Controlling Your Blood Cholesterol Level Is Very Important

By Dr. Okechukwu Amako, MBBS (Ibadan)
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Most people are aware of the importance of having a healthy blood sugar level, especially those with a family history of diabetes (someone in the family has diabetes mellitus).

But a lot of people are not aware that their blood cholesterol is equally important as it plays a role in the development of diabetes, heart attack, stroke, chronic kidney disease and disease of the blood vessels known as peripheral vascular disease. This is because a high blood cholesterol increases the risk of plaques (fatty deposits) building up within the tissue lining the lumen of the blood vessels (arteries) and these plaques can balloon out to narrow or block these vessels anywhere in the body, contributing to the disease conditions mentioned above.

While you can check your blood sugar at home with a portable medical device known as a glucometer, you can only get to know whether your blood cholesterol is high or normal by going to the hospital for a blood test in the lab.

If you are above 18 years, it is advised you check your blood cholesterol every 5 years; while men above 40 and women above 50 are advised to check theirs every 3 years. The doctor may recommend checking your blood cholesterol more often than the this recommended once every 3 or 5 years if your first test shows you have a higher than normal level (because a high level increases the risk of developing heart disease) and your medical history further indicates you have a high risk of heart disease (from family history of heart attack, stroke, diabetes to having lifestyle behaviours such as cigarette smoking and lack of physical exercise).

The blood cholesterol test is known as lipid profile in the hospital and is usually recommended for those presenting to a doctor for the first time with symptoms of diabetes mellitus. If you have not checked your blood cholesterol in the last 5 years, you can walk into any good hospital to see a doctor for this test. A complete blood cholesterol test (lipid profile) involves checking the level of 4 types of fats in your blood which are

1. Total cholesterol which is an estimate of the sum of the body's cholesterol content

2. High-density lipoprotein (HDL) cholesterol also known as good cholesterol; HDL cholesterol helps prevent fatty deposits from building up in the arteries, allowing more free flow of blood

3. Low-density lipoprotein (LDL) cholesterol also known as bad cholesterol.

LDL cholesterol is the main culprit in heart attack and stroke because a high level of this cholesterol type is responsible for the accumulation of fatty deposits within the wall of the arteries. Over time of continuous accumulation, these fatty deposits bulge out to partially block the lumen of the arteries; in the arteries of the brain, this can cause a temporary stroke (what doctors call a transient ischaemic attack) in which a part of the person's body becomes paralysed but this paralysis resolves in less than 24 hours with no brain injury (people reported to have completely recovered after having something that appeared to be a stroke had this transient ischaemic attack and need medical treatment to lower their blood cholesterol to prevent a future recurrence that may be permanent)

These bulges of fatty deposits can rupture the thin lining of the inner wall of the arteries, causing blood to clot in such arteries, totally cutting out blood flow to the tissues supplied by the arteries. If this occurs in the arteries supplying the tissues of the heart, it results in a heart attack; in the arteries supplying the brain, it results in a stroke.

4. Triglyceride is the type of fat derived from the excess calories which the body doesn't need immediately after you eat foods rich in carbohydrate and fats. Triglycerides are stored in fat cells for later use in energy production.

Those who regularly eat food high in carbohydrate and fats and who don't exercise are likely to have high triglycerides and this is bad for the heart and the blood vessels.

If your blood cholesterol comes out very high, the doctor will take a full history from you to know whether you have other risk factors for developing a heart disease or a stroke. After this, he or she will counsel you on lifestyle modification to help lower your blood cholesterol:

1. Regular physical exercise, at least 3 times a week

2. Cut down on the amount of alcohol you consume (if you take alcohol)

3. If you smoke cigarette, it is very important you make efforts and stop it completely

4. Watch your weight to ensure you are within the normal range; one way is to control what you eat. Your diet should be rich in protein and low in carbohydrate; eat more of diets prepared with or containing unsaturated fats like vegetable oil, nuts, and fish.

Stay away from processed foods as most of them contain large quantities of bad fats; instead, prepare your foods yourself.

Always eat lots of fruits and vegetables.

Depending on how elevated your blood cholesterols are, the doctor can prescribe some cholesterol-lowering medications after counselling you.

People with high blood cholesterol usually don't show any physical symptoms and may not be overweight, but they can develop a heart attack or stroke because the fatty deposits in their arteries can rupture suddenly. Therefore, the only way to know if your blood cholesterol is high is to do a lipid profile test.

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For more advice and help, feel free to consult a doctor.
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Published Friday, May 19th 2017

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