Cholesterol is a substance that every cell in the body needs. It is contained in cell membranes. Cholesterol is not found in blood serum by itself, but forms a single complex with proteins that carry it. Such compounds are called lipoproteins.
The role of cholesterol
Cholesterol has a very important function for the body:
- this is one of the important components of cell membranes, it is responsible for their permeability;
- serves as a precursor for the formation of steroid hormones (androgens, estrogens, corticosterone, cortisol, etc.);
- with his participation, the synthesis of bile acids is carried out.
Total cholesterol is not predictive in determining the possible risk of developing ischemic and other heart diseases, but its increased value suggests the need for a detailed study of lipoprotein metabolism.
Types of Lipoproteins
Several types of lipoproteins are known, but only two of the most important ones are distinguished:
- LDL - low density.
- HDL - high density.
The role of each of them is strictly defined and directly opposite in the mechanism of lipid metabolism disorders (HDL cholesterol and LDL cholesterol), the norm of these indicators is up to 1.05 mmol / l and 4.5 mmol / l, respectively. In addition, triglycerides also belong to cholesterol fractions. All these components are determined in a study called a lipid profile. This biochemical analysis determines the quantitative content of total cholesterol, LDL, HDL and triglycerides.
LDL is “bad” cholesterol, and its increased concentration may indicate an increased risk of developing cardiovascular disease. HDL, in contrast, acts as a protective factor against the occurrence of atherosclerosis.
HDL cholesterol
Values of LDL cholesterol below 1.03 mmol / L may indicate a serious risk of developing coronary heart disease and atherosclerosis, regardless of the concentration of total cholesterol. These indicators are indicators of the early detection of such risks, and are also used to evaluate the effect of treatment aimed at lowering blood lipids.
HDL indices of 1.55 mmol / L or more, on the contrary, indicate that the risk factor for the development of cardiovascular diseases is negative or reduced to zero.
About 25% of the total cholesterol is transported in the HDL fraction.
LDL cholesterol
High LDL cholesterol plays a major role in the development of heart disease and may indicate hereditary hyperlipidemia. This is proved by numerous epidemiological and clinical studies that also demonstrate its atherogenic properties. If LDL cholesterol is elevated in combination with triglycerides, then this combination may indicate an increased risk of developing atherosclerosis. This combination provides an opportunity for early diagnosis of this disease. The results of these studies allow us to evaluate the effectiveness of therapy, which is aimed at lowering the content of lipids in blood serum.
If LDL cholesterol is lowered, this may be due to malnutrition or malabsorption.
Approximately 70% of the total cholesterol structure is occupied by LDL.
LDL cholesterol is elevated. How is this dangerous?
In simple terms, "bad" cholesterol (LDL) is a molecule that can oxidize and penetrate into the blood vessels, forming atherosclerotic plaques on their inner side. They significantly impede blood flow and can even completely block the lumen of a blood vessel and form a blood clot. This can lead to the development of acute myocardial infarction.
The formation of such a blood clot in a vessel supplying blood to the brain can trigger a stroke.
Due to the fact that the lumen of the vessels is narrowed, the blood, saturated with oxygen, enters the heart muscle in insufficient quantities. This provokes the development of ischemic and other heart diseases. In addition, the walls of the vessels on which atherosclerotic plaques are concentrated lose their elasticity. If LDL cholesterol is elevated, it strikes both the heart and blood vessels.
An increase in the level of LDL can provoke the development of obliterating atherosclerosis of the vessels of the lower extremities, as well as gallstone disease, etc.
LDL cholesterol: the norm in women and men
Consider the normal values of LDL cholesterol.
| Age | Men | Women | unit of measurement |
| Under 19 years old | 1,5-3,6 | 1.5-3.9 | mmol / l |
| From 20 to 29 years old | 1,5-4,5 | 1,5-4,2 |
| 30 to 39 years old | 2.0-4.9 | 1.8-4.4 |
| 40 to 49 years old | 2,3-5,3 | 2.0-4.9 |
| 50 to 59 years old | 2,3-5,3 | 2,3-5,7 |
| 60 to 69 years old | 2,3-5,6 | 2.6-6.0 |
| 70 and older | 2,3-4,9 | 2.4-5.6 |
The table below shows how, depending on age and gender, one of the main fractions of the lipid profile, LDL cholesterol, changes. The norm in women is slightly different from the male one. This is due to differences in hormonal levels of representatives of different sexes. Normal LDL levels in men aged 20 to 60 are slightly higher than in the fair half. However, at a more mature age, everything changes, and LDL cholesterol (normal) in women catches up with male indicators and even becomes slightly higher. So affects the lack of female hormones in the menopause.
Also, its level may be affected by regional affiliation. For example, the concentration of cholesterol in residents of India and Pakistan is slightly higher than in other ethnic groups.
Reasons for an increase in LDL
Some factors can influence the increase in LDL cholesterol:
- nutritional factors - malnutrition;
- insufficiently mobile lifestyle;
- metabolic disorders - overweight;
- smoking;
- alcohol abuse
- endocrine diseases - diabetes mellitus, hypothyroidism;
- hypertension;
- liver disease
- hereditary hyperlipoproteinemia.
How to determine the level of LDL?
To determine the level of cholesterol, it is enough to donate blood from a vein in the treatment room of any clinic. A referral from a doctor to an LDL cholesterol analysis will be required. It can be obtained at the appointment with a therapist, cardiologist, surgeon, or in a pre-hospital office.
Blood for analysis of LDL cholesterol is given in the morning on an empty stomach. On the eve it is advisable not to eat fatty foods, and dinner should be no later than 19.00. Otherwise, the true indicators of cholesterol may be somewhat distorted.
The result of the analysis can be obtained the very next day. If it turns out that LDL cholesterol is elevated, the doctor will prescribe treatment. With total cholesterol greater than 10 mmol / L and a high LDL fraction, hospitalization in the cardiology department or outpatient treatment may be suggested. Most likely, statins will be recommended. If LDL cholesterol is elevated, as well as general, and non-drug methods do not help, then taking statins can be prescribed for life.
Medication-free cholesterol reduction
Before you start lowering cholesterol with drugs, you need to try to do this with a special diet and exercise. How to lower LDL cholesterol without pills? Regular moderate physical activity will help in solving this issue. It’s not necessary to go to the gym and train hard there. If there are no diseases of the cardiovascular system, you can do small 30-minute runs in your free time, but you need to monitor the pulse. It should not be higher than usual by more than 80%, that is, immediately after a run, the pulse of 100-140 beats per minute is the norm. And after 5-10 minutes, he should return to his normal values - 60-80 beats per minute.
Sometimes jogging is contraindicated, in this case a 40-minute walk at a normal pace is an excellent solution.
Diet to lower cholesterol
Along with physical activity, one should change one's taste preferences. This can be difficult to do, but it is a matter of health, therefore such a step is necessary.
Exclude from the diet all foods that contain a lot of saturated fats. These include:
- all sausages;
- all meat semi-finished products;
- all pastries and pastries, cakes and cookies;
- fatty meats;
- fat;
- vegetable oil (except soybean, rapeseed and corn);
- cream and sour cream;
- mayonnaise;
- hard cheese.
Fruits, fresh vegetables and freshly squeezed juices from them, on the contrary, are recommended to be included in your diet. Sea fish will also be useful, because it contains omega-3 fatty acids. Sardines and salmon are especially useful, but fish should not be salted or fried. It is best to steam it or bake it in the oven.
The weak green tea also reduces cholesterol to some extent, since flavonoids are part of it, they are able to strengthen the walls of blood vessels.
Some experts believe that drinking red wine in very small quantities can lower bad cholesterol. Other scientists disagree with these data and say that alcohol, even in small doses, harms the body. Therefore, it is better to postpone such treatment until all experts come to a consensus.
It is well established that there are products whose regular use can lower cholesterol by 10%. These include:
- Nuts - they can interfere with the absorption of saturated fats by the body. But they should be consumed in a limited amount (not more than 10-12 pieces per day), because they are too high in calories.
- Cereals - oats, barley, as well as wild rice and bran contain fiber necessary for good digestion.
- Soy, or rather the isoflavones contained in it, is able to lower LDL cholesterol.
- Polyunsaturated vegetable oils (soybean, linseed, peanut, canola, and corn) can be consumed with high cholesterol. These types of oils contain polyunsaturated fatty acids that can lower cholesterol. It is they who are recommended to season salads from fresh vegetables.
- Sea fish should be included in the menu at least 3 times a week.
- Any fruits and vegetables contain soluble fiber, it is they that help to remove LDL cholesterol from the body. It is especially useful to include cabbage, carrots, citrus fruits, apples and apricots in the diet. Of legumes, beans are especially useful.
- It is believed that garlic, especially in combination with lemon, is able to clear blood vessels from cholesterol plaques . These two products are part of a large number of folk recipes for cleansing blood vessels and lowering cholesterol.
If LDL cholesterol is below normal, this condition does not require treatment. This may be the result of malnutrition and low-calorie diets. In this case, you should return to a balanced diet. It'll be enough.
Medical treatment
As it turned out, increasing LDL cholesterol plays one of the main roles in the development of atherosclerosis. In order to prevent the formation of this disease and its complications, it is necessary to constantly monitor the level of this substance, especially if there is a predisposition to increase it. If LDL cholesterol is elevated, treatment should be done by a cardiologist.
If nutrition and physical activity have not helped to cope with high cholesterol, you should take medications prescribed by your doctor. It can be:
- statins
- niacin (nicotinic acid);
- fibrates or salts of fibrinic acid, which lower triglycerides and increase HDL, respectively lowering the "bad" fraction of cholesterol - LDL;
- sequestrants of bile acids;
- cholesterol absorption inhibitors (Ezetimibe drug);
- food additives containing omega-3 fatty acids.
Statins
We should talk about statins in more detail. They are chemicals that can reduce the production of enzymes. Without them, the synthesis of cholesterol in the body is impossible.
It is important to remember that you need to take statins separately from other medicines that lower cholesterol, and they can not be combined with the intake of grapefruit juice. This is due to the fact that grapefruit contains substances that can affect the liver enzyme responsible for the destruction of statins. Thus, an increased concentration of statins accumulates in the body, more than necessary. This can lead to impaired liver function and destruction of muscle structure.
The most common types of statins in Russia are:
- The drug "Lovastatin" - is able to lower cholesterol by 25%.
- Means "Fluvastatin" - lowers cholesterol by 29%.
- Medication "Simvastatin" - reduces cholesterol by 38%.
- Means "Atorvastatin" - is able to lower cholesterol concentration by 47%.
- The drug "Rosuvastatin" (its other name is "Mertenil") is the most effective of the widely known statins, it reduces cholesterol up to 55%.
Natural statins
In addition to medicines, in nature there are many plants containing natural statins, but the concentration of these substances in plant materials is much lower than in medicines. However, they can also be used for treatment.
Statins are found in the leaves and roots of eleutherococcus and ginseng, plantain leaves and dry chaga mushroom. Somewhat less of them in plants that can be found in summer cottages, these are:
- lemongrass;
- fenugreek;
- St. John's wort
- hawthorn;
- safflower levze;
- Rhodiola rosea.
This plant material can be used individually or mixed and prepared from it water infusions in a water bath and taken during meals. This treatment is long, its duration can reach 4-6 months or more.
Conclusion
If non-drug measures to combat cholesterol do not help, and his rates are still high, then you should contact the doctor and adhere to his recommendations.