Triglycerides (ePub)

Why Cholesterol Matters?

Cholesterol is a waxy, fat-like substance found in the walls of cells in all parts of the body, from the nervous system to the liver to the heart. The body uses cholesterol to make hormones, bile acids, vitamin D, and other substances.

The body makes all the cholesterol it needs. Cholesterol circulates in the bloodstream but cannot travel by itself. As with oil and water, cholesterol (which is fatty) and blood (which is watery) do not mix. So cholesterol travels in packages called lipoproteins, which have fat (lipid) inside and protein outside.

Two main kinds of lipoproteins carry cholesterol in the blood:

■ Low density lipoprotein, or LDL, which also is called the "bad" cholesterol because it carries cholesterol to tissues, including the arteries. Most of the cholesterol in the blood is the LDL form. The higher the level of LDL cholesterol in the blood, the greater your risk for heart disease.

■ High density lipoprotein, or HDL, which also is called the "good" cholesterol because it takes cholesterol from tissues to the liver, which removes it from the body. A low level of HDL cholesterol increases your risk for heart disease.

If there is too much cholesterol in the blood, some of the excess can become trapped in artery walls. Over time, this builds up and is called plaque. The plaque can narrow vessels and make them less flexible, a condition called atherosclerosis or "hardening of the arteries."

This process can happen to blood vessels anywhere in the body, including those of the heart, which are called the coronary arteries. If the coronary arteries become partly blocked by plaque, then the blood may not be able to bring enough oxygen and nutrients to the heart muscle. This can cause chest pain, or angina. Some cholesterol-rich plaques are unstable—they have a thin covering and can burst, releasing cholesterol and fat into the bloodstream. The release can cause a blood clot to form over the plaque, blocking blood flow through the artery—and causing a heart attack.

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