Cholesterol
To understand high blood cholesterol (ko-LES-ter-ol), it is important to know more about cholesterol.
- Cholesterol is a waxy, fat-like substance that is found in all cells of the body. Your body needs some cholesterol to work the right way. Your body makes all the cholesterol it needs.
- Cholesterol is also found in some of the foods you eat.
- Your body uses cholesterol to make hormones, vitamin D, and substances that help you digest foods.
Blood is watery, and cholesterol is fatty. Just like oil and water, the two do not mix. To travel in the bloodstream, cholesterol is carried in small packages called lipoproteins (lip-o-PRO-teens). The small packages are made of fat (lipid) on the inside and proteins on the outside. Two kinds of lipoproteins carry cholesterol throughout your body. It is important to have healthy levels of both:
- Low-density lipoprotein (LDL) cholesterol is sometimes called bad cholesterol.
- High LDL cholesterol leads to a buildup of cholesterol in arteries. The higher the LDL level in your blood, the greater chance you have of getting heart disease.
- High-density lipoprotein (HDL) cholesterol is sometimes called good cholesterol.
- HDL carries cholesterol from other parts of your body back to your liver. The liver removes the cholesterol from your body. The higher your HDL cholesterol level, the lower your chance of getting heart disease.
What Is High Blood Cholesterol?
Too much cholesterol in the blood, or high blood cholesterol, can be serious. People with high blood cholesterol have a greater chance of getting heart disease. High blood cholesterol on its own does not cause symptoms, so many people are unaware that their cholesterol level is too high.
Cholesterol can build up in the walls of your arteries (blood vessels that carry blood from the heart to other parts of the body). This buildup of cholesterol is called plaque (plak). Over time, plaque can cause narrowing of the arteries. This is called atherosclerosis (ath-er-o-skler-O-sis), or hardening of the arteries.
Special arteries, called coronary arteries, bring blood to the heart. Narrowing of your coronary arteries due to plaque can stop or slow down the flow of blood to your heart. When the arteries narrow, the amount of oxygen-rich blood is decreased. This is called coronary heart disease (CHD). Large plaque areas can lead to chest pain called angina (an-JI-nuh or AN-juh-nuh). Angina happens when the heart does not receive enough oxygen-rich blood. Angina is a common symptom of CHD.
Some plaques have a thin covering and can burst (rupture), releasing cholesterol and fat into the bloodstream. The release of cholesterol and fat may cause your blood to clot. A clot can block the flow of blood. This blockage can cause angina or a heart attack.
Lowering your cholesterol level decreases your chance for having a plaque burst and cause a heart attack. Lowering cholesterol may also slow down, reduce, or even stop plaque from building up.
Plaque and resulting health problems can also occur in arteries elsewhere in the body.
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Diabetes
Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.
There are 23.6 million children and adults in the United States, or 7.8% of the population, who have diabetes. While an estimated 17.9 million have been diagnosed with diabetes, unfortunately, 5.7 million people (or nearly one quarter) are unaware that they have the disease.
In order to determine whether or not a patient has pre-diabetes or diabetes, health care providers conduct a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). Either test can be used to diagnose pre-diabetes or diabetes. The American Diabetes Association recommends the FPG because it is easier, faster, and less expensive to perform.
With the FPG test, a fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes. A person with a fasting blood glucose level of 126 mg/dl or higher has diabetes.
In the OGTT test, a person's blood glucose level is measured after a fast and two hours after drinking a glucose-rich beverage. If the two-hour blood glucose level is between 140 and 199 mg/dl, the person tested has pre-diabetes. If the two-hour blood glucose level is at 200 mg/dl or higher, the person tested has diabetes.
Major Types of Diabetes
Type 1 Diabetes
Results from the body's failure to produce insulin, the hormone that "unlocks" the cells of the body, allowing glucose to enter and fuel them. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes.
Type 2 diabetes
Results from insulin resistance (a condition in which the body fails to properly use insulin), combined with relative insulin deficiency. Most Americans who are diagnosed with diabetes have type 2 diabetes.
Gestational diabetes
Immediately after pregnancy, 5% to 10% of women with gestational diabetes are found to have diabetes, usually, type 2.
Pre-diabetes
Pre-diabetes is a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. There are 57 million Americans who have pre-diabetes, in addition to the 23.6 million with diabetes.
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High Blood Pressure
High blood pressure (HBP) is a serious condition that can lead to coronary heart disease, heart failure, stroke, kidney failure, and other health problems.
“Blood pressure” is the force of blood pushing against the walls of the arteries as the heart pumps out blood. If this pressure rises and stays high over time, it can damage the body in many ways.
Overview
About 1 in 3 adults in the United States has HBP. HBP itself usually has no symptoms. You can have it for years without knowing it. During this time, though, it can damage the heart, blood vessels, kidneys, and other parts of your body.
This is why knowing your blood pressure numbers is important, even when you’re feeling fine. If your blood pressure is normal, you can work with your health care team to keep it that way. If your blood pressure is too high, you need treatment to prevent damage to your body’s organs.
Blood Pressure Numbers
Blood pressure numbers include systolic (sis-TOL-ik) and diastolic (di-a-STOL-ik) pressures. Systolic blood pressure is the pressure when the heart beats while pumping blood. Diastolic blood pressure is the pressure when the heart is at rest between beats.
You will most often see blood pressure numbers written with the systolic number above or before the diastolic, such as 120/80 mmHg. (The mmHg is millimeters of mercury—the units used to measure blood pressure.)
The table below shows normal numbers for adults. It also shows which numbers put you at greater risk for health problems. Blood pressure tends to goes up and down, even in people who have normal blood pressure. If your numbers stay above normal most of the time, you’re at risk.
Categories for Blood Pressure Levels in Adults (in mmHg, or millimeters of mercury)
Category
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Systolic (top number)
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Diastolic (bottom number)
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Normal
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Less than 120
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And
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Less than 80
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Prehypertension
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120 - 139
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Or
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80 - 89
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High Blood Pressure
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Stage 1
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140 - 159
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Or
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90 - 99
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Stage 2
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160 or higher
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Or
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100 or higher
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The ranges in the table apply to most adults (aged 18 and older) who don’t have short-term serious illnesses.
All levels above 120/80 mmHg raise your risk, and the risk grows as blood pressure levels rise. “Prehypertension” means you’re likely to end up with HBP, unless you take steps to prevent it.
If you’re being treated for HBP and have repeat readings in the normal range, your blood pressure is under control. However, you still have the condition. You should see your doctor and stay on treatment to keep you blood pressure under control.
Your systolic and diastolic numbers may not be in the same blood pressure category. In this case, the more severe category is the one you're in. For example, if your systolic number is 160 and your diastolic number is 80, you have stage 2 HBP. If your systolic number is 120 and your diastolic number is 95, you have stage 1 HBP.
If you have diabetes or chronic kidney disease, HBP is defined as 130/80 mmHg or higher. HBP numbers also differ for children and teens.
Outlook
Blood pressure tends to rise with age. Following a healthy lifestyle helps some people delay or prevent this rise in blood pressure.
People who have HBP can take steps to control it and reduce their risks for related health problems. Key steps include following a healthy lifestyle, having ongoing medical care, and following the treatment plan that your doctor prescribes.
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Overweight and Obesity
Staying at a healthy weight and preventing overweight and obesity can be achieved through living a healthy lifestyle. Because lifetime habits begin in childhood, it’s important for parents and families to create habits that encourage healthy food choices and physical activity early in life.
- Follow a healthy eating plan. Make healthful food choices, keep your and your family’s calorie needs in mind, and focus on the balance of energy IN and energy OUT.
- Focus on portion size. Watch the size of portions in fast food and other restaurants. The portions served are often enough for two or three people. Children’s portion sizes should be smaller than those for adults. Cutting back on portion size is a sure way to help keep energy IN and energy OUT in balance.
- Be active. Make personal and family time active. Find activities that everyone will enjoy. For example, go for a brisk walk, bike or rollerblade, or train together for a walk or run.
- Reduce screen time. Limit the use of TVs, computers, DVDs, and video games, because they crowd out time for physical activity. Health experts recommend 2 hours or less a day of screen time that’s not work- or homework-related.
- Keep track of weight and other measurements. Monitor your weight, body mass index, and waist circumference on a regular basis. Also, keep track of your children’s growth.
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Hypotension
Hypotension (HI-po-TEN-shun) is low blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood.
Blood pressure is measured as systolic (sis-TOL-ik) and diastolic (di-a-STOL-ik) pressures. Systolic blood pressure is the pressure when the heart beats while pumping blood. Diastolic blood pressure is the pressure when the heart is at rest between beats.
You will most often see blood pressure numbers written with the systolic number above or before the diastolic, such as 120/80 mmHg. (The mmHg is millimeters of mercury-the units used to measure blood pressure.)
Normal blood pressure in adults is lower than 120/80 mmHg. Hypotension is blood pressure that's lower than 90/60 mmHg.
Overview
Blood pressure changes during the day. It lowers as you sleep and rises when you wake up. It also can rise when you're excited, nervous, or active. Your body is very sensitive to changes in blood pressure. Special cells in the arteries can sense if your blood pressure begins to rise or fall. When this happens, the cells trigger your body to try to bring blood pressure back to normal. For example, if you stand up quickly, your blood pressure may drop. The cells will sense the drop and will quickly take action to make sure that blood continues to flow to your brain, kidneys, and other important organs. Most forms of hypotension happen because your body can't bring blood pressure back to normal or can't do it fast enough. Some people have low blood pressure all of the time. They have no signs or symptoms, and their low blood pressure is normal for them. In other people, certain conditions or factors cause blood pressure to drop below normal. Hypotension is a medical concern only if it causes signs or symptoms, such as dizziness, fainting, or, in extreme cases, shock.
Outlook
In a healthy person, low blood pressure without signs or symptoms usually isn't a problem and needs no treatment. If low blood pressure causes signs or symptoms, your doctor will try to find and treat the underlying condition that's causing it.
Hypotension can be dangerous. It can make a person fall because of dizziness or fainting. Shock, a severe form of hypotension, is a condition that's often fatal if not treated right away. With prompt and proper treatment, shock can be successfully treated.
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