Can you have high cholesterol and still be healthy
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Can You Have High Cholesterol and Still Be Healthy?
Understanding Cholesterol: HDL vs. LDL
Cholesterol is a fatty substance found in your blood, essential for building cells but potentially harmful in excess. It is categorized into two main types: high-density lipoprotein (HDL) and low-density lipoprotein (LDL). HDL is often termed "good cholesterol" because it helps remove other forms of cholesterol from your bloodstream, while LDL is known as "bad cholesterol" due to its association with plaque buildup in arteries, leading to cardiovascular diseases (CVD) .
The Protective Role of HDL Cholesterol
Research consistently shows that higher levels of HDL cholesterol are associated with a lower risk of cardiovascular diseases. A large-scale study involving over 100,000 individuals demonstrated a strong, graded, and independent inverse relationship between HDL-C levels and both CVD and coronary heart disease (CHD) mortality. This protective effect was observed across all age groups and risk categories, highlighting the importance of maintaining high HDL levels. Another study confirmed that individuals with higher HDL levels had a reduced risk of all-cause mortality and cardiovascular events compared to those with lower HDL levels.
Risks of Extremely High HDL Levels
While moderate to high levels of HDL cholesterol are beneficial, extremely high levels may not be as protective as once thought. A pooled analysis of Japanese cohorts found that extremely high HDL levels (≥90 mg/dL) were associated with an increased risk of atherosclerotic CVD mortality. Similarly, the CANHEART study indicated that individuals with very high HDL levels had an increased hazard of non-cardiovascular mortality, suggesting that extremely high HDL might not be universally beneficial.
Total Cholesterol and Health Risks
High total cholesterol levels, which include both HDL and LDL, are generally considered a risk factor for coronary heart disease. Data from the National Health and Nutrition Examination Survey (NHANES) showed a decline in the percentage of adults with high total cholesterol over the years, yet a significant portion of the population still remains at risk . High cholesterol intake has also been linked to an elevated risk of type 2 diabetes, further complicating the health profile of individuals with high cholesterol.
Cholesterol Absorption and Genetic Factors
High intestinal cholesterol absorption, influenced by genetic variants in the ABCG8 and ABO genes, has been associated with increased cardiovascular risk. This suggests that not just the levels of cholesterol, but also how your body processes it, can impact your health.
Conclusion
In summary, while high levels of HDL cholesterol are generally protective against cardiovascular diseases, extremely high levels may pose additional risks. High total cholesterol, particularly when driven by high LDL levels, remains a significant risk factor for heart disease and other health issues. Therefore, it is crucial to maintain a balanced cholesterol profile through a healthy diet, regular exercise, and, when necessary, medication. Regular cholesterol screening is essential for early detection and management of potential risks.
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