What do I need to know about cholesterol?
Living in Indonesia comes with an exposure to a lot of risks. This includes exposure to all sorts of food and perhaps a less active lifestyle. That is why I think it is important to have some knowledge about cholesterol. High cholesterol levels are a risk factor for cardiovascular diseases. Cardiovascular risk is also calculated based on among others your cholesterol levels.
Cholesterol is a fatty substance which is known as a lipid. It is also needed for normal functioning of your body. Most of the cholesterol is made by your liver, but it can also be found in food.
A high level of lipids in your blood can affect your health.
High cholesterol doesn’t cause any symptoms. High cholesterol does increase your risk of other serious diseases.
Cholesterol is carried around by proteins in the blood. A lipid and protein combination is called a lipoprotein. There are 2 types:
- HDL is a high-density lipoprotein. The important thing is that HDL helps to break down your cholesterol. This is your GOOD cholesterol.
- LDL is a low-density lipoprotein. LDL can cause a build-up of cholesterol in the artery walls. This can lead to disease of the arteries. This is your BAD cholesterol.
Should I lower my cholesterol?
High cholesterol increases the risk of:
- Narrowing of your arteries (caused by a build-up of cholesterol)
- Heart attack
- Stroke
- Mini stroke and peripheral artery disease (blockage of arteries to your limbs)
If cholesterol builds up in your artery walls, it can restrict the blood flow to your heart, brain and the rest of your body. You are also at an increased risk of developing a blood clot. You are at more risk of getting a heart attack for example.
What are the causes of high cholesterol?
There are multiple causes. Partly it is because of your genetic make-up. You may just produce more cholesterol than others! Other causes are:
- Unhealthy diet – that contains a lot of saturated fats.
- Smoking – a substance in cigarettes stops HDL helping to break down cholesterol.
- Diabetes and high blood pressure.
- A family history of stroke or heart disease
It can also run in your family. In that case, you can have high cholesterol even if you eat healthily.
Should I test my cholesterol levels?
Your GP (Good Practice) can advise you if your cholesterol needs to be tested. This is likely if
- You have a family history of cardiovascular disease at a young age.
- A close family member has a cholesterol-related condition
- Are overweight
- You have high blood pressure or diabetes.
Are there any cholesterol target levels?
In this part of the world, we measure cholesterol in units called mg per deciliter.
A rough guideline for total cholesterol is 200 mg/dl or less for adults.
LDL (bad) cholesterol should be less than 100 mg/dl.
An ideal HDL (good) cholesterol is above 50 or 60 mg/dl.
A ratio of total cholesterol to HDL may also be calculated. This ratio should be below four, as a higher ratio indicates a higher risk of heart disease.
Cholesterol is just only one risk factor and treatment will depend on the presence of other risk factors, like smoking, high blood pressure, diabetes, age and gender.
How to lower the cholesterol level?
A healthy and balanced diet. It should be low in fatty foods.
Try to find alternatives for food containing saturated fat and switch to fruit, vegetables and wholegrain cereals.
Lifestyle changes, like physical exercise and stopping smoking, can also help.
If you continue to have high cholesterol your medical practitioner (GP) may prescribe cholesterol-lowering medication, like statins.
Discuss your risks with your trusted medical practitioner. Find out if you need testing.
It is important that you identify a clinic that you are comfortable with. GOOD PRACTICE has patients from 79 countries. Our English-speaking team implements international guidelines. We provide highly personalised care. Try us!
Dr Steven Graaff, MD, MRCGP, the founder of Good Practice Clinic is a graduate of the Vrije Universiteit Amsterdam. Before completing his formal training in General Practice in the UK, he worked in several hospitals, occupational health and general practice in the Netherlands and the UK. As a medical professional with international experience, Steven decided to start his clinic – Good Practice, in Jakarta.