Overview of Cholesterol

Although cholesterol tends to have a bad reputation, it plays a vital role in the human body's metabolic processes. Cholesterol is naturally produced in our bodies where it is an essential part of our cell membranes. It is also used by the body to make hormones, help in the absorption of vitamins, and to produce bile, which helps in the digestion of fats. Our bodies naturally make enough cholesterol to perform all of these functions, though more cholesterol may be introduced through the diet. Animal products, such as meat, eggs, dairy products, and seafood all contain cholesterol which can be absorbed into the bloodstream.


When cholesterol is derived from the diet, it enters the bloodstream by association with a lipoprotein, a molecule that contains fats and proteins. If the cholesterol binds a high-density lipoprotein (HDL), it will be removed from the bloodstream, so this is often referred to as "good cholesterol." Low-density lipoproteins (LDL) remain in the bloodstream. So cholesterol that binds with it stays in the blood stream. If it is oxidized by free radicals it will become very reactive and can cause damage to the walls of the arteries, leading to cardiovascular disease. Although the cholesterol that binds to LDL is no different than that which binds to HDL, it is often called "bad cholesterol" because of this potential effect.

The levels of HDL and LDL in the bloodstream are considered markers that may indicate a person's risk for developing atherosclerosis (thickening of the arteries due to cholesterol build-up) and other cardiovascular disorders, so they should be monitored on a regular basis. Normally, the overall level of cholesterol is measured, but the proportions of HDL and LDL are the most telling part of the diagnostic. A high proportion of LDL indicates a risk for developing cardiovascular disease, as this type of cholesterol remains in the bloodstream, where it can thicken, harden, and potentially block the arteries. It is healthier to have a higher proportion of HDL since it works to remove cholesterol from the blood.

The American Heart Association recommends that adults get their cholesterol checked every five years. Heart disease and stroke are among the leading causes of death in the United States (they are number one and three respectively). Risks for both may be radically reduced by identifying and dealing with high cholesterol before it begins to create complications.

Symptoms of High Cholesterol

There are rarely symptoms associated with high cholesterol. Most people do not realize they have a cholesterol imbalance until a blood test is performed as part of routine medical tests.

In cases where cholesterol is severely elevated, some people develop cholesterol deposits in their bodies. These fat deposits, also called xanthomas, often form at the tendons, and are more often associated with high cholesterol due to genetic issues, rather than high dietary cholesterol. These fatty deposits may also form on the skin and eyelids and cause nodules on the hands and feet.

If a person lives with high blood cholesterol for a long time, however, they will develop cardiovascular complications and develop the symptoms related to these diseases, including hypertension, atherosclerosis, angina, and coronary artery disease.

Risk Factors of High Cholesterol

The main risk of high cholesterol is the development of vascular disease. Part of what makes LDL, or "bad cholesterol," bad is that it can undergo a chemical reaction with oxygen (oxidation) in the blood to become oxidized LDL. This oxidized LDL can be very destructive to the artery cell walls, prompting the immune system to call in the help of special white blood cells called macrophages. Normally, macrophages help the body in an immune response by "eating" and ingesting the pathogen or particle that is causing the immune response. Unfortunately, macrophages are unable to ingest the oxidized LDL they eat. Instead, the oxidized LDL accumulates within the macrophage until it eventually bursts, releasing highly concentrated oxidized LDL into the artery. Again, this can be very damaging to the artery walls, once again sparking the immune response that recruits more macrophages. This cycle can continue if the oxidized LDL cannot be cleared and eventually leads to chronic inflammation and the vascular disease known as atherosclerosis. The bad cholesterol can gradually thicken and harden the arteries, constricting them and reducing their elasticity, leading to high blood pressure. Sometimes, cholesterol lesions can develop in the arteries, and should one of these lesions break off, it could potentially block blood flow and cause a stroke or heart attack. The gradual constriction of the arteries by cholesterol can also potentially lead to congestive heart failure, as the heart is unable to pump enough blood through these narrowed arteries to the organs in the body.

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