Good vs. Bad cholesterol: how do they affect the heart?

Posted on 11 September 2018

There is a common misconception that all cholesterol is bad for you. But that’s not always true. Two Mediclinic experts offer a closer look at the various types of cholesterol, as well as solutions to prevent cholesterol-related heart attacks.

The Heart and Stroke Foundation of SA estimates that one in four South African adults have a high total cholesterol score. But what exactly is cholesterol? And is it really such a bad thing?

First, let’s look at the acronyms.

HDL, or high-density lipoprotein, is “good” cholesterol and acts in a recycling capacity. By transporting leftover deposits of cholesterol back to the liver for disposal, HDL is affectionately known as “nature’s garbage truck”. High levels of this type of cholesterol is therefore considered a good thing.

LDL, or low-density lipoprotein, also helps build cells in the form of cholesterol deposits. And while LDL itself is not actually bad, its oxidation and subsequent accumulation of fatty deposits in the arteries is. Because of this clogging effect, too much LDL is an invitation for heart disease.

“High levels of fat in the blood is a known cause of cardiovascular disease,” says Dr Aine Mugabi, a cardiologist at Mediclinic Pietermaritzburg. “Ideally, you should strive to lower your LDL and boost your HDL. We see in a majority of cases, because of the primary causes of strokes and heart attacks, the answer to better heart health lies in lifestyle adjustment.”

Good or Bad? Cholesterol Demystified

Cholesterol is an important substance. Produced in the liver, it is a major structural and functional component of our cell membranes, and assists in bile and hormone production. Add in the fact that cholesterol is converted to all-important vitamin D when we are exposed to sunlight, its function becomes more obvious.

Our cells need cholesterol. And because cholesterol is a water-soluble fatty substance, it needs to travel through the bloodstream to perform its important cellular functions.

What to expect from your cholesterol check-up.

Getting Tested

Ignorance is often bliss as far as cholesterol values are concerned. The reason for this is that high levels of the substance tend not to have definitive symptoms. So it is better to play it safe and be tested by your family doctor every five years. A cholesterol test is a simple procedure. Blood is tested either by a finger prick for an almost immediate result or as a full sample for further laboratory analysis. And while HDL levels are marginally affected if food has been ingested, a 12-hour fast is recommended for an accurate LDL score.

Have your cholesterol levels checked today. “Once you know the risk factors you can manage them, either with medication or lifestyle changes. This could help lower your risk of developing a cardiovascular issue like a heart attack or a cerebrovascular problem like a stroke, by up to 80%,” says Mugabi.

Do you know the best ways to keep your cholesterol in check?

The Balancing Act

It is the optimal balance between the cholesterol types that lowers the risk of heart disease. Of a total cholesterol level, an LDL reading of less than 100 is considered healthy, as is a value of 60-plus for HDL. And while genetics can play a part in naturally high cholesterol levels, certain lifestyle factors go a long way in ensuring a healthy cholesterol score.

Take the first step to reduce your risk of heart disease.

“High cholesterol is a major warning sign as it is a common risk factor for a range of heart conditions,” says Dr Franco Erasmus, clinical manager at Mediclinic Bloemfontein. Fortunately, this is fixable.

Diet: Not all fats are unhealthy. On the contrary, fibre-rich foods like fish, nuts, avocados and green vegetables contain polyunsaturated omega-3 fats and should make up the bulk of one’s diet.

Exercise: Along with a healthy eating plan, regular low-intensity exercise keeps one’s waistline in check. Aiming for around 150 minutes of weekly walking is more than adequate.

Hydrate: Drinking adequate amounts of water not only promotes good bodily function, but also aids in weight management.


Published in Cardiology

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.

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