Cholesterol: Why you should know your blood lipid levels

Elevated blood lipid levels increase the risk of arteriosclerosis and thus the risk of life-threatening cardiovascular disease such as heart attack or Stroke to suffer. cholesterol plays a major role. But there is good and bad cholesterol.

Cholesterol itself is not the devil's work, but is vital for our body, as it plays a key role in the structure of the cell membrane and in many metabolic processes in the brain. It is also a starting material for the production of bile acids for fat digestion and for the formation of vitamin D and hormones (e.g. estrogen, testosterone, cortisol).

The human body produces around three quarters of its cholesterol in the liver. Cholesterol also leaves the body from there: around 500 mg per day are transported to the intestines via the bile ducts in the form of bile acids. We only absorb a quarter of the total cholesterol through food.

Nevertheless, a healthy lifestyle is a prerequisite for healthy lipid levels in the blood. “Blood lipids are similar to Hypertension or Diabetes: As long as you feel healthy, you pay less attention to your lifestyle. And if you no longer feel healthy, you tend to blame other factors such as aging,” says Dr. Reinhold Lunow, medical director of the practice clinic Bornheim between Cologne and Bonn. Based on his many years of experience as an internist, he advises: "Get a complete health check regularly, or at least a blood and vascular check, in order to avoid the creeping danger of arteriosclerosis and its life-threatening secondary diseases."

If the cholesterol level in the blood is too high (hypercholesterolemia), arteriosclerosis can occur over time: the cholesterol builds up in the walls of the blood vessels, thickens them, and plaques form. The vessels lose elasticity and narrow, and circulatory problems arise.

The consequences are dramatic: peripheral arterial occlusive disease (PAD), a blockage of arteries in the arms and legs that are far from the heart, which leads to severe pain when walking. If a blood clot (thrombus) breaks off from the vessel wall, it can be carried to the heart with the bloodstream and block a coronary artery. The blood supply and thus the functionality of the heart muscle is restricted. A coronary heart disease (CHD) with chest pain (angina pectoris), heart failure (heart failure) or even a Heart attackIf a thrombus disrupts the oxygen supply to the brain, it leads to Stroke.

The Interaction of Good and Bad Cholesterol

As a fat-like substance, cholesterol combines with water-soluble proteins to be transported in the blood and reach where it is needed in the body. This creates lipoproteins with different densities: low-density (LDL) and high-density (HDL) lipoproteins. Because of its high lipid content and thus its low density, LDL is considered "bad" cholesterol, while HDL is considered "good" cholesterol because of its lower lipid content and higher density.

In order to assess blood fats, you have to look at the ratio of HDL to LDL. The "good" cholesterol HDL works as an antagonist to LDL: it collects the cholesterol deposited on the blood vessel walls and transports it back to the liver. There it is repackaged into lipoproteins or converted into other substances (e.g. bile acids) that are released into the intestine.

"A high HDL level means that the vessels are well cleaned of deposits. HDL therefore reduces the risk of cardiovascular disease and can also regulate elevated LDL levels to a certain extent. The more other risk factors for cardiovascular disease there are, the lower the LDL cholesterol levels should be," says Dr. Lunow.

When measuring the Cholesterinspiegels Three values ​​are therefore determined: total cholesterol, LDL cholesterol and HDL cholesterol. The average guideline value for a healthy person is a total cholesterol of less than 200 mg/dl (milligrams per deciliter). The LDL value should be less than 160 mg/dl and the HDL value at least 40 mg/dl.

If cholesterol levels are too low, this may indicate liver damage, hyperfunction of the thyroid (Hyperthyroidism) or malnutrition. Raised cholesterol levels are inherited in about 30 percent of cases (primary or familial hypercholesterolemia). In 70 percent of cases they result from incorrect and fatty Nutrition: with too many saturated fatty acids and trans fatty acids, too few polyunsaturated fatty acids, omega-3 fatty acids and fiber. Also Diseases can confuse the values, such as an underactive thyroid (Hypothyroidism), a kidney disease (nephrotic syndrome), a diabetes or excessive alcohol consumption.

cholesterol and triglycerides

Triglycerides should be determined along with cholesterol levels. These blood fats also perform important functions in the body: They are stored as energy reserves in fatty tissue and make up around 10 percent of body weight. Triglycerides insulate the body against cold and protect the organs from pressure.

For healthy people, a triglyceride level of less than 150 mg/dl is considered normal. Too many triglycerides increase the risk of heart and vascular diseases, as they also contribute to the development of arteriosclerosis. An increased triglyceride level is particularly dangerous in conjunction with a low HDL level.

Although we only absorb part of our cholesterol through food, diet has a major influence on cholesterol levels. "It's not just about a low-cholesterol diet with little animal fat, but also a balanced diet with the 'right' fats, the unsaturated fatty acids," explains Dr. Lunow. "That's why sea fish and vegetable oils are just as important to a healthy, balanced diet as fiber, fruit and vegetables." If you lower your triglyceride levels by avoiding alcohol and sugary foods, for example, your total cholesterol will also be reduced and the ratio of HDL to LDL will improve.

Regular exercise also has a positive effect. Endurance sports such as jogging, Nordic walking, hiking, cycling and swimming reduce triglycerides and LDL and increase HDL. Even moderate 30-minute exercise three days a week protects the heart and blood vessels.

That physical activity also Stress is broken down, also has a positive effect on cholesterol metabolism. Relaxation techniques such as autogenic training, yoga or breathing exercises are also helpful, as are regular breaks from everyday stress.

Have your cholesterol checked regularly

Only those who know their blood lipid levels can take timely countermeasures to prevent risks to the heart and circulation. “Younger people should also know how high their cholesterol is,” advises Dr. Lunow. “In our practice clinic In addition to HDL and LDL cholesterol, we also determine triglyceride levels as standard. Since elevated cholesterol levels affect each person differently, responsible prevention also the measurement of blood sugar, liver and kidney values.”

Depending on the individual situation, further diagnostics may be indicated, for example to detect incipient arteriosclerosis in carotid artery or leg vessels (color Doppler sonography) or circulatory disorders of the heart (Echocardiography).

Based on such examinations, suitable preventive measures can be initiated quickly. "If lifestyle changes and treatment of any underlying disease do not lead to a lasting improvement in cholesterol levels, you should resort to cholesterol-lowering medication, such as statins," recommends Dr. Lunow. "In any case, we will advise you on which health check and which measures are best for you."
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