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Heart Disease Health Center

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The Dangers of High Cholesterol

High cholesterol is tough on arteries and your health. Here's how to fight back.

How Arteries Harden continued...

Scientists aren't sure how high cholesterol injures arteries, Gotto says, but he explains one theory: The fatty acids carried by LDL become oxidized and injure blood vessel walls. "The higher the level of LDL circulating in the blood, the more the wall gets injured." An inflammatory reaction ensues, Gotto says. "The blood vessel responds by a reaction to injury. It treats this as if you scratched your finger."

Atherosclerosis begins when white blood cells move into the lining and artery wall. They transform into foam cells, which accumulate fat and cholesterol. Other substances, such as calcium, also collect at the site. Eventually, an atherosclerotic plaque, or atheroma, forms.

These plaques thicken and harden the artery wall and bulge into the bloodstream to reduce or block blood flow. When an atheroma ruptures, it can trigger a blood clot leading to heart attack or stroke. Most commonly, atherosclerosis affects the left anterior descending coronary artery [one of the main arteries of the heart], the carotid arteries in the neck, and the abdominal aorta, Gotto says.

Lowering Your Cholesterol

While LDL is harmful, HDL, a "good" form of cholesterol, helps arteries. Besides quieting down inflammation in damaged arteries, "it blocks the oxidation of LDL," Gotto says, "and we think that HDL has the ability to pull some of the cholesterol out of the cells on the arterial wall and transport it back to the liver, where the body can get rid of it. The higher the level of HDL, the lower the risk of heart attacks and cardiovascular disease."

Know your cholesterol numbers, he adds. "It's better to talk to your doctor about atherosclerosis before you get symptoms, and unfortunately for many people, the first symptom may be the fatal one if they have sudden cardiac death or cardiac arrest."

Gotto suggests people talk to their doctor about risk factors for atherosclerosis while still in their 20s and get a blood test to check cholesterol levels. Before age 40, get a cholesterol test every three years, Gotto says, and after age 40, test annually.

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