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What Is It? Cholesterol is a fatty substance that occurs naturally in the body. It performs several vital functions. It is needed to make the walls surrounding the body's cells and is the basic material that is converted to certain hormones. Your body makes all the cholesterol you need. You need only a small amount of fat in your diet to make enough cholesterol to stay healthy. The fat and cholesterol you eat are absorbed in the intestine and transported to the liver. The liver converts fat into cholesterol, and releases cholesterol into the bloodstream. There are two main types of cholesterol: low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol) and high-density lipoprotein (HDL) cholesterol (the "good" cholesterol). High levels of LDL cholesterol are linked to atherosclerosis, which is the accumulation of cholesterol-rich fatty deposits in arteries. This can cause arteries to narrow or become blocked, slowing or stopping the flow of blood to vital organs, especially the heart and brain. Atherosclerosis affecting the heart is called coronary artery disease, and it can cause a heart attack. When atherosclerosis blocks arteries that supply blood to the brain, it can cause a stroke. High levels of HDL cholesterol actually protect against heart attacks and strokes by removing cholesterol from the arteries and bringing it back to the liver. Because high cholesterol levels can cause atherosclerosis, doctors recommend that people keep their cholesterol levels within a specific range. In general, adults older than 20 should try to keep their total cholesterol level below 200 milligrams per deciliter. For a more precise assessment of the risk of atherosclerosis, your LDL cholesterol should be checked. According to guidelines established by the government-sponsored National Cholesterol

Atherosclerosis

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Atherosclerosis

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Page 1: Atherosclerosis

What Is It?

Cholesterol is a fatty substance that occurs naturally in the body. It performs several vital functions. It is needed to make the walls surrounding the body's cells and is the basic material that is converted to certain hormones. Your body makes all the cholesterol you need. You need only a small amount of fat in your diet to make enough cholesterol to stay healthy.

The fat and cholesterol you eat are absorbed in the intestine and transported to the liver. The liver converts fat into cholesterol, and releases cholesterol into the bloodstream. There are two main types of cholesterol: low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol) and high-density lipoprotein (HDL) cholesterol (the "good" cholesterol).

High levels of LDL cholesterol are linked to atherosclerosis, which is the accumulation of cholesterol-rich fatty deposits in arteries. This can cause arteries to narrow or become blocked, slowing or stopping the flow of blood to vital organs, especially the heart and brain. Atherosclerosis affecting the heart is called coronary artery disease, and it can cause a heart attack. When atherosclerosis blocks arteries that supply blood to the brain, it can cause a stroke.

High levels of HDL cholesterol actually protect against heart attacks and strokes by removing cholesterol from the arteries and bringing it back to the liver.

Because high cholesterol levels can cause atherosclerosis, doctors recommend that people keep their cholesterol levels within a specific range. In general, adults older than 20 should try to keep their total cholesterol level below 200 milligrams per deciliter.

For a more precise assessment of the risk of atherosclerosis, your LDL cholesterol should be checked. According to guidelines established by the government-sponsored National Cholesterol Education Program, the desirable level for LDL cholesterol depends on whether or not a person already has a disease caused by atherosclerosis or diabetes or other risk factors for coronary artery disease. In addition to a high LDL cholesterol level and diabetes, risk factors for coronary artery disease include:

Being a male older than 45 Being a female older than 55 Being a female with premature menopause Having a family history of premature coronary artery disease (a father or brother younger

than 55 with coronary artery disease or a mother or sister younger than 65 with coronary artery disease)

Smoking cigarettes Having high blood pressure Not having enough good cholesterol (high density lipoprotein or HDL)

If you have coronary artery disease, peripheral arterial disease or have had a stroke from atherosclerosis, your LDL cholesterol should be 70 milligrams per deciliter or less.

Page 2: Atherosclerosis

The more risk factors you have, the lower your target LDL cholesterol should be. In general, an LDL cholesterol level of less than 100 is best, but less than 130 may be acceptable for people with few or no risk factors.

Your level of HDL cholesterol is also very important. People with levels below 40 milligrams per deciliter are more likely to develop atherosclerosis, heart disease and stroke. Levels of HDL cholesterol above 60 milligrams per deciliter are associated with less atherosclerosis and are thought to help protect against heart disease and stroke.

Symptoms

Most people with high cholesterol don't have any symptoms until cholesterol-related atherosclerosis causes significant narrowing of the arteries leading to their hearts or brains. The result can be heart-related chest pain (angina) or other symptoms of coronary artery disease, as well as symptoms of decreased blood supply to the brain (transient ischemic attacks or stroke).

About 1 out of every 500 people has an inherited disorder called familial hypercholesterolemia, which can cause extremely high cholesterol levels (above 300 milligrams per deciliter). People with this disorder can develop nodules filled with cholesterol (xanthomas) over various tendons, especially the Achilles tendons of the lower leg. Cholesterol deposits also can occur on the eyelids, where they are called xanthelasmas.

Low Density Lipoprotein

Low density lipoprotein cholesterol (LDL-C) is an important factor when assessing the risk for developing heart disease. LDL -particles, in particular those who are small and dense, are atherogenic and increase the risk of cardiovascular disease (CVD). There is a strong and graded correlation between LDL-C and the risk of CVD, both in women and men, although this has been debated by some investigators. The evidence that reducing plasma LDL cholesterol reduces CVD risk is unequivocal. According to the European Society of Cardiology, the results of epidemiological studies as well as trials with angiographic or clinical endpoints confirm that the reduction of LDL cholesterol must be of prime concern in the prevention of CVD.

Cholesterol is an organic molecule included in the sterol family. Sterols are chemical substances, generally classified as lipids, although they are chemically different from other types of dietary fat, such as triglycerides and phospholipids. Unlike triglycerides, sterols contain no fatty acids. Because of the publicity generated by its proposed role in atherosclerosis and cardiovascular disease, Cholesterol is the best known sterol, mainly because of its proposed role in atherosclerosis and cardiovascular disease.

What is Smoking?

Smoking refers to the inhalation and exhalation of fumes from burning tobacco in cigars, cigarettes and pipes. Historically, smoking as a practice, was followed by natives of the Western Hemisphere, in religious rituals and for medicinal purposes. It has a history starting from the late 1500s. We would try to answer the question as to what is smoking later in the article.

Explorers of the New World saw it fit to introduce tobacco into Europe, in-spite of the opposition from the then rulers. But the novelty and thrill factor won over many a new user. Towards the end of the

Page 3: Atherosclerosis

nineteenth century, cigarettes were higher in demand than the cigars and pipes, which had been popular amongst smokers until then.

High Blood PressureHigh blood pressure increases your chance (or risk) for getting heart disease and/or kidney disease, and for having a stroke. It is especially dangerous because it often has no warning signs or symptoms. Regardless of race, age, or gender, anyone can develop high blood pressure. It is estimated that one in every four American adults has high blood pressure. Once high blood pressure develops, it usually lasts a lifetime. You can prevent and control high blood pressure by taking action.

Diabetes mellitus (DM) also known as simply diabetes, is a group of metabolic diseases in which there are high blood sugar levels over a prolonged period.[2] This high blood sugar produces the symptoms of frequent urination, increased thirst, and increased hunger. Untreated, diabetes can cause many complications.[3] Acute complications include diabetic ketoacidosis and nonketotic hyperosmolar coma.[4] Serious long-term complications include heart disease, stroke, kidney failure, foot ulcers and damage to the eyes.[3]

Obesity

Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. A crude population measure of obesity is the body mass index (BMI), a person’s weight (in kilograms) divided by the square of his or her height (in metres). A person with a BMI of 30 or more is generally considered obese. A person with a BMI equal to or more than 25 is considered overweight.Overweight and obesity are major risk factors for a number of chronic diseases, including diabetes, cardiovascular diseases and cancer. Once considered a problem only in high income countries, overweight and obesity are now dramatically on the rise in low- and middle-income countries, particularly in urban settings.

Atherosclerosis is a potentially serious condition where arteries become clogged up by fatty substances known as plaques or atheroma.

The plaques cause affected arteries to harden and narrow, which can be dangerous as restricted blood flow can damage organs and stop them functioning properly.

If a plaque ruptures, it can cause a blood clot. This can block the blood supply to the heart, triggering a heart attack, or it can block the blood supply to the brain, triggering a stroke.

Cardiovascular disease (CVD)

Atherosclerosis is a major risk factor for many conditions involving the flow of blood.

Collectively, these conditions are known as cardiovascular disease (CVD). Examples include:

peripheral arterial disease  – where the blood supply to your legs is blocked, causing muscle pain coronary heart disease  – the coronary arteries (the main arteries that supply your heart) become

clogged with plaques stroke  – where the blood supply to your brain is interrupted

Page 4: Atherosclerosis

heart attack  – where the blood supply to your heart is blocked

What causes atherosclerosis?

Exactly how arteries become clogged is still unclear, although the following things increase your risk of atherosclerosis:

smoking a high-fat diet lack of exercise being overweight or obese having either type 1 or type 2 diabetes having high blood pressure (hypertension) having high cholesterol