On the Coast – Families Issue 94 I June/July 2018 | Page 26

Cholesterol information
a bigger picture
by Diana Arundell
W
ith 30-50% ofAustralian adults
having high cholesterol it’s
important to understand more about
this substance and its impact on
the body.
Firstly cholesterol is essential for life.
The cells in our body require cholesterol
to function and many of our hormones
are derived from cholesterol, so it
certainly isn’t something to be scared
of. More recent studies in the British
Medical Journal (BMJ) looking into high
cholesterol and mortality suggest that
high cholesterol may not cause heart
disease as we originally thought and
higher levels of cholesterol may in fact
be protective in the elderly. It’s important
to consider the individuals bigger picture
of health including the ratios of the
different types of cholesterol, particle
size, triglycerides (fats) and all other
cardiovascular risk factors.
High total cholesterol in the blood on
its own doesn’t give adequate
information nor is it an indicator of
mortality. The real question is what
makes up the high total cholesterol.
Cholesterol is carried around the blood
stream attached to proteins called
lipoproteins and there are two main
types of these lipoproteins that have
been referred to as ‘good’ cholesterol and
‘bad’ cholesterol. These are high density
lipoproteins (HDL) which are considered
‘good’ cholesterol as these HDL molecules
help transport cholesterol away from
arteries to the liver for elimination. It’s the
low density lipoproteins (LDL – and very
low density lipoproteins VLDL) which
have the ‘bad’ cholesterol tag as these are
the ones that can deposit in the arteries,
become sticky and cause atherosclerosis
which is a known risk factor for heart
attack and stroke. It’s important to know
the ratio of protective HDL cholesterol to
potentially harmful LDL cholesterol and
it’s often the combination of high
triglycerides, high LDL and low HDL that
is more of a concern when it comes to
cardiovascular disease.
Recently there are more specific
functional tests available to establish
more accurately the impact of high
cholesterol on the body as high
cholesterol levels aren’t always associated
with plaque build up in the arteries. If
people with high cholesterol levels are
otherwise leading a healthy lifestyle and
consuming good nutrition it may not be
necessary to take medication as long as
other risk factors have been investigated.
Coronary calcium score can establish if
there is calcium build up in the arteries
and establish cardiac event risk. Other
blood tests can also identify other risk
factors for cardiac events including high
homocysteine levels and high sensitive
c reactive protein. Raised levels of blood
homocysteine (>10mcmol/L) is linked to
high cholesterol levels and associated
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