High Cholesterol in Singapore

Some people inherit genes that cause them to have high levels of cholesterol. Familial hypercholesterolaemia is a genetic disorder that prevents the body from removing LDL cholesterol efficiently.

A diet rich in saturated fats, trans fats, and cholesterol can raise blood cholesterol levels. These include full-fat dairy products, red meat, and processed foods.

Lack of physical activity can lower HDL (good) cholesterol levels and contribute to weight gain, which increases LDL cholesterol.

Excess body weight increases LDL cholesterol levels while lowering HDL cholesterol. A body mass index (BMI) over 30 increases the risk of developing high cholesterol.

Cigarette smoking damages blood vessel walls, making them more susceptible to fatty deposits. It also reduces HDL cholesterol levels.

Cholesterol levels tend to rise with age. Before menopause, women generally have lower total cholesterol levels than men of the same age; however, after menopause, women often experience an increase in LDL cholesterol levels.

Certain health conditions, including diabetes, hypothyroidism, liver disease, and kidney disease, can affect cholesterol levels in the blood.

Some medications, including certain birth control pills, diuretics, beta-blockers, and steroids, can impact cholesterol levels.

• Heart-Healthy Diet: Reducing saturated fats, trans fats, and dietary cholesterol while increasing fibre-rich foods like fruits, vegetables, whole grains, and legumes helps lower LDL (bad) cholesterol and improve overall heart health. Replacing unhealthy fats with healthy fats from sources like nuts, seeds, and oily fish can further support cholesterol balance.
• Regular Physical Activity: At least 150 minutes of moderate-intensity exercise per week (brisk walking, swimming, or cycling) helps improve cholesterol balance. Strength training further supports metabolism and cardiovascular health.
• Weight Management: Losing excess weight and maintaining a healthy body mass index (BMI) can significantly lower LDL cholesterol and triglycerides. Even a 5-10% reduction in body weight can lead to noticeable improvements in cholesterol levels and heart health.
• Smoking Cessation: Quitting smoking not only improves HDL (good) cholesterol but also enhances blood circulation and reduces the risk of plaque buildup in arteries. Over time, the cardiovascular benefits continue to increase, reducing the risk of heart attacks and strokes.
• Alcohol Moderation: Excessive alcohol intake can elevate triglyceride levels, contributing to cholesterol imbalances and increasing the risk of heart disease. Keeping alcohol consumption within recommended limits can help maintain healthy cholesterol levels.

• Statins: These medications reduce LDL cholesterol by blocking cholesterol production in the liver. Common statins include atorvastatin, simvastatin, and rosuvastatin, usually taken once daily. They also provide a modest increase in HDL cholesterol.
• Cholesterol Absorption Inhibitors: Medications like ezetimibe lower LDL cholesterol by reducing absorption in the intestines. They can be used alone or combined with statins for better cholesterol control, especially for those who cannot tolerate statins.
• PCSK9 Inhibitors: These injectable medications improve the liver’s ability to clear LDL cholesterol, lowering levels. They are typically used for familial hypercholesterolaemia or for patients who do not achieve their target levels with statins alone.
• Bile Acid Sequestrants: These drugs bind to bile acids in the intestines, prompting the liver to use more cholesterol to produce bile, thereby lowering LDL cholesterol. They may cause gastrointestinal side effects such as bloating and constipation.
• Fibrates: Primarily used to lower triglycerides and moderately increase HDL cholesterol. They help clear triglycerides from the blood and are especially beneficial for individuals with high triglyceride levels and low HDL cholesterol.
• Omega-3 Fatty Acid Supplements: Prescription-strength omega-3s reduce triglycerides by decreasing their production in the liver and improving their clearance from the blood. They are often used alongside other lipid-lowering treatments.