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Why is high cholesterol a problem? Article

Why is high cholesterol a problem?

The main risk associated with high cholesterol is coronary heart disease (CHD). This is caused by blood vessels
becoming narrowed with fatty deposits called plaques, which cholesterol contributes to. The narrowed blood vessels
reduce blood flow to the heart. This can result in angina (chest pain) or, if the vessel is blocked completely, a
heart attack. For more information see the BUPA factsheets on Angina and Heart attack.

High cholesterol can also increase the risk of other conditions, depending on which blood vessels are narrowed or
blocked. These include stroke if the blood supply to part of the brain is reduced. For more information see the BUPA
factsheet on Stroke. There is also a risk of peripheral vascular disease. This is caused by narrowed blood vessels in
the limbs, particularly the legs. It may result in leg pain, ulcers, infections and eventually gangrene.

Types of cholesterol
Cholesterol is transported around the body in the blood attached to a protein. This fat-protein combination is called
a lipoprotein. Lipoproteins can be high density (HDL), low density (LDL) or very low density (VLDL), depending on how
much protein there is in relation to fat.

LDL (low density lipoprotein)
About 70% of cholesterol is transported as LDL. This is mostly fat and not much protein.

LDL causes cholesterol to be deposited in the arteries. High levels of LDL are associated with an increased risk of
heart disease. LDL is sometimes referred to as "bad cholesterol".

HDL (high density lipoprotein)
About 20% of cholesterol is transported as HDL, which is mostly protein and not much fat.

HDL actually helps prevent cholesterol building up in the arteries. Low levels of HDL are associated with an
increased risk of heart disease. HDL is sometimes referred to as "good cholesterol". Women tend to have a higher HDL
cholesterol level than men.

If the total cholesterol level is too high, this is one risk factor for health problems. However, it's important to
consider the relative amounts of HDL and LDL. A high level of HDL and a low level of LDL is desirable.

Triglycerides
Triglycerides are a different type of fat, which mostly come from fats in food. Calories that are eaten and not used
immediately are converted into triglycerides and transported to fat cells for storage.

Although most triglycerides are stored in fat tissue, low levels are also found in the blood. They are carried in the
blood as very low density lipoproteins (VLDL).

A raised level of blood triglycerides together with high LDL can increase the risk of heart disease.


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