Cholesterol
ENGLISH / MALTESE
What is cholesterol?
Cholesterol is an organic substance which falls under the category of lipids (fat molecules).
Cholesterol may be found in our body and is mostly produced by the liver; however, some is also obtained from food sources.
“Cholesterol is essential for our body to function.”
What are the types of cholesterol?
Cholesterol is carried around the body combined with proteins which are known as lipoproteins. There are two main types of lipoproteins:
High-Density Lipoproteins (HDL): known as ‘good’ cholesterol. This cholesterol clears up the ‘bad’ cholesterol from your blood and transports it to the liver for breakdown.
Low-Density Lipoproteins (LDL) and Non- HDL: known as ‘bad’ cholesterol. This cholesterol may build up in the walls of blood vessels leading to a reduction of blood and oxygen supply. This is known as atherosclerosis.
Why is high cholesterol harmful?
If your ‘bad’ cholesterol is high, it will build up in the walls of your blood vessels until it eventually completely blocks the vessels. If the vessels to the heart (coronary arteries) or brain become blocked, this may lead to a heart attack or a stroke, respectively.
What causes high cholesterol?
Many factors may lead to high cholesterol levels; some factors may be changed (modifiable) while others are not within your control.
Modifiable factors which increase your cholesterol include:
An unhealthy diet with too much saturated fats (butter, fat derived from animal products, poultry skin, palm oils)
High amounts of body fat (obesity).
Poor diabetic control.
Factors which increase cholesterol but are beyond your control:
Older age
Kidney or liver disease
Familial Hypercholesterolaemia (FH). This is an inherited condition from your biological parents where your liver is unable to process and remove the excess ‘bad’ cholesterol. FH should be suspected in people who
a) suffer from elevated cholesterol levels at a young age and/or
b) succumb to a heart attack or stroke at a young age.
Slow thyroid function
How do I know if I have high cholesterol?
Elevated cholesterol levels are usually silent and therefore you would not know they are elevated unless you take a blood test.
These tests can be performed by most family doctors or at your local Health Centre.
There is no specific target for all the population. Your cholesterol levels must be evaluated together with other risk factors (mentioned above). Clinical risk scores will help determine your overall risk.
However, if you suffered from a heart attack your target LDL value is 1.4 mmol/L or less.
Maintain a healthy body weight
How can I prevent and lower high cholesterol levels?
Maintain a healthy diet with low saturated fats
Stop smoking- Local smoking cessation services are available, and you can always ask your family doctor for advice
Control blood sugar levels (in the case of diabetic patients)
Remain physically active- Taking the stairs instead of the lift, walking to local shops instead of taking the car. It is recommended to do around 150 minutes of moderate intensity exercise per week
Maintain a healthy body weight
Diagnose and control your high blood pressure.
Reduce alcohol consumption
How can I treat high cholesterol levels?
Elevated cholesterol can be treated by following the above steps. If this is not enough, medication can be used to a) further lower cholesterol levels to the desired target range whilst also b) stabilising established atherosclerosis. The medications commonly used to lower cholesterol levels are known as statins. Fibrates may also be necessary in case of drug intolerance. Statins work by blocking LDL production within the liver. Common statins available locally include:
Simvastatin
Atorvastatin
Rosuvastatin
Consult your doctor before starting any new medication.
Take-Home Messages
There are different types of cholesterol; not all types of cholesterol are ‘bad’ cholesterol
High cholesterol levels can lead to a heart attack and stroke
Maintain a healthy lifestyle to prevent and lower high cholesterol levels
Ask your family doctor for advice
HELP AND SUPPORT
If you have any questions regarding our article feel free to contact us on info@maltaheartfoundation.org or our Facebook page.
This article was authored by Dr. Matthew Farrugia and edited by Dr. Neil Grech, in collaboration with the Malta Heart Foundation and Maltese Cardiac Society.