High cholesterol levels are primarily associated as a risk factor for diseases such as heart attack, stroke, arteriosclerosis and diabetes. The focus is on the LDL-HDL quotient. Nevertheless, cholesterol is an essential substance for humans.
- Cholesterol is vital, though. But too much of it in the blood can damage our health. Fortunately, the values can often be lowered with simple measures.
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It is an important component of cell membranes and the starting material for the synthesis of many hormones: Cholesterol is used to produce bile acids, vitamins and hormones.
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What is cholesterol
Three quarters of all cholesterol is produced by the body in the course of cholesterol synthesis in the liver and in the intestinal mucous membrane itself. The rest gets into the body through food. Eating too much and too fatty food, especially animal fat, results in too much cholesterol being absorbed in industrialized countries.
Cholesterol is a fat in the blood. If the concentration in the blood is too high, cholesterol is deposited in the blood vessels: This can gradually clog them and the blood can no longer flow freely. Elevated blood lipid levels are therefore a risk factor for diseases such as arteriosclerosis, high blood pressure, heart attacks and strokes.
HDL and LDL – good and bad cholesterol
In the blood test, a distinction is made between HDL cholesterol and LDL cholesterol. HDL (high density lipoprotein) cholesterol consists of half each protein and fat. It is found in the intestinal lining as well as in the liver and is used to transport excess cholesterol back to the liver. Dangerous fat deposits are "collected" along the way. Cholesterol can be broken down in the liver and then excreted in the bile.
That is why the vernacular also calls HDL cholesterol good cholesterol. It makes up about 25 percent of the total cholesterol in the body. Women have a hormonal advantage here: With them, estrogens ensure that they produce a particularly large amount of the "good" cholesterol, which largely prevents dangerous vascular deposits. This advantage gradually disappears after the menopause.
LDL cholesterol is high in fat
LDL (low density lipoprotein) cholesterol is the antagonist and is often referred to as bad cholesterol. LDL cholesterol is produced in the liver protein with high Fat percentage. It transports the cholesterol from the liver to the cells. If too much of it circulates in the blood, this increases the risk of so-called plaques forming and calcifying the vessels. If this calcification is very pronounced, the risk of high blood pressure, attacks, heart attacks and strokes increases. The healthy HDL helps prevent the harmful vascular deposits.
When and how is the blood cholesterol level determined?
The total cholesterol in the blood is determined in preventive examinations (health checkups). The values of HDL and LDL (plus triglycerides, the third blood lipid group) are added together. The values obtained are used to estimate the risk of cardiovascular diseases, diabetes or thyroid dysfunction.
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If relevant diseases have already been diagnosed or if there is excess weight that needs to be reduced, the therapy and course can be monitored with the blood lipids. Important to know: A high level of cholesterol in the blood is often detected too late because it does not cause any symptoms. It is therefore important to have the cholesterol level checked early and regularly.
The proportion of cholesterol is determined from the blood serum. The blood sample should be taken on an empty stomach, so the patient must not have eaten anything in the past twelve hours.
Cholesterol Levels: Which Guideline Values Are Healthy?
The normal values for cholesterol in the blood depend on age and gender. The concentration of blood lipids generally increases with age; the cholesterol level is then higher in women than in men. It is also significantly increased during pregnancy. A total cholesterol value of less than 200 milligrams per deciliter (mg / dl) is considered a healthy normal value.
Millimoles per liter (mmol / l) are also used as a unit of measurement for the cholesterol level. 200 mg / dl correspond to 5.17 mmol / l.
The LDL level in the blood should be basically as low as possible fail. When making the assessment, the doctor will use existing risk factors. These factors are:
- Smoke
- High blood pressure
- diabetes
- Obesity
- diagnosed cardiovascular diseases
- low HDL cholesterol
- Heart disease in the family
- Age (men over 45 years, women over 55 years)
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Table cholesterol levels
Depending on how many risk factors someone has, the following target limits for LDL cholesterol and total cholesterol apply, which should not be exceeded:
| risk | LDL cholesterol | Total cholesterol |
| low risk (fewer than two risk factors) | below 160 mg / dl | below 200 mg / dl |
| moderate risk (two or more risk factors) | below 115 mg / dl | below 200 mg / dl |
| high risk (for example very high blood pressure) | below 100 mg / dl | below 180 mg / dl |
| very high risk (already diagnosed diseases such as diabetes, arteriosclerosis, CHD, heart attack, stroke) | Aim below 70 mg / dl | below 180 mg / dl |
If your own values for LDL cholesterol are above the recommended values, the LDL value should be lowered below the upper limit of the normal value through a change in diet or with medical support.
The percentage of HDL cholesterol in the blood should be basically as high as possible be greater than 40 milligrams per deciliter in men and more than 50 milligrams per deciliter in women.
What does the LDL-HDL quotient mean?
The ratio of LDL to HDL cholesterol is important for assessing the risk of arteriosclerosis and other cardiovascular diseases. This quotient may be around 3.5 in a healthy person. Lower values apply for people who are pre-stressed by certain risk factors; for patients with already manifest cardiovascular diseases, it should be below 2.5.
Causes of high cholesterol levels
An unhealthy lifestyle with lots of high-fat foods and little exercise can raise blood cholesterol levels. In addition, a number of diseases have an impact on the blood lipid level. Kidney disease or an underactive thyroid can be causes of an increased value.
Too high LDL values can indicate biliary obstruction or urine poisoning (uremia). The value is also influenced when taking medication. These include steroid hormones or luteal hormones (progestins).
Causes of Low Cholesterol
In general, low total cholesterol and low LDL are considered desirable. However, remarkably low values should still be examined. These can occur, among other things, in:
If your LDL cholesterol is too low, unlike if your LDL level is too high, it does not need treatment. However, too low a value of good HDL cholesterol has an unfavorable effect on the LDL-HDL ratio and thus increases the risk of heart disease or a stroke.
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Lowering cholesterol reduces the risk of blood vessels
The composition of blood lipids can be influenced primarily through a conscious diet – and thus the risk of vascular diseases can be reduced. The general recommendation to use no visible fat at all is no longer upheld today. What kind of fat is eaten is much more important for a healthy diet. In order to increase the HDL cholesterol level, one should avoid animal fat and instead consume vegetable fat with unsaturated fatty acids. So-called trans fats are also dangerous and should be avoided. These are mainly found in products with hydrogenated vegetable fats (margarine, deep-frying fat, shortening). In addition, obesity should be reduced, and regular exercise can also help lower cholesterol.
In the case of diseases of the blood vessels that have already been diagnosed (CHD, heart attack, stroke, arteriosclerosis), drugs (cholesterol-lowering drugs, statins) can help to reduce cholesterol to less dangerous levels.