescribing medications | Healthy lifestyle and immediate prescription of medications | Healthy lifestyle and immediate prescription of medications | ||
| > 10%, or very high risk | Improving lifestyle, possibly prescribing medications | Healthy lifestyle and immediate prescription of medications | Healthy lifestyle and immediate prescription of medications | Healthy lifestyle and immediate prescription of medications | Healthy lifestyle and immediate prescription of medications |
Postponed myocardial infarction, operations on the heart and blood vessels.
Several risk factors, when assessed according to the SCORE table, the total risk is > 10%.
Ischemic heart disease, severe atherosclerosis of the carotid arteries, diabetes mellitus.
Several risk factors, when assessed according to the SCORE table, the total risk is 5-9%.
Several risk factors, when assessed according to the SCORE table, the total risk is 1-4%.
Family history of early CVD (onset of CAD or other vascular disease in immediate male relatives< 55 лет, по женской — < 65 лет).
One risk factor, when assessed according to the SCORE table, the total risk< 1%.
Then everything is simple. We look at what is written in the box at the intersection of the level of bad cholesterol and the risk category. “Better lifestyle” refers to dietary changes, weight loss, and smoking cessation. If “prescribing drugs” is recommended, then statins should be started.
We will talk about a diet for high cholesterol and taking statins next time.
There is a widespread misconception that cholesterol is harmful to the body, and its level in the blood is one of the most important indicators of a person's health. Many in an attempt to maintain their health adhere to strict diets, excluding all foods containing cholesterol. However, few people know that it is part of cell membranes, gives them strength and ensures the exchange of substances between the cell and the intercellular substance and regulates the activity of enzymes. Thus, without cholesterol, the normal functioning of our body is impossible.
Despite the importance of cholesterol, excessive consumption of fatty foods of animal origin can lead to an increased content in the body, which negatively affects health and can cause serious illness.
Controlling cholesterol levels will help maintain your health for many years, increase the body's natural resistance, increase life expectancy and improve its quality. In this article, we will dispel the most common myths about the role of cholesterol in our body and its metabolism. We will also look at the most effective ways to control cholesterol levels.
Cholesterol (from the Greek. chole - bile and stereo - solid, hard) - was first identified in gallstones from here and got its name. It is a natural water-insoluble lipophilic alcohol. About 80% of cholesterol is synthesized in the body (liver, intestines, kidneys, adrenal glands, gonads), the remaining 20% must come from the food we consume.
Circulating in the bloodstream, cholesterol, if necessary, is used as a building material, as well as for the synthesis of more complex compounds. Since it is insoluble in water (and, accordingly, in the blood), its transportation is possible only in the form of complex water-soluble compounds, which are divided into 2 types:
Low density lipoproteins (LDL)
High density lipoproteins (HDL)
Both of these substances must be in a strictly defined ratio, their total volume should also not exceed the norm. This can lead to serious diseases of the cardiovascular system.
Functions of cholesterol in the body:
- ensuring the strength of cell walls, regulation of their permeability for various molecules;
- synthesis of vitamin D;
- synthesis of steroid (cortisone, hydrocortisone), male (androgens) and female (estrogen, progesterone) sex hormones by the adrenal glands;
- in the form of bile acids, it participates in the formation of bile and the absorption of fats during digestion;
- participates in the formation of new synapses in the brain, thereby improving mental abilities and memory.
In fact, it is not cholesterol as such that causes harm, but its fluctuations beyond the norm. Health problems can cause both excess and lack of it in the body.
According to statistics, people who died from cardiovascular diseases had low levels of high density lipoproteins, but high levels of low density lipoproteins.
Lipoproteins with their wrong ratio or prolonged high content in the blood can settle on the walls of blood vessels and cause atherosclerosis.
This dangerous disease occurs when plaques form on the vascular endothelium, which, over time, grow more and more and accumulate calcium. As a result, the lumen of the vessels narrows, they lose their elasticity (stenosis), which leads to a decrease in the supply of oxygen and nutrients to the heart and tissues and the development of angina (cessation of arterial blood flow to certain parts of the heart due to blockage of the coronary artery, accompanied by pain and discomfort in the chest) . Often, it is because of a violation of the blood supply that a heart attack or myocardial infarction occurs. The formation of cholesterol plaques leads to damage on the inner wall of the vessels, a blood clot can form, which can subsequently clog the artery or come off and cause an embolism. Also, a vessel that has lost its elasticity can burst with an increase in pressure in the bloodstream.
HDL is considered a "good" lipoprotein due to its ability to dissolve cholesterol plaques and remove it from the walls of arteries, the higher its percentage in relation to LDL ("bad" lipoprotein), the better. LDL transports cholesterol from the organs that synthesize it into the arteries, and with an increased content of this compound, these large insoluble molecules combine to form fatty plaques, attach to the vessels and clog them. Being subjected to oxidative processes, cholesterol loses its stability and can easily penetrate into the thickness of the walls of the arteries.
Specific antibodies begin to be produced in large quantities against the formed oxidized LDL, which leads to severe damage to the walls of the arteries. In addition, cholesterol lowers nitric oxide levels, increasing the risk of cardiovascular disease.
Nitric oxide plays an important role in the body:
- dilates blood vessels, lowers blood pressure, prevents the formation of blood clots in the bloodstream;
- plays an important role in the fight against bacteria and viruses that enter the body, destroys cancer cells;
- increases the endurance of muscle tissue;
- participates in the exchange of information between different cells, is a neurotransmitter in synapses.
HDL not only removes cholesterol from the blood back to the liver, but also prevents the oxidation of LDL.
An increase in cholesterol levels is associated with a violation of lipid (fat) metabolism. This can be a symptom not only of atherosclerosis, but also of other serious diseases:
- liver;
- kidneys (chronic renal failure, glomerulonephritis);
- pancreas (chronic pancreatitis);
- diabetes mellitus (a serious disease associated with a violation of the synthesis of beta cells of the islets of Langerhans in the pancreas);
- hypothyroidism (decreased synthesis of thyroid hormones);
- obesity.
Symptoms of atherosclerosis are caused by narrowing of the lumen of blood vessels as a result of prolonged and persistent elevated cholesterol levels, and deterioration of blood circulation in different parts of the bloodstream.
Main symptoms:
- angina pectoris (sudden discomfort or pain in the chest that occurs during exercise or emotional stress);
- shortness of breath;
- arrhythmia (violation of the heart rhythm);
- cyanosis and swelling of the peripheral parts of the body (fingers, toes);
- periodic cramps in the legs (intermittent claudication);
- memory impairment, inattention;
- decrease in intellectual abilities;
- yellow-pink lipid deposits in the skin (xanthomas), most often observed on the skin of the eyelids and in the ankle joints.
Still, the opinion that the total level of HDL and LDL lipoproteins affects the state of health and their increase entails terrible consequences for the functioning of the whole organism. However, this statement is not entirely true. Yes, the above diseases will be accompanied by an increased content of lipoproteins in general, but what is much more important is the exact ratio of “good” HDL and “bad” LDL in the blood. It is the violation of this proportion that leads to health problems. When determining the content of lipoproteins in the blood, 4 indicators are taken into account: the total amount of cholesterol, the level of HDL, LDL and triglycerides.
Total cholesterol in the blood - 3.0 - 5.0 mmol/l;
With the threat of atherosclerosis, total cholesterol rises to 7.8 mmol / l;
LDL at men- 2.25 - 4.82 mmol / l;
LDL in women- 1.92 - 4.51 mmol / l;
HDL at men- 0.72 - 1.73 mmol / l;
HDL at women- 0.86 - 2.28 mmol / l;
Triglyceridesin men- 0.52 - 3.7 mmol / l;
Triglyceridesamong women- 0.41 - 2.96 mmol / l.
The most indicative is the ratio of HDL and LDL against the background of total cholesterol. In a healthy body, HDL is much higher than LDL.
There are many drugs that lower cholesterol in cases where this indicator poses a serious threat to health, or already at the onset of atherosclerosis. It is necessary to pay tribute, an important part of which is proper nutrition. In such cases, diet and moderate exercise will help not only bring all blood counts back to normal, but also completely heal and rejuvenate your body.
For a faster therapeutic effect, pharmacological preparations are used:
— Statins- the most popular drugs, the principle of their action is to inhibit the synthesis of cholesterol in the liver by blocking the corresponding enzymes. Usually they are taken once a day at bedtime (at this time, the active production of cholesterol in the body begins). The therapeutic effect occurs after 1-2 weeks of systematic use, with prolonged use they are not addictive. Side effects may include nausea, abdominal and muscle pain, and in rare cases, there may be individual sensitivity. Drugs of the statin group can reduce cholesterol levels by 60%, but with their long-term use, it is necessary to regularly take tests for AST and ALT every six months. The most common statins are cerivastatin, fluvastatin, and lovastatin.
— Fibrates stimulate the production of HDL, are recommended when the amount of triglycerides is 4.5 mmol / l. Not recommended for use with statins. Side effects are manifested in the form of gastrointestinal disorders, flatulence, nausea, vomiting, and abdominal pain. Representatives of this group of drugs: clofibrate, fenofibrate, gemfibrozil.
— bile acid sequestrants. This group of drugs is not absorbed into the blood, but acts locally - it binds to bile acids, which are synthesized from cholesterol, and remove them from the body naturally. The liver begins to increase the production of bile acids, using more cholesterol from the blood, a visible positive effect occurs a month after the start of medication, to enhance the effect, simultaneous administration of statins is possible. Prolonged use of drugs can lead to impaired absorption of fats and vitamins, increased bleeding is possible. Side effects: flatulence, constipation. These drugs include: colestipol, cholestyramine.
— Cholesterol absorption inhibitors interfere with the absorption of lipids from the intestine. Drugs in this group can be prescribed to people who have contraindications to taking statins, since they are not absorbed into the blood. In Russia, only 1 drug of the group of cholesterol absorption inhibitors, ezetrol, is registered.
The above measures are used in advanced cases, when it is necessary to quickly reduce cholesterol levels, and lifestyle changes cannot quickly give the desired effect. But even when taking pharmacological agents, do not forget about prevention, and harmless natural supplements that, with long-term regular use, will help you prevent diseases of the cardiovascular system in the future.
- Niacin (nicotinic acid, vitamin PP, vitamin B 3). The mechanism of action is not fully understood, but experiments show that after a few days of taking high doses of the vitamin, the level of LDL and triglycerides in the blood decreases markedly, but the amount of HDL increases up to 30%. Unfortunately, it does not reduce the risk of developing cardiovascular complications and seizures. For maximum effectiveness, niacin can be combined with other treatments.
— . Contained in fish oil and seafood, as well as in vegetable oils of cold pressing (unrefined). They have a positive effect on the nervous system, prevent rickets during the period of active growth, help lower cholesterol and blood pressure, improve blood circulation, strengthen blood vessels and give them elasticity, prevent their thrombosis, participate in the synthesis of hormone-like substances - prostaglandins. Regular intake of sources of essential fatty acids will miraculously affect the functioning of the whole organism, in particular, it will help prevent the development of atherosclerosis.
— Vitamin E. An extremely strong antioxidant that prevents the breakdown of LDL and the formation of fatty plaques. For the onset of a positive effect, it is necessary to constantly use the vitamin in appropriate doses.
— Green tea contains polyphenols - substances that affect lipid metabolism, they reduce the level of "bad" cholesterol and increase the content of "useful". In addition, tea contains antioxidants.
- Garlic. Fresh garlic is recommended to use to lower cholesterol levels, prevent the formation of clots in the vessels (thinns the blood). The active components that make up garlic are sulfur-containing compounds, in particular, alliin.
— Soy protein. By action, they are similar to estrogens - they reduce the likelihood of atherosclerosis. Genistein prevents LDL oxidation due to its antioxidant properties. In addition, soy stimulates the production of bile, thereby helping to remove cholesterol from the body.
— Vitamins B 6 (pyridoxine), B 9 (folic acid), B 12 (cyanocobalamin). A sufficient amount of these vitamins in the diet contributes to the proper functioning of the heart muscle, significantly reduces the risk of developing atherosclerosis and coronary heart disease.
What factors contribute to high cholesterol levels and the development of atherosclerosis?
Most often, atherosclerosis affects people who have neglected their health for a long time. The sooner you change your lifestyle, the less likely you are to develop serious diseases. Here are 4 main factors that contribute to high blood cholesterol levels:
— Passive lifestyle. With low mobility, lack of physical activity, the level of "bad" cholesterol rises, creating a threat of the development of cardiovascular diseases.
— Obesity. Violation of lipid metabolism is closely related to high cholesterol. Overweight people are prone to various diseases of the cardiovascular system.
— Smoking. It leads to narrowing of the arteries, an increase in blood viscosity, thrombosis, entails the risk of heart disease.
— Consumption of fatty animal products in large quantities leads to an increase in LDL.
— Heredity. The predisposition to high cholesterol levels is genetically transmitted. Therefore, people whose relatives suffer from this pathology should carefully monitor their health.
As long as you adhere to proper nutrition and an active lifestyle, the risk of developing various diseases decreases. This is especially true for people at risk. By changing your lifestyle, you improve the work of the whole organism, even despite the tendency to any pathologies, internal defense mechanisms can easily cope with the threat.
Active sports improve metabolism, train the heart muscle simultaneously with the skeletal muscles, contribute to a better blood supply to all organs and systems (during physical exertion, the blood from the depot goes into the general channel, this contributes to a better saturation of the organs with oxygen and nutrients).
Sports exercises also lead to the strengthening of the walls of blood vessels, prevent the development of varicose veins.
Don't forget the importance of proper nutrition. Do not abuse strict diets. The body must receive all the nutrients it needs in the optimal ratio, vitamins and minerals, fiber. The diet should contain enough vegetables, fruits, cereals, lean meat, sea and ocean fish, vegetable unrefined oils, milk and dairy products. If there is a lack of any vitamins in the diet, it is worth periodically taking preparations with their content to prevent beriberi.
Quitting smoking will reduce the risk of developing not only atherosclerosis, but also a number of other diseases, such as bronchitis, stomach ulcers, and cancer.
Sport is the best remedy for stress and depression, it tempers the nervous system. Regular physical activity, whether it's a run in the park or 3 hours of exercise in the gym, helps to remove the negativity and irritation accumulated over the whole day, many athletes experience euphoria during training. It has been experimentally proven that active people are much less prone to stress than those who lead a sedentary lifestyle.
As you can see, cholesterol is an extremely important compound that performs a number of vital functions. It is necessary for our life, but in the body its amount should not go beyond the norm. An imbalance in the ratio of high and low density lipoproteins entails serious consequences.
The best treatment is timely prevention. The most effective way to prevent high cholesterol levels in the blood is a healthy lifestyle.
When you give up bad habits and start adhering to the above rules, you will completely forget about health problems.
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Cholesterol is a chemical compound, a natural fatty alcohol, with a soft, waxy consistency found in all parts of the body, including the nervous system, skin, muscles, liver, intestines, and heart. Cholesterol is naturally produced in the body and is a structural combination of lipids (fats) and steroids. Cholesterol is the building block for cell membranes and hormones such as estrogen and testosterone. About 80% of the cholesterol in the body is produced by the liver, and the rest comes from our diet. The main source of cholesterol are meat, poultry, fish and dairy products. After eating, cholesterol is absorbed from the intestines and accumulates in the liver. The liver has the ability to regulate cholesterol levels in the blood and can release cholesterol if the body needs it. Cholesterol is insoluble in water, but highly soluble in fats.
Our body needs a small amount of cholesterol in order to function properly. But excess cholesterol can clog arteries and lead to heart disease. The risk of developing heart disease and atherosclerosis increases as blood cholesterol levels increase.
More than half of the adult population has blood cholesterol levels higher than the desirable range. High cholesterol levels are often noted in childhood. Some children may be at higher risk due to a family history of high cholesterol and the family's dietary habits.
Before menopause, women generally have lower levels of total cholesterol than men of the same age. They also have higher levels of HDL cholesterol, the "good" cholesterol. One reason is estrogen: the female sex hormone raises HDL cholesterol levels.
Estrogen is produced during childbearing years and drops during menopause. After age 55, women's risk of developing high cholesterol begins to rise.
Cholesterol helps the body produce hormones, bile acids, and vitamin D. Cholesterol is carried in the blood throughout the body to be used in all parts of the body.
Cholesterol is found in eggs, dairy products, animal meat and poultry meat. Egg yolks and organ meats (liver, kidney, thymus, and brain) are particularly high in cholesterol. Fish usually contains less cholesterol than other types of meat, but some shellfish, such as shrimp, crayfish, and fish roe, are also high in cholesterol. Plant foods: Vegetables, fruits, grains, cereals, nuts and seeds do not contain cholesterol. Fat content is not an objective measure of cholesterol content. For example, meat, liver contain almost no fat, but are very high in cholesterol.
Some cholesterol is considered "good" and some is considered "bad". Therefore, different blood tests are needed to measure each type of cholesterol individually.
To determine the level of cholesterol, as a rule, take blood from a vein.
Low-density lipoprotein cholesterol (LDL or beta-lipoproteins) is referred to as “bad” cholesterol. If too much "bad" cholesterol circulates in the blood, it begins to gradually settle on the inner walls of the arteries, forming the so-called plaques, which make the arteries narrow and less flexible. This disease is called atherosclerosis. Blockage of arteries by atherosclerotic plaques can lead to a stroke or heart attack.
High-density lipoprotein cholesterol (HDL or alpha lipoproteins) is the "good" cholesterol. About 25-33% of cholesterol is transported by "good" lipoproteins. High HDL levels protect against heart attacks. Low HDL levels (less than 40 mg/dL) increase the risk of heart disease.
Triglyceride is a form of fat created in the body. An increase in triglycerides can be associated with being overweight, physical inactivity, smoking, alcohol consumption, and a diet high in carbohydrates. People with elevated triglyceride levels very often have high blood cholesterol - high LDL and low HDL.
The body converts excess calories, sugar, and alcohol into triglycerides, a type of fat that travels in the blood and is stored in fat cells throughout the body. People who are overweight, sedentary, smoke or drink tend to have high triglyceride levels, just like those on a high carbohydrate diet. A triglyceride level of 150 or higher increases the risk of developing metabolic syndrome, which is associated with heart disease and diabetes.
LP is a genetic variation of LDL (low density lipoprotein). High Lp levels are a major risk factor for the premature development of fatty deposits in the arteries, leading to coronary heart disease.
To get the most accurate results, you should not eat or drink anything for 9 to 12 hours before the test. You can drink water, but avoid soft drinks such as coffee, tea, or sodas. Your healthcare provider may tell you to stop taking medications that may affect the results of the test.
At least 10% of the population suffers from hypercholesterolemia.
Screening for Children: High cholesterol levels in children are unfortunately not uncommon these days, so every child over the age of two who has a parent with a cholesterol level of 240mg/dL or more should get tested.
Screening for adults: The first screening test is performed at the age of 20 - 35 in men, and between the ages of 20 - 45 in women. A follow-up inspection should be carried out every 5 years. Screening is recommended for those who develop diabetes, high blood pressure, heart disease, or other diseases caused by atherosclerosis.
Follow-up testing is done to determine how well diets and medications control high cholesterol.
This test is often done to determine the risk of developing coronary heart disease. High blood cholesterol and triglycerides have been linked to heart attack and stroke.
A general cholesterol test can be done as part of a lipid profile, which also checks for LDL (low density lipoprotein), HDL (high density lipoprotein) and triglycerides.
Total cholesterol is an important indicator of both bad and good cholesterol. Other laboratory tests are performed to measure specific amounts of good (HDL) and bad (LDL) cholesterol. LDL and HDL levels are preferred under certain circumstances.
The norm of total cholesterol in the blood: 3.0 - 6.0 mmol / l.
Norm of LDL cholesterol for men: 2.25 - 4.82 mmol / l.
Norm of LDL cholesterol for women: 1.92 - 4.51 mmol / l.
Norm of HDL cholesterol for men: 0.7 - 1.73 mmol / l.
Norm of HDL cholesterol for women: 0.86 - 2.2 mmol / l.
LDL levels are the best predictor of cardiovascular disease and determine how your high cholesterol should be treated.
Less than 200 mg/dl: normal triglycerides
200 - 400 mg/dl: maximum allowed level
400 - 1000 mg/dl: high triglycerides
More than 1000 mg/dl: very high triglycerides
mg/dl = milligram per deciliter.
Any acute illness can raise or lower the total amount of cholesterol in the blood. If you had an acute illness in the 3 months prior to your cholesterol test, you should repeat the test 2 or 3 months later. Even an arthritis outbreak can affect your cholesterol levels.
Reducing cholesterol levels is now the most important factor in the prevention of atherosclerosis and heart attacks.
The benefits of lowering "bad" LDL cholesterol are:
Many people are able to lower their cholesterol through a combination of medications and lifestyle changes. But to what level should it be reduced? For people with diabetes or a high risk of developing heart disease, an LDL of less than 100 is desirable. If you already have heart disease or coronary heart disease, some doctors recommend lowering your LDL to 70 or below.
The dietary guidelines for children are similar. It is very important that children get enough calories to maintain their growth and activity levels. It is equally important that the child achieves and maintains the desired body weight.
No more than 35% of your daily calories should come from fat. But not all fats are the same. Saturated fats - fats from animal products and tropical oils, such as palm oil, increase LDL cholesterol. Trans fats carry the double whammy of increasing bad cholesterol while lowering good cholesterol. These two unhealthy fats are found in many baked goods, fried foods (donuts, french fries, chips), margarine, and cookies. Unsaturated fats can lower LDL when combined with other healthy diet changes. They are found in avocados, olive oil, and peanut butter.
The following two sample menus are provided as an example to compare calories and fat sources:
Breakfast
1 egg
2 slices white bread with 1 teaspoon butter
2 pieces of sausage
1/2 cup coffee
Snack
1 bun or donut
Dinner
1 sandwich with ham and cheese and white bread
1 teaspoon mayonnaise
30 g potato chips
350 g soft drinks
2 chocolate chip cookies
Snack
chocolate bar
Dinner
100 g roasted meat
1 medium baked potato
1 tablespoon sour cream
1 teaspoon butter
1 slice white bread with 1/2 teaspoon butter
Total: 2,000 calories, 84g fat, 34g saturated fat, 425mg cholesterol. Diet 38% fat, 15% saturated fat.
Breakfast
1 cup oatmeal or muesli
1 slice whole grain bread
1 banana
Snack
1 raisin bagel with 1/2 teaspoon butter
Dinner
Turkey sandwich (85-100 g) on rye bread with salad
1 orange
3 rice or oatmeal cookies
1 glass of apple juice
Snack
Low fat yogurt with fruit
Dinner
85-100g fried chicken breast
1 medium baked potato
1 tablespoon low fat yogurt
1/2 cup broccoli
1 piece of bread with jam
1 cup skim milk
Total: 2,000 calories, 38g fat, 9.5g saturated fat, 91mg cholesterol. Diet 17% fat, 4% saturated fat.
Fruits and vegetables
Quitting tobacco is a must in the fight against high cholesterol. When you stop smoking, your good cholesterol can improve by as much as 10%.
If you are healthy but not very active, start with aerobic exercise, it can increase your good cholesterol by 5% in the first two months. Regular exercise also lowers bad cholesterol levels. Choose exercises that raise your heart rate, such as running, swimming, or walking, for at least 30 minutes most days of the week. Classes should not exceed 30 minutes per set, two 15 minute sets work just as well.
Cholesterol-lowering medications may be used when lifestyle changes don't help lower LDL cholesterol to the desired level. The most effective and widely used drugs to lower cholesterol are called statins - these are the most widely used and also the most powerful drugs for lowering low-density lipoprotein cholesterol. Clinical trials have shown that statins reduce the risk of heart attack (and stroke) and improve quality of life. Statins have virtually no side effects when used for a long period of time.
The following statins are currently on the pharmaceutical market:
- Vitamin C. Vitamin C levels are directly related to cardiovascular health. Ascorbic acid is an effective natural statin that acts as an inhibitor in the production of low density lipoproteins. A large amount of vitamin C is found in citrus fruits (grapefruit, orange, lemon).
- Vitamin B3 (Niacin). B vitamins are powerful natural statins that come from green vegetables, meat, grains and milk.
- Garlic. Frequent consumption of garlic helps to normalize cholesterol levels. In just 4-12 weeks of regularly eating garlic, blood cholesterol levels are significantly reduced. In addition, garlic slows down the formation of low-density lipoproteins and cholesterol in the blood vessels.
- Canadian goldenseal (Curcumin). Curcumin, as a natural statin, is effective in the treatment of all diseases of the cardiovascular system. Curcumin stimulates the production of cholesterol by the liver and the removal of excess cholesterol from the body.
- Cellulose. Regular consumption of fiber-rich cereals, oatmeal, barley, certain vegetables and fruits, beans, carrots, apples, avocados, berries - helps in lowering cholesterol levels. The fiber in these foods acts as a natural statin, transporting excess cholesterol to the intestines and preventing it from circulating and clotting in the blood.
- Fish fat. Fish oil contains omega-3 fatty acids that regulate lipid production. Sources of fish oil are oil of oily fish, salmon, mackerel. In addition, fish oil is available in the form of capsules.
- Flax seeds. Another powerful natural statin is flaxseed, which contains a similar amount of omega-3 fatty acids.
- Red fermented rice extract. This natural statin is used in many Asian cuisines as an ingredient to add color and flavor to dishes. A by-product of fermentation, monacolin K, helps lower cholesterol and triglycerides.
- Policanol. Effective natural statin. It is made from sugar cane and comes in the form of capsules. The main advantages of policanol are the ability to prevent blood clots, regulate blood pressure, reduce low-density lipoprotein levels. In addition, Policanol is effective in the fight against excess weight.
- Fermented soy products. Soy products - such as tofu, miso, tempeh - are also effective in lowering cholesterol levels and act as natural statins.
- Artichoke, basil
.
Other herbs that may lower cholesterol include fenugreek seeds, artichoke, yarrow leaves, and basil.
Fibrates are effective drugs that lower blood triglyceride levels. Fibrates inhibit the production of very low density lipoproteins in the liver and accelerate the removal of triglycerides from the blood. Fibrates are also effective in raising blood levels of HDL cholesterol, however, fibrates are not effective in lowering LDL cholesterol levels. Doctors may consider combining fibrates with statins. This combination will not only lower LDL cholesterol levels, but also lower blood triglycerides and increase HDL cholesterol levels.
Fibrates can also only be used to prevent heart attacks in patients with elevated blood triglycerides and low HDL cholesterol.
Bile acid preparations bind bile acids. This reduces the amount of bile acid returned to the liver, which allows the liver to produce more bile acids to replace the lost bile acids in the stool. In order to produce more bile acids, the liver converts more cholesterol into bile acids, which lowers blood cholesterol levels.
Nicotinic acid (vitamin B3 or niacin) is a B vitamin. In the treatment of blood cholesterol and triglyceride disorders, high doses (1-3 grams per day) of nicotinic acid are essential. Nicotinic acid is available in several formulations. Nicotinic acid is most effective in raising HDL cholesterol, and moderately effective in lowering LDL cholesterol and triglycerides. Used alone, it can raise HDL cholesterol levels by 30% or more. However, nicotinic acid is not as effective as statins for lowering LDL cholesterol.
This is a relatively new class of cholesterol-lowering drugs that prevents absorption of cholesterol from the intestines. Selective cholesterol uptake inhibitors are most effective in lowering LDL (bad cholesterol), but may also have modest effects in lowering triglycerides (blood fats), and raising HDL (good cholesterol). One such drug is ezetimibe (Zetia)
Indications: Ezetimibe (Zetia) lowers blood cholesterol levels by reducing the absorption of cholesterol from the intestines. Used in combination with statins, it lowers total cholesterol, LDL cholesterol and triglycerides. May raise HDL cholesterol levels. Combining ezetimibe with statins is more effective than either drug alone.
Modern medicine has another modern drug to lower cholesterol levels. This is the latest development of American scientists. The drug contains an extract of their soybeans called Lunasin (Lunasin). In addition to the ability to lower cholesterol, drugs based on Lunasin have antioxidant and anti-cancer effects, help maintain normal weight, increase immunity and have anti-inflammatory effects.
Below are some questions you can ask your doctor or nurse to help you take care of your cholesterol levels.
What is cholesterol level?
What level of cholesterol in the blood is considered normal?
What does my cholesterol level mean?
What are the values of HDL ("good" cholesterol) and LDL ("bad") cholesterol?
Is my cholesterol level abnormal?
How can you lower your blood cholesterol levels?
How often should cholesterol levels be measured?
How to maintain normal cholesterol in the blood?
What medications should I take to treat high cholesterol?
Do they have any side effects?
What should I do if I miss a drug?
Are there foods, other medications, vitamins, or herbal supplements that can lower my cholesterol?
What are statins?
What can replace statins?
How should you eat to lower your cholesterol?
What are low fat foods?
What types of fats are good for my diet?
How can I tell food labels how much fat they contain?
What are the ways to eat healthy when I go to a restaurant?
Can I eat at fast food restaurants again?
Should you limit your salt intake? Can I use other spices to improve the taste of food?
Does alcohol increase cholesterol?
Does smoking increase cholesterol?
Can you drink alcohol if you have high cholesterol?
What is the best way to start an exercise program to lower cholesterol?
Are there activities or exercises that are not safe for me?
How long and how hard can I exercise to lower my cholesterol?
What symptoms should alert me?
Cholesterol or, as it is more correct to call it, cholesterol, is a special substance related to lipids (fats), which is produced in the liver and is necessary for the body to perform many metabolic processes, cellular health, the synthesis of various hormones and the absorption of food. Cholesterol is involved in the formation of bile, isolates nerve fibers and is directly involved in the synthesis of vitamin D. Without cholesterol, metabolic processes and other vitamins important for human health - A, E and K, are impossible.
But cholesterol is insoluble in water, so for its transportation through the body, special compounds are needed - lipoproteins. which are compounds of cholesterol and proteins.
There are two main types of these compounds
Low-density lipoprotein or LDL is also called "bad" cholesterol. Due to their low density, such lipoproteins settle on the walls of blood vessels and form cholesterol plaques.
High-density lipoproteins or HDL are considered "good" cholesterol, they transport cholesterol through the cells. But besides this, they clean the walls of blood vessels from LDL settled on it and transport them back to the liver, where “bad” cholesterol is processed and removed from the body along with bile.
There is another type of lipoprotein - very low density lipoprotein or VLDL. In addition to protein and cholesterol, they contain another fat - trigdicerides. In fact, VLDL are the precursors of low-density lipoproteins, into which they turn after they give up their triglycerides for their intended purpose - to produce the energy the body needs.
Total cholesterol is the sum of all these three types of lipoproteins.
A blood test for total cholesterol is usually ordered as part of a regular medical examination and other doctor visits to assess the risk of developing atherosclerosis and related diseases. Also, a similar analysis is done if the patient has already been prescribed treatment with stanins to lower cholesterol levels.
When analyzing blood, it is important to take into account not only the level of total cholesterol, but also individual indicators of high and low density lipoproteins.
Knowing the concentration of various lipoproteins in the patient's body, it is easy to calculate an indicator called the atherogenic coefficient.
K xs \u003d Total cholesterol - HDL-C / HDL-C
This coefficient shows the ratio of the content of harmful cholesterol - low density lipoproteins to the content of good cholesterol.
An analysis for total cholesterol is prescribed in the following cases:
The following patients are at risk:
Cholesterol levels should also be regularly checked for those people in whose family cases of atherosclerosis or related diseases of the heart and blood vessels have already been noted. An increase in cholesterol may well be a hereditary factor, which leads to such diseases.
Blood is taken from a vein, strictly on an empty stomach, in the morning. It is recommended not to eat for 12-14 hours before the test.
The norm of total cholesterol in the blood depends on the age and gender of the patient. Among women:
For men:
The norm of cholesterol in the blood of ordinary people and pregnant women:
An upward deviation in the level of total cholesterol from the norm is called hypercholesterolemia. It can be either hereditary or acquired. A high cholesterol level is considered if its values exceed 6.2 mmol / l. In any case, if we are talking about an increase in the level of total cholesterol, you need to conduct a lipidogram and determine what kind of cholesterol caused such an increase, the risk of developing atherosclerosis and concomitant diseases exists only if total cholesterol increased precisely due to low lipoproteins. density.
It should be understood that for a correct assessment of the risk of developing cardiovascular diseases, it is necessary to take into account not only the level of cholesterol, but also other factors. So, with high blood pressure, the presence of diabetes, overweight, smoking or alcohol abuse, it may be dangerous to increase the level of total cholesterol already up to 4 mmol / l.
Other diseases that can cause high cholesterol levels include:
The level of total cholesterol rises during pregnancy and returns to normal again one and a half to two months after childbirth. Prolonged fasting, as well as taking certain medications, in particular, corticosteroids, anabolics, and drugs based on the male sex hormone - androgen, can lead to the same result. Until recently, it was believed that eating cholesterol-rich foods could lead to high cholesterol levels. But the results of official studies published in 2006 convincingly prove that the intake of cholesterol along with food in no way affects the increase in its level in the human body.
A decrease in the level of total blood cholesterol is called hypocholesterolemia. It can be no less dangerous indicator than elevated levels of total cholesterol. We have already said that “good” cholesterol is necessary for the body. It has been proven that low cholesterol levels significantly increase the risk of cancer. When the rate of total cholesterol in the blood decreases, this can cause all kinds of mental disorders - unmotivated aggression, dementia, and even suicide. And although the causes of its occurrence are still not fully understood, today it is possible to list some diseases that lead to a similar result. Firstly, these are any pathological processes that occur in the liver - after all, it is here that cholesterol is produced. Secondly, these are all kinds of extreme diets that exclude sufficient fat intake by the body. Besides:
The unjustified use of statins and other drugs containing estrogens or erythromycin often leads to a decrease in the level of total cholesterol.
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