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High Cholesterol

If you are having any symptoms or have any questions, please call 811 to speak with a registered nurse 24 hours a day.

OVERVIEW

What is cholesterol?

Cholesterol is a waxy substance your body uses to protect nerves, make cell tissues and produce certain hormones. Your liver makes all the cholesterol your body needs. Your body also gets cholesterol directly from the food you eat (such as eggs, meats and dairy products). Too much cholesterol can have negative impacts on your health.

What is the difference between “good” cholesterol and “bad” cholesterol?

Low-density lipoprotein (LDL) is often called “bad” cholesterol. It delivers cholesterol to the body. High-density lipoprotein (HDL) is often called “good” cholesterol. It removes cholesterol from the bloodstream.

This explains why too much LDL cholesterol is bad for the body, and why a high level of HDL cholesterol is good. For example, if your total cholesterol level is high because of a high LDL level, you may be at higher risk of heart disease or stroke. But, if your total cholesterol level is high only because of a high HDL level, you’re probably not at higher risk.

Triglycerides are another type of fat in your blood. When you eat more calories than your body can use, it turns the extra calories into triglycerides. When you change your lifestyle to improve your cholesterol levels, you want to lower LDL, raise HDL and lower triglycerides.

What should my cholesterol levels be?

Your healthcare provider can determine your target levels based on your risk factors for heart disease using your age, gender, total and HDL cholesterol, blood pressure level, medications and smoking status

Total cholesterol level (Total cholesterol HDL-C ratio)

  • If you have a low risk for heart disease, it should be <6.0 mmol/L.
  • If you have a moderate risk of heart disease, it should be <5 mmol/L.
  • If you have a high risk of heart disease, it should be <4.0 mmol/L.

LDL cholesterol levels

  • An LDL cholesterol level of <3.0 mmol/L is best
  • If your risk is low, your LDL cholesterol should be < 5.0 mmol/L
  • If your risk is moderate, your LDL should be >3.5 mmol/L
  • If your risk is high, your LDL should be <2.0 mmol/L

HDL cholesterol levels

  • Less than 1.0 mmol/L means you’re at higher risk for heart disease.
  • An HDL above 1.0 mmol/L is best.

Triglycerides

  • Less than 1.7 is best

CAUSES & RISK FACTORS

Risk factors for heart disease

  • Already had a heart attack
  • A man, 45 years of age or older
  • A woman, 55 years of age or older
  • A woman who is going through menopause or has completed menopause
  • Have an immediate family member (parent or sibling) who has had heart disease
  • Cigarette smoking
  • High blood pressure or diabetes
  • Overweight or obese
  • Inactive

DIAGNOSIS & TESTS

When should I start having my cholesterol level checked?

You can’t tell if you have high cholesterol without having it checked.

Men 40 years of age and older should have their cholesterol checked.   Women aged 50 and older or who are post-menopausal should also have their cholesterol checked. People who have strong risk factors for heart disease or who have a family history of early coronary artery disease also need their levels checked.  Ask your healthcare provider how often you should your cholesterol checked.

A blood test known as a lipid panel is usually the way cholesterol is checked.

TREATMENT

What can I do to improve my cholesterol level?

If you have high cholesterol, it may be necessary for you to make some lifestyle changes. If you smoke, quit. Exercise regularly. If you’re overweight, losing just 5 to 10 pounds (2-5 kg) can help improve your cholesterol levels. Make sure to eat plenty of fruits, vegetables, whole grains and fish- all of which promote heart health. Avoid saturated and trans fats, which can raise cholesterol levels. Also limit your overall cholesterol intake to less than 300 milligrams per day and 200 milligrams if you have heart disease.

What about medicine to lower cholesterol?

Depending on your risk factors, if healthy eating and exercise don’t work to lower your cholesterol level, your healthcare provider may suggest medicine.

COMPLICATIONS

Why is a high cholesterol level unhealthy?

While some cholesterol is needed for good health, too much cholesterol in your blood can increase your risk for heart disease, including heart attack or stroke.

If you have high cholesterol, your body may store the extra cholesterol in your arteries. Your arteries are blood vessels that carry blood from your heart to the rest of your body. Buildup of cholesterol in your arteries is known as plaque. Over time, plaque can become hard and make your arteries narrow. Large deposits of plaque can completely block an artery. Cholesterol plaques can also split open, leading to formation of a blood clot that blocks the flow of blood.

If an artery that supplies blood to the muscles in your heart becomes blocked, a heart attack can occur. If an artery that supplies blood to your brain becomes blocked, a stroke can occur.

QUESTIONS TO ASK YOUR HEALTHCARE PROVIDER

  • Am I at risk for high cholesterol?
  • How often should I get my cholesterol tested?
  • What are my cholesterol levels? What do they mean?
  • What are my target cholesterol levels?
  • What lifestyle changes do I need to make to help improve my cholesterol levels?
  • Should I try adding plant sterols/stanols to my diet? What about other supplements?
  • Is there a chance that I’ll need cholesterol-lowering medicine?
  • What are the risks and benefits of taking this medicine?

FOR MORE INFORMATION

Heart and Stroke Foundation of Canada
Nova Scotia Toll free 1-800-423-4432
Prince Edward Island: (902) 892-7441

Canadian Heart and Stroke Foundation Website at:
http://www.heartandstroke.ca/

Written by familydoctor.org editorial staff.

Revised/Updated: 11-01-2010

Created: 01-01-1996

This handout provides a general overview on this topic and may not apply to everyone. To find out if this handout applies to you and to get more information on this subject, contact your family healthcare provider.

Copyright (c) by the American Academy of Family Physicians

Permission is granted to print and photocopy this material for non-profit educational uses.

Written permission is required for all other uses, including electronic uses.

Nova Scotia Telecare, Reviewed by Clinical Services Working Group, March 2019

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