Cholesterol: the all-rounder produced by your body

In Switzerland, around 12 out of 100 people are diagnosed with high cholesterol at some point in their lives. “High cholesterol” refers to the value of total cholesterol in the body. Alongside blood sugar, it is probably the most frequently measured blood value in Switzerland. High cholesterol increases the risk of cardiovascular disease and arteriosclerosis. The latter is a vascular disease in which the arteries constrict or harden due to pathological deposits, with possible consequences such as a heart attack or stroke.

What is cholesterol?

First of all, you can’t have a healthy organism without cholesterol. This fat-like substance circulates in the blood and is mostly needed for fat metabolism. However, cholesterol is also an essential building material for the body as it is an important component of every cell wall and increases its elasticity. Cholesterol is also involved in the production of hormones and vitamins, and transports substances in and out of the cells, for example for metabolism. More recent studies show that the body also uses cholesterol to produce heart-strengthening messenger substances. Cholesterol is produced by the liver itself, but it is also absorbed through our diet.

If there is too much cholesterol in the blood, this is called high cholesterol or, to use the medical term, hypercholesterolemia – that is, more than 140 grams of cholesterol, which is roughly equivalent to the weight of an apple. There are two types of cholesterol – one “good” and one “bad”.

HDL and LDL: good and bad cholesterol

As fats aren’t soluble in water, some means of transportation is needed to carry them in the blood. This is the job of lipoproteins (fat and protein). Two types of lipoproteins are relevant when it comes to cholesterol:

• High-density lipoproteins, also known as HDL cholesterol, are considered “good” cholesterol. They transport excess cholesterol back to the liver and protect against arteriosclerosis.
• Low-density proteins, also known as LDL cholesterol, are considered “bad” cholesterol. They transport the cholesterol from the liver to the cells. In excess, LDL cholesterol is harmful to the body. If too much LDL cholesterol remains in the blood, it is deposited on the inner walls of the arteries. This leads to arteriosclerosis with risks for the heart and blood vessels.

What causes high cholesterol?

Generally speaking, the ratio of total cholesterol to “good” HDL should not exceed a value of 4:1. This ratio can be disturbed by an unbalanced, high-fat diet, obesity, high blood pressure, diabetes, stress and a lack of micronutrients and exercise. Illnesses or genetic factors can also play a role in driving blood lipids up.

In genetic familial hypercholesterolemia, on the other hand, defective genes disrupt fat metabolism from a young age. However, cholesterol levels are much more likely to increase as we get older. In this case, they are referred to as acquired forms.

High cholesterol: no symptoms

You don’t usually notice if you have high cholesterol. It’s often only discovered with a simple blood test at the doctor’s or in the pharmacy. In addition to cholesterol, triglycerides are also examined. These are a type of fat or lipid that circulates in the blood. They play a role in the risk assessment of vascular diseases. Like cholesterol, triglycerides are also transported in the blood by lipoproteins.

The symptoms resulting from high cholesterol only occur through consequential damage to narrowed or hardened arteries, which lead to circulatory disorders, such as a narrowing of the coronary arteries (angina pectoris) or, if the vessel is blocked, to a heart attack or a stroke.

How can you lower high cholesterol?

Early treatment can help prevent a heart attack or stroke. From the age of 40, you should have your cholesterol levels checked regularly. “It’s best to have them checked every two to five years,” says Dr Marc Jungi, a specialist in internal medicine at Sanacare.

As well as adjusting your lifestyle and diet, cholesterol-lowering drugs, known as statins, play a preventive role. They inhibit the formation of cholesterol in the body. A positive side-effect is that statins are also anti-inflammatory and help prevent vascular calcification. Advanced stages of vascular constrictions or blockages can be treated endovascularly, i.e. within a vessel, or surgically.

“The treatment usually involves three steps,” explains Jungi. Step 1: Understand the patient’s situation: How is their lifestyle? What about their diet? Do they have any pre-existing health conditions? Are there other risk factors for cardiovascular diseases, such as diabetes, high blood pressure or smoking? Step 2: Analyse potential for improvement. What can the patient do to bring about positive change, for example, adjust their diet, lose weight or do more exercise? Step 3: Let the patient know how they can improve the situation “After the first three steps, patients with a low overall risk potential are given at least six months to turn their situation around. Then their blood values are taken again to check if any progress has been made,” says Jungi.

Home remedies and ways to lower high cholesterol

Unfortunately, there is no cure for high cholesterol, but there are many natural ways to address the imbalance in the body. Four important factors: