High cholesterol can be inherited, but it’s often the result of unhealthy lifestyle choices, such as inactivity, smoking and an unhealthy diet. Metabolic conditions such as type 2 diabetes can also influence an individual’s cholesterol and triglyceride levels.
Behavioural risk factors
Unhealthy diet: A diet high in saturated fat (found, for example, in animal products) and trans fats (found in various industrially processed foods) can lead to an increase in cholesterol levels. Excess sugar and starch intake contributes to high triglycerides.
Physical inactivity: Being physically inactive can have a detrimental effect on non-HDL cholesterol levels. regular physical activity as been shown to have a beneficial impact by reducing non-HDL cholesterol concentrations.
Smoking: Cigarette smoking damages the walls of the blood vessels, making them more likely to accumulate fatty deposits. Smokers are 2-4 times more likely to develop heart disease than non-smokers. Conversely, smoking cessation typically leads to an increase in HDL cholesterol levels.
Obesity: The typical dyslipidaemia of obesity consists of increased triglycerides, decreased HDL cholesterol with HDL dysfunction, and normal or slightly increased non-HDL cholesterol.
Diabetes: High blood sugar reflects in part greater insulin insensitivity which contributes to higher levels of very low-density lipoprotein (VLDL) production by the liver and in turn lower HDL cholesterol. High blood sugar may also directly damage the lining of the blood vessels.
Non-modifiable risk factors
Heredity: The quantity of cholesterol produced by the body is partly genetically determined. Familial hypercholesterolemia (FH) leads to high cholesterol and, if untreated, to early heart attacks and heart disease. Each child of an individual with FH has a 50% chance of inheriting the disorder. There are many genes that impact cholesterol levels by small increments; having a lot of these genes that raise cholesterol is also not healthy. Therefore, screening parents, siblings, and children of a person diagnosed with FH to find others who may have inherited the genes is essential.
Age: Growing older constitutes a risk factor, as metabolism changes as with advancing age and may predispose individuals to dyslipidemia. For instance, with advancing age, the liver becomes less able to remove cholesterol containing lipoproteins. Furthermore, age reflects years of exposure to undesirable factors. The earlier one reduces this, the better one is able to age in a healthy fashion.
Gender: High cholesterol affects both men and women. However, oestrogen, a female hormone, raises HDL cholesterol levels, partially explaining the lower risk of CVD observed in pre-menopausal women. Conversely, LDL-cholesterol rises after menopause, which again increases the risk in post-menopausal women.
High cholesterol is also in itself a risk factor for serious health conditions. If left untreated, it can lead to atherosclerosis. This, in turn, may lead to heart disease, stroke, and other vascular diseases. The higher the LDL, the higher the risk.