(In photo: David Ugwuozor)
by VEJAY STEEDE
Cholesterol has been a health advocate buzz word for decades now, but do we really understand exactly what cholesterol is? We know that it involves food and that if it’s not monitored and controlled properly, high levels of it in our bodies can lead to several chronic diseases, but the pitfalls of high cholesterol are not quite as clear cut as those of, say, sugar.
Too much sugar can lead to diabetes, which will wreak havoc on your lifestyle choices. Cholesterol, however, can be good in certain circumstances but very bad in others.
Preeminent local pharmacist, David Ugwuozor, described cholesterol as “a waxy, fat-like substance that is found naturally in the body. It is made in the liver and found in certain foods such as meat, milk, cheese, egg yolks and cream.
The body needs cholesterol to build healthy cells, make hormones, tissues, vitamin D and bile acid.
“We can see that cholesterol is very important for our body to function properly, but too much of the bad type of cholesterol can be harmful. This is because it sticks to the inside walls of your arteries, blocks blood flow to tissues and organs, and then increases the risk of developing heart disease and stroke.”
So, cholesterol is actually produced by our bodies and is a necessary component of several vital building blocks our bodies need to function correctly. But, like all good things, excess can be dangerous!
Mr Ugwuozor broke down the distinction between good cholesterol and bad cholesterol:
“In simple terms, there are two main types of cholesterol – one is good and the other is bad. Cholesterol is carried in the blood on protein particles called lipoproteins. High-density lipoproteins cholesterol, or HDL-C, is usually referred to as the ‘good’ cholesterol. It helps protect you from heart disease by getting rid of excess cholesterol that may potentially clog the arteries.”
Good cholesterol, it appears, actually defends our bodies against bad cholesterol.
Mr Ugwuozor continued: “Non-high-density lipoproteins cholesterol, or non-HDL-C, is called ‘bad’ cholesterol. The non-HDL particles carry their cholesterol from the liver and deposit it in the walls of arteries. One of the main components of non-HDL-C is LDL-C. You may have heard about ‘bad’ cholesterol being called ‘LDL’ cholesterol.
“In the UK, according to the National Institute for Health and Care Excellence (NICE) guidelines, non-HDL-C has replaced LDL-C and it is now used as the main measure of ‘bad’ cholesterol, because there are other forms of non- HDL cholesterol that are also harmful.
However, other international guidelines such as the European Society of Cardiology and the American College of Cardiology still use the LDL-C as their treatment goal.”
Of course, lifestyle choices can directly affect the levels of bad cholesterol in our bodies. According to Mr Ugwuozor, triglycerides are another kind of problematic fat that can be found in our blood. “Eating a lot of sugary and fatty foods, drinking too much alcohol and being very overweight can make you more likely to have a high triglyceride level, which raises the risk of heart disease and stroke.”
The connection between high levels of bad cholesterol and chronic disease is indelible, and the diseases this can lead to are very prevalent in Bermuda.
“Cardiovascular disease (CVD) such as heart attacks and strokes remain the leading cause of death in Bermuda, and worldwide, with a large economic burden on society. There are several risk factors associated with heart attacks and stroke, for example high cholesterol, diabetes and high blood pressure (a ‘silent killer’).”
Once your cholesterol levels rise to undesired levels, changing your diet and lifestyle may be imperative, but even that won’t guarantee that your cholesterol levels will decrease. In that instance, medicine may be the way to go.
“Medicines may be needed to reduce the level of cholesterol if your cholesterol level has not decreased after changing diet and lifestyle, or you are at a high risk of developing a heart attack or stroke. Statins are the most common medicines used for high cholesterol and this will reduce the amount of cholesterol the body produces. Patients always ask when to take their statins.
Long-acting statins such as atorvastatin and rosuvastatin can be taken at a time of day that is easy to remember, but short-acting statins, such as simvastatin and pravastatin, is best to be taken at night.”
Mr Ugwuozor expounded on high cholesterol treatments by highlighting the importance of understanding your test numbers:
“Better understanding of test or laboratory results will enable patients to ask informed questions, make informed decisions and it will lead to better communication between the patient and their doctor, or other healthcare professional. It will also empower patients to have more interest, ultimately leading to better health for patients in Bermuda.
“Unlike blood sugar levels, where it is quite easy to understand your test numbers, there is a lot more to consider with cholesterol levels. To simplify, there is a guide that can be utilised, but it is important to note that the levels to aim for can be different for everyone according to your treatment plan.”
Mr Ugwuozor closed with some pearls of wisdom for people struggling with high cholesterol levels:
“My main advice will be to take your medicine regularly, and follow the lifestyle and dietary advice provided by your doctor or other healthcare professionals. Seek medical advice if you develop unexplained muscle symptoms – pain, tenderness or weakness – whilst taking statins.”
Monitoring what foods you consume while taking medication is always a good idea as well. “Some foods such as grapefruit juice and supplements like St John’s wort, may interact with statins. Always ask your pharmacist or doctor if in doubt.”
Lastly, always do your bloodwork!
“Blood tests are needed to check the effectiveness of the medicine, assess your general state of health, or see how well your organs, such as the liver and kidneys, are working. So, if your doctors request a blood test, and it is for a valid reason, please follow their advice.”