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         Types of cholesterol

What is cholesterol, and what are blood lipids?
Blood lipids is the name for all the fatty substances in the blood, including cholesterol and triglycerides.

Cholesterol is a waxy substance which is mainly made in the body. The liver makes it mostly from the saturated fats in food. (Very little cholesterol is found in foods, except for eggs, liver and kidneys, and seafood such as prawns, all of which do contain some cholesterol.)

Cholesterol plays a vital role in how every cell works, throughout the body. It is also the material which the body uses to make other vital chemicals. However, too much cholesterol in the blood can increase your risk of getting heart and circulatory disease. (Heart and circulatory disease includes coronary heart disease, stroke, and diseases that affect the circulation such as peripheral arterial disease.)

LDL cholesterol and HDL cholesterol
Cholesterol has a special ‘transport system’ for reaching all the cells which need it. It uses the blood circulation as its ‘road system’ and is carried on ‘vehicles’ made up of proteins. These combinations of cholesterol and proteins are called lipoproteins.

There are two main types of lipoproteins – LDL (low-density lipoprotein) and HDL (high-density lipoprotein). The lower the density of the lipoprotein, the more fats it contains.

Low-density lipoproteins – sometimes called LDL cholesterol – carry cholesterol from the liver, through the bloodstream, to the cells.

High-density lipoproteins – sometimes called HDL cholesterol – return the extra cholesterol, that isn’t needed, from the bloodstream to the liver. HDL cholesterol is a ‘good’ type of cholesterol because it removes the bad cholesterol from the bloodstream rather than depositing it in the arteries.

Triglycerides are another type of fatty substance in the blood. They are found in foods such as dairy products, meat and cooking oils. They can also be produced in the body, either by the body’s fat stores or in the liver. People who are very overweight, eat a lot of fatty and sugary foods, or drink too much alcohol are more likely to have a high triglyceride level.

Cholesterol, triglycerides and the risk of coronary heart disease and  stroke
People who have a high total cholesterol level have a higher risk of coronary heart disease than those with lower levels. The risk is particularly high if you have a high level of LDL cholesterol and a low level of HDL cholesterol (the good cholesterol).

People with a high triglyceride level have a greater risk of coronary heart disease and stroke than people with lower levels. The risk is even greater if you also have other risk factors – for example, if you have a high cholesterol level, or you smoke, or you have diabetes or high blood pressure. (A risk factor is something that increases your chances of getting a disease.)

What part does cholesterol play in coronary heart disease?
Coronary heart disease is caused when the coronary arteries (the arteries that supply the heart muscle with oxygen-containing blood) become narrowed by a gradual build-up of fatty material within their walls. This condition is called atherosclerosis, and the fatty substance is called atheroma.

Atheroma develops when the level of the ‘bad’ LDL cholesterol is too high. On the other hand, HDL cholesterol is ‘good’ because it removes excess cholesterol from the circulation, and helps to protect against coronary heart disease.

The aim is to have:
• a low total cholesterol level
• a low level of LDL cholesterol, and
• a high level of HDL cholesterol.

Eating a healthy diet can help to improve yourcholesterol levels. The most important thing is to reduce the total amount of fat in your diet, especially saturated fat (animal fat).

When does a high blood cholesterol level matter?

A high level of cholesterol is one of the most important risk factors for coronary heart disease. The other major risk factors are:
having diabetes
having high blood pressure
not being physically active enough
being overweight or obese
having diabetes
having a family history of premature coronary heart disease. (This means if a close blood relative of yours developed coronary heart disease before the age of 55 for a man, or 65 for a woman.)

There is also a greater risk of heart attacks among people who have familial  hyperlipidaemia – an inherited condition in which the blood cholesterol level is very high.

      Doctor Tips
Angina is an uncomfortable feeling or pain in the chest.
It usually feels like a heaviness or tightness.
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