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Update on cholesterol

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Have you noticed that many of your friends say they have high cholesterol? In 2009-2011, Statistics Canada reported that 40% of Canadians had a high cholesterol level. Despite the frequency of this problem, do you really know the facts about hypercholesterolemia, or high cholesterol?

Le point sur le cholestérol

Cholesterol: a two-faced issue

Although we often hear it mentioned, cholesterol and what is also known in medical circles as hypercholesterolemia, or dyslipidemia, continue to be vague concepts in the minds of many people. And yet, they are so much a part of the reality of North Americans that everyone should take an interest in the details of health problem that has become a social issue.

Cholesterol is a fatty substance that circulates in the blood and which is essential to the manufacture of numerous hormones, vitamin D, and our cell membranes. Without cholesterol, our body would not be able to function. The liver manufactures 80% of the cholesterol present in our body; the rest comes from our diet.  

In the bloodstream, cholesterol must be transported by a substance called lipoprotein. There are two classes of lipoprotein:

  • high density lipoprotein (or HDL cholesterol);
  • low density lipoprotein (or LDL cholesterol).

LDL cholesterol is associated with “bad cholesterol.” LDL takes cholesterol from the liver and distributes it through the body. When there is an excess of LDL cholesterol, it accumulates on the walls of arteries and forms a plaque. This is called atherosclerosis. With time, the surface of these plaques breaks off and forms a stone that blocks the bloodstream. If the obstruction occurs in a brain artery, it is known as a cerebrovascular accident (CVA). By reducing blood cholesterol, we prevent certain cardiovascular diseases (related to blood vessels).

HDL cholesterol is better known as “good cholesterol.” It is beneficial, as it captures any excess cholesterol and returns it to the liver to be eliminated.

Diagnosing hypercholesterolemia

Hypercholesterolemia is known as the silent killer; it displays no symptoms. It can only be diagnosed through a blood sample test. Are you concerned that your cholesterol level is too high? Medical specialists recommend testing cholesterol levels for:

  • men aged 40 and older;
  • menopausal women or those aged 50 and older;
  • people who have diabetes, high blood pressure or heart disease;
  • smokers;
  • men with a waistline larger than 102 cm;
  • women with a waistline larger than 88 cm;
  • people with a family history of heart or stroke disease;
  • men suffering from erectile dysfunction.

These people are more at risk of having high cholesterol levels.

A blood test will measure total cholesterol, HDL cholesterol and LDL cholesterol, and triglycerides. Triglycerides are not cholesterol, but appear to be associated with an increase in cardiovascular disease. Their rate is often high among those with poorly controlled diabetes and obese people. The next step is to calculate total cholesterol/HDL cholesterol levels; this allows your healthcare professional to assess your risk of heart disease.

Target values for cholesterol

Lowering LDL cholesterol levels is the target goal in the treatment of hypercholesterolemia. However, there is no set optimum level of LDL cholesterol for everyone. The cholesterol level based on which your doctor will decide on a treatment plan will depend on your risk factors for heart disease, your medical history and your current health. Thus, an LDL cholesterol level that is considered normal among young women in good health will be considered harmful among older men who have had a myocardial infarction (heart attack).

For all those patients who begin treatment, whether with or without medication, the goal is a 50% or more decrease in LDL cholesterol levels from their pre-diagnosis levels. For patients with intermediate to high risk of heart disease, the desired goal for LDL cholesterol levels will be less than 2 mmol/litre. Discuss it over with your healthcare professional to determine your cardiovascular risk factor.

On the other hand, when it comes to HDL cholesterol, a higher level is normally associated with a lowering of a risk of stroke and heart disease; this is why it is called the “good cholesterol.” Optimum target levels are:

  • HDL cholesterol higher than 1.0 mmol/litre among men;
  • HDL cholesterol higher than 1.3 mmol/litre among women.

Once you receive the results of your cholesterol levels, it is important to record them and understand what they mean. Ask your healthcare professional to help you clearly understand the significance of your results. This will then help you to implement measures to rebalance your levels

Now that you understand the different hidden faces of hypercholesterolemia, it will be easier for you to demystify it. Recognizing and understanding your cholesterol levels is a big plus when it comes to managing your health, so learn more about this important health issue. Many people are not aware they suffer from hypercholesterolemia; so they make no effort to reduce their cholesterol levels. Remember that your pharmacist is a competent healthcare professional who is available and who can provide you with many tips on how to keep your heart young and your arteries flowing freely!

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