Modern high pressure lifestyles often result in stress with its concomitant health problems like cardiovascular diseases associated with high blood cholesterol levels. Cholesterol is a lipid, or fat, needed for building cell membranes. It comes either from diet or is otherwise manufactured by the body (endogenous cholesterol). The lipid is combined with certain proteins by the liver to make lipoproteins which carry the lipid through the bloodstream, to the cells. There are two types of lipoproteins. One is low density lipoprotein (LDL) and the other is high density lipoprotein (HDL). While cholesterol is essential for the cells and for making certain hormones, too high a concentration in the blood is a major risk for coronary heart disease.

Cholesterol in the blood comes preponderantly from LDL while a small portion is from HDL. The risk of coronary disease from cholesterol comes chiefly from the so called ?bad? LDL cholesterol. If the level of LDL is too high, deposition of fat (lipid), as plaque, occurs on the artery walls, narrowing them. This often leads to high blood pressure, heart attacks and strokes. Hence a low level of LDL is desirable. The HDL cholesterol is thought to scour the artery walls of deposited plaque, and is therefore called ?good?. Hence the higher the level of HDL, the better it is.

To stay healthy, the aim should be to reduce the LDL cholesterol level; increase the HDL level; and maintain the total cholesterol level within normal limits i.e. desirable levels which correspond to lower risk of heart diseases. As per the American Heart Association (AHA), less than 200 mg/dL (milligram per deciliter) i.e. < 200 mg/dL, corresponding to < 5.2 mmol/Lt (millimole per liter) of total cholesterol is the desirable (low heart disease risk) level; 200 to 239 mg/dL (5.2-6.2 mmol/Lt) is a borderline high risk level; and greater than 240 mg/dL (> 6.2 mmol/Lt) is the high risk category. Considering that LDL and HDL cholesterols are determined separately, the desired upper limit for the ?bad? LDL cholesterol is considered to be 100mg/dL (2.6 mmol/Lt). In the case of the ?good? HDL, >60 mg/dL is considered the best.

There are a number of medicines available to reduce cholesterol levels, including the ?statin? group of drugs. However, the first option, before use of drugs, should be the non-prescription route of diet, physical exercise and weight loss ? a tried and tested method when other reasons for high cholesterol level, like previous history of artery disease, do not exist.