Zahid Ahmad, M.D. Answers Questions On: Cholesterol

Cholesterol is not fat, per se. The body uses cholesterol to make hormones, as part of cell membranes, and to produce bile acids in the liver. Cholesterol also can deposit in the arteries, clog them up, and lead to cardiovascular events such as heart attacks and stroke.

HDL (“good”) and LDL (“bad”) cholesterol are, respectively, high- and low-density lipoproteins. 

Triglycerides are fat molecules that are transported in the blood to be used as energy or stored as fat.

Extremely elevated triglyceride levels can cause pancreatitis, a dangerous and painful condition in which the pancreas gets inflamed.

Fortunately, these conditions are preventable. It simply requires that people get their cholesterol and triglyceride levels checked regularly so that we can manage elevated levels as soon as possible.

A tendency toward high cholesterol levels almost always runs in the family.

This is why it’s important for patients diagnosed with high cholesterol to encourage their relatives to get their cholesterol levels checked. People with high cholesterol can be thin and fit, so you can’t simply look at somebody and tell that there’s a problem. 

In cases of extremely high cholesterol levels, a genetic disease called familial hypercholesterolemia may be to blame. The condition, which affects approximately one in 500 people, can cause LDL cholesterol levels to reach as high as 1,000.

Identifying patients with familial hypercholesterolemia – as well as their family members – helps us treat the condition earlier in people’s lives in an effort to prevent them from developing cardiovascular disease later.

UT Southwestern is one of only 30 to 40 U.S. centers that offers LDL apheresis, a procedure we use to treat patients with extreme elevations in cholesterol levels and no other treatment options.

Most patients who undergo LDL apheresis have familial hypercholesterolemia.

LDL apheresis is similar to dialysis treatment. We remove the blood from patients’ bodies, take out a lot of the LDL cholesterol in the blood – about 50 to 70 percent – and return the blood to the body.

Unfortunately, these people’s cholesterol levels tend to jump back up a week or two after the procedure, so those who need apheresis have to keep getting it.