Complex “plaques” are deposits that can form in the walls of arteries. Cholesterol is a key component of these plaques. Over time, they can get bigger and cause narrowing of the arteries. In the heart arteries this can restrict blood supply to the heart muscle leading to angina or a heart attack.
People with narrowing in heart arteries may have absolutely no symptoms and lead a normal life. Others can get chest/jaw/arm pain especially when they exert themselves (angina) or shortness of breath. Unfortunately, in some people a clot may form and block a narrowed artery, leading to a heart attack (myocardial infarction).
However, heart disease is complex and although cholesterol is an important ingredient in the plaques discussed above, there is no way of reliably knowing when or whether someone with high cholesterol will develop problems in the future. Other factors also have a major influence on one’s risk of developing heart disease including your genetic make-up, presence of diabetes, high blood pressure, and lifestyle choices such as smoking and lack of exercise.
What is “bad” and “good” cholesterol?
The human body actually needs a small amount of cholesterol. Cholesterol forms the building blocks of important hormones and Vitamin D, which are necessary for optimal body function.
Cholesterol is transported to and from cells by two special carriers called lipoproteins; high-density lipoprotein (HDL) and low-density lipoprotein (LDL). A healthy level of HDL cholesterol may protect against heart attacks, while low levels of HDL cholesterol have been shown to increase the risk of heart disease
LDL cholesterol is labelled as the “bad” cholesterol because it contributes to the complex plaques that cause narrowing and obstruction in heart arteries. HDL cholesterol is “good” because it helps move LDL cholesterol from the arteries back to the liver, where it is broken down and then removed from the body.
How can I lower my cholesterol level?
Lifestyle changes such as exercise and dietary modification are important to reduce your risk of heart attack. In some cases, cholesterol lowering medications like statins may be helpful too.
The latest guidelines from the American Heart Association and the American College of Cardiology, recommend “considering” statin therapy if your 10-year risk score for suffering a heart attack or stroke is ≥ 7.5%. In the UK, draft guidelines published by the National Institute for Health and Care Excellence (NICE) in 2014, recommend statins in people with a 10-year risk score of 10%. A discussion with your GP or Cardiologist will determine your risk and whether statins are right for you.
I have been prescribed a Statin, should I worry about side effects?
Statins are well tolerated by the majority of patients, but as with any medicine, some people will develop side-effects such as diarrhoea, headaches, fatigue, disturbed sleep patterns. Mild muscle aches are common when you start taking a statin but serious side-effects (including severe muscle damage and liver function abnormalities) are rare. If you are concerned speak to your GP or cardiologist who may recommend reducing the dose you are taking or stopping the statin altogether. There are now alternatives (tablets and injections) to statins which may be more suitable for some people with high cholesterol.
