Cholesterol is one of several blood fats, also known as lipids. The human body needs cholesterol to make several hormones, cell membranes, and vitamin D, as well as bile acids, which help in digestion. For example, the body uses cholesterol to make the male and female sex hormones testosterone and estrogen. However, while some is good, more is not better; high cholesterol has been implicated in heart disease. Plaque, the waxy substance that can build up in arteries, includes cholesterol. Plaque is thought to contribute to heart attacks because it narrows the blood vessels. Plaque is also thought to increase the risk of stroke.
The body can actually manufacture cholesterol, but people also take in cholesterol in the diet. For many years, diet was thought to be a major factor in cholesterol levels, but the Scientific Report of the 2015 Dietary Guidelines Advisory Committee of the US Department of Agriculture found that cholesterol is no longer “a nutrient of concern.” Diet still matters, however. Regular exercise can help lower cholesterol levels while being overweight tends to elevate cholesterol. Cholesterol levels are also affected by age, heredity, and gender. For example, women tend to have lower cholesterol levels, but only until they reach menopause.
At one time, a cholesterol-lowering diet was one of the first recommendations for high cholesterol. In some cases, this may still be recommended, but other lifestyle modifications are more likely, such as weight loss and increased physical activity. The medications most commonly used to lower cholesterol include nicotinic acid, fibric acids, cholesterol absorption inhibitors, statins, and bile acid sequestrants. Medications may be used alone or in combination, but are usually combined with lifestyle changes. Other blood lipids like triglycerides may also be elevated with high cholesterol and should also be treated.
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