By Jannie Ko
It is widely known that high cholesterol levels can lead to increased risk of cardiovascular events such as heart attack and stroke. Cholesterol is a waxy substance that is used to help build cells and make vitamins and other hormones in the body. (1) There are two types of cholesterol: one is carried by low density lipoprotein particles (LDL) and the other is carried by high density lipoprotein particles (HDL). HDL cholesterol is often referred to as “good” cholesterol because HDL transports excess cholesterol from the bloodstream to the liver to be eliminated. (2) In contrast, LDL is often referred to as “bad” cholesterol because LDL transports cholesterol throughout the body and deposits it onto the arteries. This results in the narrowing or hardening of the arteries which leads to atherosclerosis (the build-up of plaque on artery walls). (2) Triglycerides are another type of fat found in the body. It is the most common form of fat and helps the body to store excess energy from a meal. (3) A typical clinical assessment of cholesterol includes measures of total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides.
Unfortunately, it is a common misconception that high cholesterol is only a concern in middle-aged and elderly adults. A recent study by Brunner et al. (2019) analyzed data from 398,864 participants across 19 countries and found that reduced concentrations of non-HDL cholesterol were strongly associated with a decrease in risk of cardiovascular disease (4). The reduction in risk was “greater the earlier cholesterol levels were reduced,” pointing to the importance of managing cholesterol levels from an early age. (4) It is clear that early awareness and prevention are key to decreasing the risk of cardiovascular events later in life, as lifestyle choices such as diet and exercise can impact heart health throughout the lifespan.
A study by Statistics Canada found that 6% of Canadians aged 6-11, 5% of Canadians aged 12-19, and 12% of Canadians aged 20-39 had unhealthy levels of LDL cholesterol, which puts them at increased risk for cardiovascular events. (5) Since high cholesterol typically isn’t associated with any unique symptoms, cholesterol testing is crucial to manage risk for cardiovascular disease. Current Canadian guidelines recommend routine cholesterol testing for males over 40, females over 50 or post-menopause, and for individuals with risk factors such as diabetes, high blood pressure, and a family history of cardiovascular disease. If there is a personal or family history of premature heart disease or high cholesterol levels, genetic testing can be done to verify for familial hypercholesterolemia. (6) Even if you are a younger individual under the recommended age for testing, there are still steps that you can take to manage your cholesterol levels and improve your cardiovascular health.
The Heart and Stroke Foundation offers many helpful tips that can be implemented to achieve optimal heart health by lowering unhealthy cholesterol levels. These include eating a healthy diet (focused around whole and plant-based foods), cooking more meals at home, maintaining an active lifestyle with at least 150 minutes per week of exercise, and not smoking. (6) No matter what age you are, it is never too early to start learning more about your heart health and taking action to decrease your risk for cardiovascular disease.
References:
1. American Heart Association. (2020). What is Cholesterol? https://www.heart.org/en/health-topics/cholesterol/about-cholesterol
2. Castelli, W. P. (1988). Cholesterol and lipids in the risk of coronary artery disease–the framingham heart study. The Canadian Journal of Cardiology, 4 Suppl A, 5A.
3. American Heart Association. (2020). HDL (Good), LDL (Bad) Cholesterol and Triglycerides. https://www.heart.org/en/health-topics/cholesterol/hdl-good-ldl-bad-cholesterol-and-triglycerides
4. Brunner, F. J., Waldeyer, C., Ojeda, F., Salomaa, V., Kee, F., Sans, S., . . . Umeå universitet. (2019). Application of non-HDL cholesterol for population-based cardiovascular risk stratification: Results from the multinational cardiovascular risk consortium. The Lancet, 394(10215), 2173-2183. doi:10.1016/S0140-6736(19)32519-X
5. Statistics Canada. (2013, February 13). Cholesterol levels of Canadians, 2009-2001. https://www150.statcan.gc.ca/n1/pub/82-625-x/2012001/article/11732-eng.htm
6. Heart and Stroke. (n.d.). Managing Cholesterol. https://www.heartandstroke.ca/heart/risk-and-prevention/condition-risk-factors/managing-cholesterol