High Cholesterol - Causes of High Cholesterol

This factsheet is for people who want to learn more about cholesterol levels and health. Cholesterol is a type of fat (lipid) made by the body. It is essential for good health and is found in every cell in the body. However, a high cholesterol level in the blood (hypercholesterolaemia) is associated with an increased risk of heart disease and stroke. Seven out of 10 people over 45 have high cholesterol.

Causes

There are several factors that may contribute to high blood cholesterol:

• A diet that's high in saturated fat and, less so, high in cholesterol
• Lack of exercise may increase LDL ("bad") cholesterol and decrease HDL ("good") cholesterol
• Family history - people are at a higher risk of high cholesterol if they have a direct male relative aged under 55 or a female relative aged under 65 affected by heart disease
• Being overweight, which may increase LDL ("bad") cholesterol and decrease HDL ("good") cholesterol
• Age and sex - cholesterol generally rises slightly with increasing age, and men are more likely to be affected than women
• Drinking more than the recommended amount of alcohol (ie more than three to four units per day for men and two to three units per day for women)

Rarely, high cholesterol can be caused by a condition that runs in the family called a lipid disorder (familial hypercholesterolaemia). About one in 500 people have this condition.

Other health conditions such as poorly controlled diabetes, certain kidney and liver diseases and an underactive thyroid gland may also cause cholesterol levels to rise. Some medicines such as beta-blockers, steroids or thiazides (a type of diuretic) may also affect blood lipid levels.

Symptoms

High cholesterol has no symptoms. A blood test is the only way to detect high cholesterol.

When to see a doctor

Ask your doctor for a baseline cholesterol test at age 20 and then have your cholesterol retested at least every five years. If your test results aren't within desirable ranges, your doctor may recommend more frequent measurements. Your doctor may also suggest you have more frequent tests if you have a family history of high cholesterol or other risk factors, like smoking or diabetes.

Treatment

Treatment of high cholesterol depends upon its cause. Where high cholesterol is caused by a diet high in fatty foods, it can be lowered by altering your diet. Foods to avoid include whole eggs; shellfish; organ meats such as liver, brain, heart, kidneys, and sweetbreads; snacks and lunch meats that are high in saturated fats; fried foods; and desserts that are high in fats.

Some tips for lowering your fat intake include removing the fat from meats before cooking them, using egg whites instead of whole eggs, substituting applesauce for oil when baking, and using skim milk and other low fat dairy products. A diet high in fresh fruits, grains, vegetables, and beans is important to good health. Read the labels on the products you buy; sometimes just reading the ingredients of unhealthy foods is enough to prevent you from buying them! Some people, such as those whose high cholesterol is caused by an inherited disorder, must take medication to control their cholesterol levels, in addition to following a healthy diet. Commonly prescribed medications include cholestyramine, colestipol, lovastatin, pravastatin, simvastatin, probucol, gemfibrozil, or niacin. Like most drugs, these have possible side effects that your doctor should discuss with you. Where high cholesterol is caused by disease, treatment is specific to the underlying disease. Everyone with high cholesterol also benefits from a doctor-approved exercise program.

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