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            Cholesterol is a waxy material
found throughout the body.
            The body needs cholesterol
to digest dietary fats, make hormones, build cell walls
and other important processes. Too much cholesterol in your body
means you have a higher risk of developing heart disease.
Over time, if you have too much cholesterol in your body, it can
build up on the walls of the arteries that carry blood to your heart.
This leads to accumulation of cholesterol laden "plaque" in the
vessel linings, a condition called atherosclerosis, which
impedes blood flow. When this happens the heart muscle becomes starved for oxygen,
causing chest pain (angina). If a blood clot completely obstructs
a coronary artery affected by athersclerosis, a heart attack
(myocardial infarction) or death can occur.
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Accumulation of cholesterol laden "plaque" in vessel
linings is called "atherosclerosis"
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Right: artery with "plaque"
Left: artery without "plaque"
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People get cholesterol in two ways:
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1.
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The body, mainly the liver, produces varying
amounts daily.
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2.
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It comes directly from foods
from animals (Vegetables contain
no cholesterol).
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            Typically the body
makes all the cholesterol it requires, so people don't need
to consume it. Saturated fatty acids are the chief culprit
in raising blood cholesterol. Some excess cholesterol is removed
from the body by the liver. The
Canadian Heart and Stoke Foundation
recommends that you limit your daily average cholesterol
intake to less than 300 mg (and 200 mg if you have heart
disease).
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Several Factors affect blood cholesterol:
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1.
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Heredity   Often high cholesterol runs
in families. Genes play an important role in influencing
blood cholesterol
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2.
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Weight   Excess weight tends to increase
blood cholesterol.
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3.
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Exercise   Regular physical activity
may not only lower LDL-C (bad cholesterol) but it increases
the HDL-C (good cholesterol).
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4.
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Age and Gender   Before menopause, women
tend to have total cholesterol levels lower than men at
the same age. Cholesterol levels naturally rise as men
and women age. Menopause is often associated with an increase
in LDL-C and a decrease in HDL-C.
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5.
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Stress   Experts say people
sometimes over eat fatty foods when under stress. This practice
or behaviour can contribute to high blood cholesterol.
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Cholesterol Breakdown
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High ("Healthy") Density Lipoprotein (HDL-C)
This is the "GOOD" cholesterol. . It prevents
cholesterol from building up in the arteries. It is
mostly protein and contains only a small amount of fat. HDL-C
clears the bad cholesterol from the body by picking up
cholesterol from the walls of the arteries and carrying
it back to the liver for disposal. Exercise increases the
production of HDL-C. A higher HDL-C is
linked with a lower risk of heart disease, stroke and
atherosclerosis. Exercise can also help control weight,
diabetes and high blood pressure.
Exercise that uses oxygen to provide energy to large
muscles (aerobic excercise) raises your heart and breathing
rates. Stopping smoking will also improve HDL-C levels.
Estrogen (female sex hormone) and moderate alcohol intake
can also raise HDL-C. One reason why women are relatively
protected from heart disease prior to menopause appears to be
related to the fact that women have higher levels of HDL-C as
compared to men. Women are just as likely as men to die for
heart disease but the onset tends to be later in life.
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Low ("Lousy") Density Lipoprotein (LDL-C)
This "BAD" cholesterol is
carried into the blood and is the main cause of harmful fatty
buildup in the arteries. LDL-C is mostly fat with a small amount
of protein. The higher the LDL-C level in the blood, the greater
the risk of heart disease. LDL-C is strongly influenced by genetic
factors. One of the other important causes of elevated LDL-C
levels is a diet high in saturated fats (fats found in animal
products), trans fatty acids (hydrogenated fats) and cholesterol
(found only in animal products).
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Lipoprotein (a) Lp(a)
Lp(a) is a genetic variation of plasma LDL-C . LDL transports
most of the cholesterol in the blood. When high levels of
cholesterol are present in the blood, Lp(a) promotes the buildup of plaque
(cholesterol deposits) in the arteries and interferes with
the break down of blood clots. All of this leads to the
increase risk of stroke and heart disease. The risk associated
with high LP(a) levels can be decreased by lowering LDL- levels
through diet (low in saturated fats and cholesterol) or
medication (statins), treatment with niacin and by maintaining
normal body weight and following an exercise program.
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Desirable Lipid Levels
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No Risk Factors
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Risk Factors
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CHD/DM*
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Cholesterol (mmol/L)
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Below
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5.2
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5.0
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4.5
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Triglycerides (mmol/L)
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Below
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2.0
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2.0
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1.7
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LDL-C (mmol/L)
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Below
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3.5
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3.0
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2.5
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HDL-C (mmol/L)
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Above
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1.1 (Men)
1.2 (Women)
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1.1 (Men)
1.2 (Women)
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1.2 (Men)
1.3 (Women)
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Lp(a) (mg/dl)
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Below
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25
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25
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25
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*CHD/DM: Desirable lipid levels for persons with:
Coronary heart disease, stroke, TIA, peripheral
vascular disease or diabetes.
Major risk factors for CHD include smoking, diabetes,
high blood pressure, family history, sedentary lifestyle,
stress, low HDL-C, elevated LDL-C, males
over 45, women over 55.
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