Hypercholesterolemia is the presence of abnormally large amount of cholesterol in circulating blood. About 80% of total body cholesterol is made by the liver. The other 20% is from dietary sources. The body produces cholesterol because it is necessary to digest food. Cholesterol becomes a problem when there is too much "bad cholesterol" or low-density lipoproteins (LDL) present in the body. Excess LDL can trigger the formation of plaque or blockage on the walls of the arteries. Hypercholesterolemia is diagnosed using special blood tests.

What is the treatment?
The main goal is to reduce the risk of atherosclerotic heart disease and resulting myocardial infarction (heart attack). Diet modification is usually the first step in treatment and is tried for several months before any drug therapy is imitated. Fat intake is reduced to 30% of the total calories consumed; saturated fat intake is reduced by decreasing the amounts of pork, lamb, and beef; substituting low-fat dairy products; eliminating coconut and palm oil; cholesterol intake is reduced by eliminating egg yolks and organ meats. Exercise is also added to provide weight loss. Drug therapy may be started if diet, exercise, and weight loss efforts have not reduced the cholesterol levels after an adequate trial period.

It is important to take control of your dietary habits to promote a low cholesterol living. A decrease in your cholesterol level leads to a lower risk for heart disease.

Guidelines for Low-Cholesterol Living

• Set a goal for your cholesterol level. Identify your risk factors. You and your doctor can figure out an appropriate cholesterol goal.
• Reduce your risk for heart problems: Watch your weight. Do aerobic exercise. Change your dietary habits: Make wise food choices.
• Maintain visits with your health care provider: Sometimes changes in diet and exercise are not enough – you may need to take medications. See your doctor regularly, so that your levels of cholesterol can be monitored.

How to read your cholesterol results
Total Cholesterol Number:
Desirable: Less than 200
Borderline: 200-239
High: 240 or greater

Blood cholesterol levels of under 200 mg/dL are called "desirable" and put you at lower risk for heart disease. Any cholesterol level of 200 mg/dL or more increases your risk; over half the adults in the United States have levels of 200 mg/dL or greater. Levels between 200 and 239 mg/dL are "borderline-high." A level of 240 mg/dL or greater is "high" blood cholesterol. A person with this level has more than twice the risk of heart disease compared to someone whose cholesterol is 200 mg/dL. About one out of every five American adults has a high blood cholesterol level of 240 mg/dL or greater.

HDL Cholesterol Number: The higher your HDL cholesterol the better. This means that there are more good lipoproteins to remove unwanted cholesterol from your blood vessels.

Desirable: 35 or greater
Low: Less than 35

LDL Cholesterol Number: If you have a high number of bad lipoproteins, or LDL’s, in your blood, this may be a sign that cholesterol is starting to stick to your blood vessels.

Desirable: Less than 130 mg/dL
Borderline: 130 to 159 mg/dL
High: 160 mg/dL and above

Note: These categories apply to adults age 20 and above.

Taking control of your cholesterol can put you back in charge of a healthier you. This will greatly reduce your risk of heart attack, heart disease, stroke, and other serious cardiovascular diseases.

Medical Therapy
Niacin, fibric acid and statin medications are used to lower cholesterol levels:

Some of the cholesterol lowering medications are
Pravastatin (Pravacol)
Simvastatin (Zocor)
Atorvastatin (Lipitor)
Cerivastatin (Baycol)
Fluvastatin (Lescol)
Lovastatin (Mevacor)
Gemfibrozil (Lopid)
Fenofibrate (Tricor)

What is the prevention?
Genetic counseling may be of benefit to those in families with a history of familial hypercholesterolemia. Recognition of existing elevated LDL levels, and a low-cholesterol, low-saturated fat, high-unsaturated fat diet in high-risk individuals may help to control LDL levels and prevent early heart attacks.

HDL or good cholesterol
Patients with normal LDL cholesterol but low HDL are at risk of developing althrosclerotic heart disease and may benefit from therapy to raise their HDL with Niacin or a statin.