Cholesterol in a 70-year-old: Everything you need to know

Cholesterol is an important part of the body's function, but excessive amounts can be harmful, especially as one ages. High cholesterol is a common issue among those over 70 years old, and it can lead to serious health problems such as cardiovascular diseases. However, the good news is that lifestyle changes can significantly impact cholesterol levels and improve heart health. In this article, we will comprehensively discuss what you need to know about cholesterol in a 70-year-old, its management, and treatment options.

High cholesterol is a very common health issue among those over 70 years old. According to statistics, nearly half of Finnish people over 70 suffer from high cholesterol.As we age, the body's ability to process fats diminishes, often leading to an accumulation of LDL cholesterol (the "bad" cholesterol) in the blood. Additionally, other age-related factors, such as decreased physical activity and hormonal changes, can contribute to rising cholesterol levels.

High cholesterol is a significant risk factor for cardiovascular diseases and can lead to serious health issues, such as heart attacks and strokes. When blood LDL cholesterol levels rise, cholesterol begins to accumulate in the walls of the arteries, forming plaques. These plaques can harden and narrow the arteries, restricting blood flow to organs and tissues. This process, known as atherosclerosis, significantly increases the risk of serious cardiovascular events.

Although high cholesterol is a common issue among the aging population, it is not an inevitable part of aging. Lifestyle changes, such as a healthy diet, regular exercise, and quitting smoking, can significantly impact cholesterol levels. With the right choices, LDL cholesterol can be lowered, HDL cholesterol (the "good" cholesterol) can be raised, and overall heart health can be improved.

Cholesterol is a fatty substance that the body needs for various functions, including building cell membranes, producing hormones, and synthesizing vitamin D. Most cholesterol is produced in the liver, but it is also obtained from food.There are two main types of cholesterol: LDL cholesterol (Low-Density Lipoprotein) and HDL cholesterol (High-Density Lipoprotein).

LDL cholesterol is commonly known as the "bad" cholesterol because it can accumulate in the walls of arteries and form plaques that narrow and harden blood vessels. This increases the risk of cardiovascular diseases, particularly the risk of heart attack and stroke. High LDL cholesterol is the most common cause of atherosclerosis, which is a serious health risk, especially for older adults.

HDL cholesterol is known as the "good" cholesterol because it helps remove excess cholesterol from the walls of arteries and transports it back to the liver, where cholesterol is broken down and eliminated from the body.A high HDL cholesterol level is generally a sign of good heart health, as it reduces the risk of plaque formation in the blood vessels.

Triglycerides are another type of fat in the blood that is an important source of energy for the body. However, high triglyceride levels combined with high LDL cholesterol can increase the risk of heart disease. Triglyceride levels often rise with overweight, excessive sugar intake, and alcohol consumption.

Measuring cholesterol levels is an important part of monitoring heart health, especially in older adults.When you know your cholesterol levels, you can make informed decisions about how to manage your risk of developing cardiovascular diseases. Cholesterol measurement is typically done through a blood test that measures total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride levels.

Here are the generally accepted reference values for cholesterol:

•  Total cholesterol: Less than 5.0 mmol/l

•  LDL cholesterol: Less than 3.0 mmol/l

•  HDL cholesterol: More than 1.0 mmol/l for men and more than 1.2 mmol/l for women

•  Triglycerides: Less than 1.7 mmol/l

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Cholesterol levels above these values may indicate an increased risk of cardiovascular diseases and may require interventions such as dietary changes, increased physical activity, or medication.

Measuring cholesterol levels is particularly important for those over 70, as the body no longer processes cholesterol as effectively as it does at a younger age. Cholesterol is considered too high when LDL cholesterol rises above 3.0 mmol/l and total cholesterol exceeds 5.0 mmol/l. Such levels can be especially dangerous if you have other risk factors for cardiovascular diseases, such as high blood pressure, diabetes, or smoking.

Lifestyle changes are the primary means of managing cholesterol levels and reducing the risk of cardiovascular diseases.Although cholesterol levels can naturally increase with age, it is possible to keep them in check and promote heart health with the right lifestyle choices.

The diet is a key factor in managing cholesterol levels. By reducing the intake of saturated fats and trans fats and increasing the intake of healthy fats, such as omega-3 fatty acids, you can lower LDL cholesterol and improve HDL cholesterol.

 Good dietary choices: 

•  Whole grains: Such as oats, barley, and brown rice, which are rich in soluble fiber that helps lower LDL cholesterol.

•  Vegetables and fruits : Especially high-fiber fruits, such as apples, pears, and berries, can help lower cholesterol.

•  Fatty fish : Such as salmon, mackerel, and sardines, which contain omega-3 fatty acids that can lower triglyceride levels and raise HDL cholesterol.

•  Nuts and seeds : Such as almonds, walnuts, and chia seeds, which contain healthy fats and fiber.

  
  

 Avoidable foods: 

•  Fatty meats and full-fat dairy products : These are high in saturated fats, which can raise LDL cholesterol.

•  Processed foods and baked goods: They often contain trans fats, which are particularly harmful to heart health.

•  Coconut oil and palm oil: Although these are plant-based, they are high in saturated fats.

Regular exercise is important for maintaining heart health and managing cholesterol levels. Exercise can raise HDL cholesterol and assist in weight management, which in turn can lower LDL cholesterol and triglyceride levels.

 Exercise recommendations for 70-year-olds: 

•  Moderate-intensity exercise: Such as walking, swimming, or cycling, at least 150 minutes per week.

•  Strength training: Twice a week, which helps maintain muscle mass and balance.

•  Balance and stretching exercises: Which help improve mobility and prevent falls.

Overweight, and especially abdominal obesity, is often associated with high LDL cholesterol and low HDL cholesterol.Weight loss, even just 5-10% of initial weight, can significantly improve cholesterol levels and reduce the risk of heart disease.

Smoking lowers HDL cholesterol levels and increases the risk of developing atherosclerosis. Quitting smoking is one of the most effective ways to improve cholesterol profiles and reduce the risk of cardiovascular diseases.

Moderate alcohol consumption, especially red wine, can raise HDL cholesterol levels. However, it is important to stay within moderation, as excessive alcohol consumption can lead to weight gain and high triglyceride levels.

If lifestyle changes are not sufficient to lower cholesterol levels adequately, medication may be necessary. This is especially important if you already have a diagnosed cardiovascular disease or if you are in a high-risk group.

Statins

Statins are the most commonly used medications for treating high cholesterol. They inhibit the liver's cholesterol production and effectively lower LDL cholesterol. Statins can also slightly raise HDL cholesterol and lower triglyceride levels. They are particularly effective in reducing the risk of cardiovascular diseases.

 Possible side effects: 

•  Muscle pain and weakness: In some patients, statins may cause muscle pain or weakness.

•  Liver effects: In rare cases, statins may affect liver function, so regular blood tests are necessary.

Ezetimibe is a medication that inhibits the absorption of cholesterol in the intestines. It can be effective in combination with statins or as an alternative for patients who cannot tolerate statins.

PCSK9 inhibitors are a newer class of medications that significantly lower LDL cholesterol by inhibiting the action of the liver's PCSK9 protein, which increases the number of LDL receptors and thus removes more LDL cholesterol from the bloodstream.

Fibrates are medications that help lower triglyceride levels and can simultaneously raise HDL cholesterol. They are particularly beneficial for patients with high triglyceride levels.

Regular monitoring of cholesterol levels is important, especially for those over 70 years old. Blood tests that measure cholesterol values are an essential part of assessing and managing the risk of cardiovascular diseases.Your doctor may recommend blood tests every 6-12 months, depending on how well cholesterol levels are managed and whether you have other risk factors.

 Interpretation of blood test results: 

•  Total cholesterol: Over 5.0 mmol/l may indicate that you should consider lifestyle changes or medication.

•  LDL cholesterol: Over 3.0 mmol/l is a risk factor, and over 4.9 mmol/l can be particularly dangerous.

•  HDL cholesterol: Below 1.0 mmol/l for men and below 1.2 mmol/l for women is a sign of increased risk of heart disease.

•  Triglycerides: Over 1.7 mmol/l may be a sign that you should consider changes to your diet and lifestyle.