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3 questions about cholesterol

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Nearly 40% of the adult Canadian population shows high levels of cholesterol. Here are three essential facts on this enemy of our arteries.

1. Is hypercholesterolemia genetic?

Yes, there is in fact a form of hereditary hypercholesterolemia that is transmitted from a generation to another. This hereditary disease, called familial hypercholesterolemia, causes cholesterol levels—specifically LDL (low density lipoprotein) or “bad” cholesterol—to increase in the blood from birth. In the majority of cases, familial hypercholesterolemia is linked to a defect of the LDLR gene that affects the LDL receptors on the outer cells. These receptors are responsible for removing the LDL cholesterol from the blood and moving it into the cells. When these receptors are missing or deficient, the bad cholesterol increases in the blood and is deposited inside the arteries. The consequences can be very serious: angina, stroke, sudden death, etc. In fact, people who suffer from familial hypercholesterolemia are at greater and earlier risk of suffering from a heart disease than the rest of the population. Early prevention is the key to reducing the consequences of high cholesterol. In Quebec, familial hypercholesterolemia affects one person in 250 and spikes to one in 80 in the Saguenay–Lac-St-Jean region.

2. Are women really more at risk for high cholesterol after menopause?

They are, yes! Before menopause, women have a much more favourable lipid profile than men. The natural production of estrogen helps keep cholesterol levels in check, which could explain why cardiovascular diseases are relatively rare among women before 50 years old. Everything changes with menopause, however. When estrogen production slows down, women become more at risk for hypercholesterolemia. The reduction of estrogen levels increases the levels of LDL cholesterol (also called “bad” cholesterol) and triglycerides, while reducing levels of HDL cholesterol (known as “good” cholesterol). Unfortunately, all these lipid profile changes place women at increased risk for heart diseases and strokes.

3. Is it possible to stop cholesterol medication once normal levels have been achieved?

Absolutely not! Hypercholesterolemia medications (that lower cholesterol levels) do not cure hypercholesterolemia but rather work consistently to manage your levels throughout the treatment. If you stop taking them, your cholesterol levels can rise, putting you at increased risk for heart diseases and strokes. This is why medical treatment of cholesterol is long-term, especially if healthy lifestyle habits don’t have a positive impact. Also, you will notice that, after taking your medication for several months, your cholesterol levels will be significantly lower, maybe even back to normal, so it’s important to keep taking your medication while maintaining a healthy lifestyle (quitting smoking, adopting a healthy diet, exercise, etc.). In any case, always ask for your pharmacist’s advice.


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