January 7, 2020

Everything You Need To Know About LDL-Cholesterol

What is Cholesterol? It is very important to be aware of the amount of cholesterol in our bloodstream. But, before we start worrying about it, we need to know more about cholesterol and its role in our health. Cholesterol is a fatty substance and is often known as lipids. Insoluble in water, lipids cannot be transported in the blood on their own. To be transported, cholesterol binds to certain proteins and is carried in the blood. The combination of the protein and fats is known as lipoproteins.

While cholesterol is essential for the human body, high levels are associated with the risk of cardiovascular diseases. This is more so in the case of cholesterol that is carried by low-density lipoprotein or LDL. Known as LDL-C, its measurements are used to evaluate the risk of any future cardiovascular problems.

Studies have shown the correlation between cardiovascular diseases (CVD) and LDL-C in both sexes. Results of clinical and epidemiological trials indicate that reducing LDL-C should be the prime concern in preventing CVD. However, it is important to know that not every person with high LDL-C develops CVD. Similarly, not every person who has CVD shows high levels of LDL-C.

The Role of Cholesterol
An organic molecule, cholesterol is included in the sterol family and is found in the cell membranes of all our body tissues. A sterol is a combination of steroids and alcohol. Its name originates from the Greek words ‘Chole’ (bile), ‘Stereos’ (solid) and the suffix for alcohol – ol. Although chemically different from types of dietary fats like phospholipids and triglycerides, sterols are classified as lipids or fats. Sterols do not contain any fatty acids, unlike triglycerides. A major structural component of cell membranes, cholesterol is abundantly found in brain and nerve tissues and is a precursor of important vitamins and hormones produced in our body. Hormones such as cortisol, progesterone, aldosterone, testosterone, and estrogens are synthesized from cholesterol as is Vitamin D. Our body can synthesize cholesterol and is therefore not needed in our diets. If our intake of nutrients is sufficient, we can live on a cholesterol-free diet as the body will produce the required quantity.

Lipoproteins and its Role
Comprising of several thousand molecules, lipoprotein particles transport fats such as cholesterol and triglycerides in the blood from one organ to another. The major types of lipoproteins are chylomicrons, VLDL (very low-density lipoprotein), IDL (intermediate-density lipoprotein), LDL (low-density lipoprotein), and HDL (high-density lipoprotein). LDL delivers cholesterol to cells and excess cholesterol from the cells is brought to the liver by HDL. HDL-C is also known as the ‘good’ cholesterol while LDL-C is termed as the ‘bad’ cholesterol. This is because a high level of LDL-C is associated with an increased risk of CVD. While the cholesterol in both is the same, the difference is in the carrier – the lipoprotein.

What does High LDL-C Mean?
LDL-receptors are specialized receptors on the cell surface that bind LDL-C. Reduced or lack of these specialized receptors on the cell surface reduces the uptake of cholesterol by the cells forcing the remaining LDL-C to remain in circulation, raising blood levels.

How do you Measure LDL-C Levels?
Depending on the country, cholesterol levels are measured in mg (milligrams) of cholesterol per dL (deciliter) of blood or as mmol (millimoles) per L (liter) of blood. While the former units are used in the United States and some other countries, most European countries and Canada use the latter units. The numbers stated in the blood test reports are not based on measurements, but on calculations using the Friedewald equation. The equation includes total cholesterol, HDL-C, and triglycerides and is based on the assumption that the ratio of cholesterol to triglyceride is constant. However, that is not always the case. Thus, if the triglyceride levels are high or low, the LDL-C calculation may be erroneous. There are methods of measuring LDL-C directly, but is not commonly done due to its high cost.

LDL-C Range and its Importance
It cannot be emphasized enough how important it is to keep our cholesterol levels, especially LDL-C within limits. A high level of LDL-C, coupled with other risk factors for heart disease, can lead to heart failure. People, who smoke, have high blood pressure and/or diabetes are at high risk of CVD. They should undergo check-ups and follow the advice of specialists dealing with heart failure treatment from Thomson Medical to ensure that they do not increase the risks further. The presence or risk of CVD needs to be taken into account when interpreting the ‘normal range’ of LDL-C in a person. Keeping this factor, the following ranges have been set.
- Below 70mg/dL is ideal for a person with a very high risk of CVD
- Between 100 mg/dL is ideal for a person at risk of CVD
- Between 100-129mg/dL is taken as near ideal
- Between 30-159mg/dL is borderline high
- Between 160-189mg/dL is considered high
- Above 190mg/dL is very high

However, other lipid numbers such as triglycerides and HDL-C are also taken into consideration when evaluating the risk of CVD. A low ratio of TG/HDL-C is better as low levels of HDL-C and high levels of triglycerides are associated with an increased risk of CVD.

Keeping our LDL-C in Check
The best way to keep your LDL-C in check is to maintain a healthy lifestyle. In case, you have high levels of LDL-C, the doctor will surely recommend lifestyle changes for you. Some of these changes are listed below.
- If you are a smoker, the first thing is to quit the habit.
- Incorporate whole grains, olive oil, oatmeal, vegetables and fruits in your daily diet.
- Reduce the intake or get on to a low-carbohydrate diet.
- Avoid Trans fats – the fats found in fried foods, cookies, and crackers.
- Increase your daily intake of soluble fiber.
- If you are overweight, take steps to bring it down.
- Regular exercise is a must. It does not matter when you do it. What matters is that you try and do at least 150 minutes of aerobic exercises every week.

The Bottom Line
Most premature deaths occur due to unhealthy lifestyle choices which increase the risk of CVD. Maintaining a healthy everyday regime coupled with regular check-ups will help reduce the risks associated with heart failure.

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