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Cholesterol is a soft, waxy fat particle (lipid) that circulates in the blood. It is produced in the liver and is the most general steroid in the body. Cholesterol is creating a block for cell membranes and it is essential in the formation of bile (which aids in the digestion of fats), vitamin D, and other steroids and hormones (e.g., progesterone, estrogen, testosterone).

The liver produces most of the cholesterol the body requires; however, many popular foods contain cholesterol and substances used by the liver to produce cholesterol. A high intake of such food stuff can increase the cholesterol level in the blood.

High cholesterol (hypercholesterolemia) can cause the formation and accumulation of plaque deposits in the arteries. Plaque is composed of cholesterol, other fatty substances, fibrous tissue, and calcium. When plaque is built up in the arteries, it results in atherosclerosis, or coronary heart disease (CHD). Atherosclerosis can lead to plaque rupture and blockages in the arteries, which then increase the risk for heart attack, stroke, blood circulation problems, and death.

When the innermost lining of the arteries (endothelium) is damaged, cholesterol particles deposit into the damaged wall and form plaques.

More cholesterol and other substances incorporate into the plaque and the plaque grows, thereby narrowing the artery.
Plaque deposits can grow bulky enough to interfere with blood flow through the artery (called a blockage). When the arteries supplying the heart with blood (coronary arteries) are blocked, chest pain (angina) may be experience; when arteries in the legs are blocked, leg pain or cramping may occur; when arteries supplying the brain with blood are blocked, stroke may occur.
If a plaque ruptures or tears, a blood clot may develop on top of it. If a blood clot completely blocks blood flow through a coronary artery, heart attack (myocardial infarction) occurs; if an artery supplying blood to the brain is completely blocked, stroke occurs.

Types of Cholesterol

Cholesterol is measured in milligrams per deciliter of blood (mg/dL). Several different types of blood cholesterol can be measured, and high levels of some types are worse or better than high levels of other types. Types include the following:

Total blood cholesterol
HDL (high-density lipoprotein) cholesterol ("good" cholesterol)
LDL (low-density lipoprotein) cholesterol ("bad" cholesterol)
Triglycerides ("backbone" of many types of fat)

Total blood cholesterol is the most common cholesterol measurement. It measures the concentration of fat (lipid) in the bloodstream, including cholesterol and triglyceride molecules contained in LDL, HDL, and other lipid particles.

Diagnosis (Cholesterol):

Cholesterol ratio

Total blood cholesterol is the most common measurement of blood cholesterol. Cholesterol is measured in milligrams per deciliter of blood (mg/dL). Knowing the total blood cholesterol level is an important first step in determining the risk for heart disease. However, a critical second step is to know the HDL or "good" cholesterol level.

Some physicians and cholesterol technicians use the ratio of total cholesterol to HDL cholesterol in place of the total blood cholesterol. It is recommended that the absolute numbers for total blood cholesterol and HDL cholesterol levels to be used. They're more useful to the physician than the cholesterol ratio in determining the appropriate treatment for patients.

The ratio is obtained by dividing the HDL cholesterol level into the total cholesterol. For example, if a person has total cholesterol of 200 mg/dL and an HDL cholesterol level of 50 mg/dL, the ratio would be stated as 4:1. The goal is to keep the ratio below 5:1; the optimum ratio is 3.5:1.

LDL cholesterol level

LDL cholesterol level greatly affects the risk of heart attack and stroke. The lower the level of LDL cholesterol, the lower is the risk. In fact, it’s a better gauge of risk than total blood cholesterol. The LDL cholesterol will fall into one of the following categories:

LDL Cholesterol Levels
Less than 100 mg/dL	Optimal
100 to 129 mg/dL	Near Optimal/ Above Optimal
130 to 159 mg/dL	Borderline High
160 to 189 mg/dL	High
190 mg/dL and above	Very High

The key point to remember here is that the lower LDL cholesterol level, the lower is the risk. Doctor may prescribe a diet low in saturated fat and cholesterol, regular exercise and a weight management program if one is overweight. If one can't lower the cholesterol level with these efforts, medications may also be prescribed to lower the LDL cholesterol.

HDL cholesterol level

On an average man, HDL cholesterol levels range from 40 to 50 mg/dL. In the average woman, they range from 50 to 60 mg/dL. HDL cholesterol that's less than 40 mg/dL is low. Low HDL cholesterol puts one at high risk of heart disease. Smoking, being overweight and being sedentary can all result in lower HDL cholesterol. If you have low HDL cholesterol, you can help raise it by:

Not smoking
Losing weight (or maintaining a healthy weight)
Being physically active for at least 30–60 minutes a day on most or all days of the week

People with high blood triglycerides mostly have lower HDL cholesterol and a higher risk of heart attack and stroke. Progesterone, anabolic steroids and male sex hormones (testosterone) also lower the HDL cholesterol levels. Female sex hormones raise the HDL cholesterol levels.

Treatments (Cholesterol):

Treatment for high cholesterol depends on which lipid is high. The main focus here is on management of high LDL ("bad") cholesterol levels. In some cases, LDL cholesterol can be lowered without medication (nonpharmacological therapy), and in other cases, medication (pharmacological therapy) is necessary.

Nonpharmacological Therapy

Standard nonpharmacological therapy consists primarily of modifying diet and lifestyle. This therapy may moderately reduce LDL cholesterol, but is not likely to lower the LDL cholesterol level more than about 30 mg/dL.

In patients without atherosclerosis who have moderately elevated LDL cholesterol levels, treatment with medication is not that urgent, and an initial 6–12 month trial of nonpharmacological therapy may be advised. If the LDL cholesterol falls to an acceptable level within this period, the patient can continue with this treatment only. If the level remains high, however, pharmacological therapy should be initiated.

Lifestyle changes that may lower LDL cholesterol levels include the following:

Diet. Minimize cholesterol and fat intake, especially saturated fat, which increases cholesterol levels more than any other substance. Cholesterol and saturated fats are found primarily in foods derived from animals, such as meats and dairy products. Dietary guidelines for reducing cholesterol and fat consumption:

Eat lean fish, poultry, and meat. Remove the skin from chicken and trim the fat from beef before cooking
Avoid commercially prepared and processed food (e.g., cakes, cookies) and breaded fried foods
Increase the intake of fruits, vegetables, breads, cereals, rice, legumes (e.g., beans, peas), and pasta
Use skim or 1% milk
Eat no more than 2 egg yolks (or whole eggs) per week
Use cooking oils that are high in unsaturated fat (e.g., corn, olive, canola, safflower oils)
Use soft margarine, which contains less saturated fat than butter

Weight loss. Losing a modest amount of weight (even 5-10 lbs.) can double the reduction in LDL levels achieved through an improved diet. Weight loss should be gradual and slow as to avoid any side effects.
Exercise. Exercise can decrease LDL levels and increase HDL levels. For example, taking a brisk 30-minute walk 3-4 times a week can positively impact cholesterol levels. Patients with chest pain and/or known or suspected heart disease should talk to their physician before starting any exercise program.

Although we have attempted to provide you with the causes, diagnosis, remedies and treatments for the above mentioned diseases we suggest you to consult your personal physician by providing your history for getting information for any of these diseases.