Did you know, our body needs a small amount of blood cholesterol to build cell membranes, to make hormones like oestrogen and testosterone, to help our metabolism work efficiently, and to produce vitamin D? All of these are functions of cholesterol that we often overlook. Cholesterol has earned itself a bad reputation, solely because of its association with cardiovascular events. But what many people don’t know is that there are two types of cholesterol. Speaking with the Only My Health team, Dr Parneesh Arora, Director- Interventional Cardiology, Cardiac Sciences, Max Super Speciality Hospital, Patparganj, explains what cholesterol is, its causes and ways to manage it.
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Good Versus Bad Cholesterol
According to Dr Arora, there are five constituents of cholesterol namely VLDL (a type of blood fat), Low-Density Lipoprotein (LDL) , Intermediate-Density Lipoproteins (IDL), High-Density Lipoprotein (HDL), and triglycerides. “HDL is considered good cholesterol, while the rest are considered bad cholesterol,” said the doctor.
This is because HDL helps carry cholesterol to the liver, where it can be removed from the bloodstream before it builds up in the arteries, whereas LDL and other 'bad' cholesterol takes cholesterol directly to the arteries.
Causes Of ‘Bad’ Cholesterol Build-Up In The Body
“Build-up of ‘bad’ cholesterol is predominantly related to lifestyle issues such as obesity, lack of exercise, and excessive consumption of unhealthy food,” said Dr Arora, adding that these factors can be controlled through lifestyle management. In cases where the risk factor is high, medication may be necessary, he added.
In addition, the doctor emphasises on managing dyslipidemia, a condition that refers to unhealthy levels of one or more kinds of lipid (fat) in the blood.
“Dyslipidemia or metabolic disorders related to cholesterol can be genetically controlled, known as familial dyslipidemia. Such disorders often require medication and advanced techniques like plasmapheresis for management,” he said.
How To Measure Cholesterol
Dr Arora recommends three ways to measure cholesterol:
The most common method is to measure the five constituents: VLDL, LDL, IDL, HDL, and triglycerides. HDL, or high-density lipoproteins, is considered good cholesterol, while the rest are considered bad cholesterol.
Another method is by calculating non-HDL cholesterol, which involves deducting HDL from total cholesterol. The remaining value, measured in milligrams per DL, represents non-HDL cholesterol or bad cholesterol.
The third method is by measuring lipoprotein levels, specifically apoprotein B and A. The ratio of apoprotein B (representing bad cholesterol) to apoprotein A (representing good cholesterol) can be used as a marker for good versus bad cholesterol. A ratio of less than 0.9 is recommended.
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A Guide To Cholesterol Management
Here’s a look at doctor-recommended ways to manage cholesterol:
Assessing the patient's risk is the first step in cholesterol management, which involves calculating the 10-year risk of coronary events. If the risk is more than 7.5%, statins are recommended for most patients.
For individuals with diabetes, peripheral vascular coronary disease, or a high atherosclerotic risk (as indicated by LDL levels above 70), statins are also recommended.
Regardless of the risk factor, lifestyle plays a crucial role in managing both familial and acquired causes of high cholesterol. This includes daily exercise of at least 30 to 45 minutes, five days a week, and adopting healthy eating habits. These habits involve reducing sugar and high carbohydrate intake, increasing protein intake, consuming good sources of polyunsaturated fats, and incorporating nuts into the diet.
Bottomline
High cholesterol can lead to a build-up of fatty deposits in the blood, which eventually makes it difficult for enough blood to flow through the arteries. These can either break suddenly or form a clot, leading to a heart attack or stroke. Ensure that you get your lipid test regularly and follow a healthy diet. In addition, regular exercise is key.