Cholesterol is a soft, waxy substance found in the bloodstream and cells. The body makes all of the cholesterol it needs; it is not inherently harmful, but too much is. Cholesterol comes from two sources - the liver and foods from animals (meat, poultry, dairy products). Animal proteins are high in saturated and trans fats which cause the liver to produce more cholesterol than it would normally. This can create an unhealthy cholesterol level. Low-density lipoprotein, or LDL, is what is commonly called “bad” cholesterol. It can join with fats and other substances to build up in the inner walls of the arteries. The arteries can become narrowed and clogged, restricting blood flow. This is called atherosclerosis, and if a blood clot forms and blocks one of these narrowed arteries, a heart attack or stroke can occur. High-density lipoprotein, or HDL, is what is commonly referred to as “good” cholesterol. It carries the harmful cholesterol away from the arteries and helps to reduce risk of heart attack and stroke.
High cholesterol is one of the major controllable risk factors for coronary artery disease, heart attack and stroke. If one smokes or has high blood pressure or diabetes, the risk is magnified. Atherosclerotic plaques can develop in the arteries of the heart, brain, pelvis, legs, arms or kidneys, and can lead to conditions such as coronary artery disease, angina, carotid artery disease, peripheral artery disease and chronic kidney disease. Plaques independently pose a risk, but it a piece of plaque breaks free from the artery wall, it can be carried to carried by the bloodstream to another part of the body until it lodges somewhere else in the cardiovascular system causing a new plaque. This can cause narrowing of the wall of the artery leading to blood clot development. This can occlude blood flow altogether. If the occlusion is in an artery that supplies the brain or heart of oxygen, a heart attack or stroke occurs. If the blockage is in an artery that supplies the extremities, often the legs, gangrene, or tissue death can occur.
Atherosclerosis is a slow, and lifelong progression of changes to the blood vessels that can begin in childhood and get worse as you age. Studies have shown that plaque begins when an arteries inner lining, the endothelium, becomes damaged by elevated cholesterol and triglycerides in the blood, high blood pressure, smoking of tobacco, and diabetes. Smoke plays a significant role in the progression of atherosclerosis in the aorta, coronary arteries and peripheral arteries (arteries in the legs). Smoking makes plaques more likely to form and accelerates the growth of plaque, leading to a much higher risk of abdominal aortic aneurysm.
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