Cholesterol and its regulation – 7 myths

All cholesterol is bad.

According to the doctor, we need cholesterol as water, proteins or carbohydrates. The body uses it as a building material for all cells of the body, steroid and sex hormones are made from it. It is also involved in the synthesis of bile, which is necessary for the digestion of fats, and vitamin D, which is necessary to strengthen bones. Thus, cholesterol is necessary for the normal functioning of the body, in addition, it is included in the composition of cell membranes.

“There are two types of cholesterol – it’s high-density cholesterol (HDL), also known as good cholesterol, which removes so-called bad cholesterol from the blood, transporting it back to the liver, where it breaks down and is removed from the body. High density cholesterol is useful to have more.

Another species is low-density cholesterol (LDL), called bad, the increase in which is associated with a higher risk of cardiovascular diseases. It can enter the vascular wall, violate its integrity and cause the formation of atherosclerotic plaque – plaques – which narrows the arteries. This process of accumulation of plaques is called atherosclerosis. This can lead to serious problems, depending on which blood vessels are more affected – the arteries of the heart, carotid or leg.

Therefore, the level of low-density cholesterol in the body should be lower.

Another type of fat in the blood is triglycerides. Their high content usually means that you eat more calories regularly than you burn them. Too much triglycerides can increase the risk of heart disease,” says prof. Peltha.

The doctor adds that the ratio of good and bad cholesterol is very important – if a person is healthy, even a slight increase in cholesterol will not cause big problems. However, the higher the risk a person has to develop cardiovascular diseases, the lower his cholesterol should be.

“If a patient already has any cardiovascular disease, it means that the inner wall of his blood vessels has microdamages. In this case, even normal cholesterol levels can stick to those damaged blood vessels, clog them and cause various complications. Therefore, you should always follow this rule – the higher the cardiovascular risk, the lower the cholesterol,” explains the professor.

According to her, when conducting blood tests, it is very important to take into account whether low-density cholesterol levels are normal.

Elevated levels of bad cholesterol are largely due to lifestyle, not genetics.

According to the doctor, risk factors can be both inherited and acquired.

“If your family has had, for example, sudden deaths, heart attacks or cardiovascular diseases at a young age, as well as cases of dyslipidemia, this must be taken into account, since genetics is a very important factor. In this case, elevated cholesterol alone can be a serious trouble, so you need to start treating it at a young age, since such patients have a higher risk of developing cardiovascular diseases. However, it is always important to take into account the whole, to evaluate all the risk factors, the entire patient’s anamnesis, you can’t judge just one criterion,” she says.

Age is also important – the older a person is, the higher the risk of suffering from cardiovascular diseases. “Young women have more hormones estrogen, which protects them from cardiovascular diseases. Therefore, in cardiovascular diseases, they usually get sick later, when there is a natural decrease in these hormones in the body. And men, on the contrary, are more likely to get sick at a young age,” says the specialist.

To control blood cholesterol levels, foods rich in cholesterol should be avoided.

According to prof. Peltha, the largest amount of cholesterol (about 80 percent) is produced by the body itself, and with food we get only about 20 percent of it. However, this does not mean that you do not need to pay attention to nutrition – sometimes it is enough to reduce cholesterol by 20-30% to significantly reduce the risk of cardiovascular events,” the doctor claims.

She says lowering cholesterol by 1 mmo/l and lowering high blood pressure by at least 10 mmHg can reduce the risk of cardiovascular disease by up to 80 percent.

Physical exercise can increase cholesterol levels.

Reguliari physical activity has the opposite effect – it increases the level of good, high-density cholesterol, which lowers the level of bad cholesterol in the blood.

“Scientific studies have proven that physical activity at least 3 times a week for 45 minutes can ensure good health. If we do not move much, smoke, consume a lot of alcohol, there is an increase in weight, high blood pressure, diabetes mellitus, we run the risk of developing cardiovascular diseases. Physical activity is a necessary part of every person’s daily routine,” the doctor points out.

Medications – the only effective way to lower blood cholesterol levels.

Each case, according to the professor, is individual. If a person is healthy, the level of cholesterol in the blood can be lowered in other ways. However, in this case, if the patient has already suffered an infarction, stroke, heart surgery, vascular narrowings or peripheral artery disease are detected, cholesterol medications – statins – are necessary.

“It’s not just my opinion, it’s a fact that’s proven by research and confirmed by all the world’s experts. If a person has already experienced cardiovascular events or has cardiovascular diseases, a healthy diet alone will not help, statins must be taken in order to reduce the level of bad cholesterol to less than 1.4 mmol / l.

In addition, it should be understood that medicines are prescribed not unnecessarily, everything is done for the well-being of the patient – so that he lives longer, so as not to have repeated events. Bad cholesterol can be reduced with statins, and if this fails, ezetimib can also be added. However, even if cholesterol medicines are used, the principles of a healthy diet should be respected – saturated fats of animal origin, hydrogenated fats and sugar should be avoided. These are our three greatest enemies.

And plant-based fats, such as olive oil and products containing these fats, such as avocados, have huge benefits for the prevention of cardiovascular diseases,” she points out.

The Mediterranean diet, which is based on vegetables, fruits, nuts, seeds, legumes, especially virgin olive oil, fish, fermented milk products and a very small amount of meat, is also very useful for the body.

Cholesterol medications can damage the liver, cause muscle pain and dementia.

Prof. Peltha says that cholesterol medicines are much more studied than most other drugs.

“Nevertheless, people are very afraid of the side effects of these drugs. Of course, side effects can occur, but this is exceptionally rare. 2019 In America, a very interesting study of SAMSON was conducted, which showed that as many as 90% of cases of side effects occur not because of the substances contained in the drug, but because of the belief of patients that the use of the drug will cause side effects.

During the study, some patients took statins, while others took placebo pills that had no effect on health. However, both experienced side reactions. It was called the ‘nocebo’ effect,” she says.

According to the specialist, some people are convinced that statins spoil the liver, cause muscle pain and even dementia. “But it’s the other way around – cholesterol medications protect against dementia and Alzheimer’s disease. In general, we have never seen patients in resuscitations who would have been there due to, for example, acute liver failure caused by cholesterol medications. Resuscitations are full of patients who have suffered a heart attack,” the doctor emphasizes.

Statins should be taken until the level of bad cholesterol in the blood decreases.

The professor urges in no case to stop taking medications without consulting a doctor. “Statins are not antibiotics that should be taken until the infection or bacteria are destroyed. Statins act as long as a person takes them. If they are stopped, the level of bad cholesterol in the blood returns to its original limits. Therefore, in no case should you take statins as you want, for example, once a week or every other day. It is mandatory to take them exactly as prescribed by the doctor. Even if your cholesterol level has dropped, you can’t stop taking your medication,” the doctor says.

Prof. Peltha is convinced that if we do something for better health every day, then medicines will not be needed, or they will be needed less and later. “I wish you to start living healthier and more consciously today, to change your eating and physical activity habits. And if diseases already appear, I really wish you to trust modern medicine, doctors and the treatment prescribed by them, as well as not to forget about the right lifestyle habits,” urges the professor.