What is high cholesterol
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Understanding High Cholesterol: Causes, Risks, and Implications
What is High Cholesterol?
High cholesterol, medically known as hypercholesterolemia, is a condition characterized by elevated levels of cholesterol in the blood. Cholesterol is a waxy, fat-like substance essential for building cell membranes, producing certain hormones, and aiding in fat digestion. It is produced by the body and also obtained from animal-based foods such as egg yolks, meat, poultry, fish, and dairy products 145.
Types of Cholesterol
Low-Density Lipoprotein (LDL) Cholesterol
Low-density lipoprotein (LDL) cholesterol is often referred to as "bad cholesterol." Elevated levels of LDL cholesterol are a significant risk factor for cardiovascular diseases (CVD), including ischemic heart disease and ischemic stroke. The Global Burden of Disease Study 2020 highlighted that high LDL cholesterol levels have been increasing globally, contributing to a substantial number of deaths and disability-adjusted life years (DALYs) due to CVD 6.
High-Density Lipoprotein (HDL) Cholesterol
High-density lipoprotein (HDL) cholesterol is known as "good cholesterol" because it helps remove other forms of cholesterol from the bloodstream. However, recent studies have shown that extremely high levels of HDL cholesterol can paradoxically increase the risk of atherosclerotic CVD mortality and all-cause mortality 389. This U-shaped relationship indicates that both very low and very high HDL cholesterol levels are associated with higher mortality risks.
Causes of High Cholesterol
Dietary and Lifestyle Factors
Acquired hypercholesterolemia is often linked to a high-fat diet, particularly one rich in saturated fats, and a sedentary lifestyle. These factors contribute to elevated cholesterol levels, which can lead to various health issues, including cardiovascular diseases 10.
Genetic Factors
Familial hypercholesterolemia is an inherited condition that results in very high levels of cholesterol in the blood. Individuals with this condition have a genetic inability to remove excess cholesterol from their bloodstream, significantly increasing their risk of heart disease 45.
Health Risks Associated with High Cholesterol
Cardiovascular Diseases
High levels of total cholesterol and low levels of HDL cholesterol are well-established risk factors for coronary heart disease. Regular cholesterol screening is recommended for adults to identify those at risk and to implement preventive measures 2.
Other Health Conditions
Excess cholesterol accumulation is not only linked to atherosclerosis but also plays a critical role in the pathogenesis of multiple diseases, including liver diseases, diabetes, chronic kidney disease, Alzheimer's disease, and immune disorders. This broad impact underscores the importance of managing cholesterol levels to prevent a wide range of health issues 7.
Conclusion
High cholesterol is a significant health concern that can lead to severe cardiovascular and other systemic diseases. Understanding the types of cholesterol, their sources, and the associated risks is crucial for effective management and prevention. Regular screening, a healthy diet, and an active lifestyle are essential strategies to maintain optimal cholesterol levels and reduce the risk of related health complications.
Sources and full results
Most relevant research papers on this topic
Hypercholesterolemia
High cholesterol levels in the blood increase the risk of developing heart disease.
Total and high-density lipoprotein cholesterol in adults: National Health and Nutrition Examination Survey, 2011-2012.
High total cholesterol and low HDL cholesterol levels in adults aged 20 and over increased from 2009-2010 to 2011-2012, indicating a need for cholesterol screening.
Highly CitedAssociation of extremely high levels of high-density lipoprotein cholesterol with cardiovascular mortality in a pooled analysis of 9 cohort studies including 43,407 individuals: The EPOCH-JAPAN study.
Extremely high levels of HDL-C are associated with an increased risk of atherosclerotic cardiovascular disease mortality, particularly in current drinkers.
Meta-AnalysisHighly CitedFamilial hypercholesterolemia
Familial hypercholesterolemia is a genetic condition, and if inherited, it increases a person's risk of developing heart disease.
Abstract MP20: Global Burden Of Elevated Low-density Lipoprotein Cholesterol, 1990-2020: Findings From The Global Burden Of Disease Study 2020
Elevated LDL levels globally increased from 1990 to 2020, leading to a third and a fifth of deaths due to ischemic heart disease and ischemic stroke, with the highest levels in high-income countries and Central and Eastern Europe and Central Asia.
Meta-Analysis
Rigorous JournalAssociation between extremely high-density lipoprotein cholesterol and adverse cardiovascular outcomes: a systematic review and meta-analysis
Extremely high HDL-C levels are associated with elevated risks of all-cause mortality, cardiovascular disease mortality, and stroke compared to normal HDL-C levels.
Meta-AnalysisExtreme high high-density lipoprotein cholesterol is paradoxically associated with high mortality in men and women: two prospective cohort studies
Extreme high HDL cholesterol levels are paradoxically associated with high all-cause mortality in both men and women.
Rigorous JournalHighly CitedLow-fat diets for acquired hypercholesterolaemia.
Low-fat diets may not be effective for lowering cholesterol levels in healthy individuals with acquired hypercholesterolaemia.
Systematic Review
Very Rigorous Journal