Cholesterol is a waxy, fat-like substance that naturally occurs in all cells of your body and is essential for producing hormones, vitamin D, and substances that help digest foods. While your liver produces all the cholesterol your body needs, additional cholesterol enters your system through certain foods, particularly those from animal sources. Understanding cholesterol levels is crucial for maintaining optimal health, especially given that cardiovascular disease remains one of the leading health concerns for Canadians.
Cholesterol travels through your bloodstream in packages called lipoproteins, which consist of fat on the inside and protein on the outside. The two main types are Low-Density Lipoprotein (LDL) and High-Density Lipoprotein (HDL). LDL cholesterol, often referred to as "bad" cholesterol, can build up in the walls of your arteries, making them hard and narrow. HDL cholesterol, known as "good" cholesterol, carries cholesterol from other parts of your body back to your liver, which removes it from your body.
According to Health Canada and the Canadian Cardiovascular Society, optimal total cholesterol levels should be less than 5.2 mmol/L, with LDL cholesterol below 3.5 mmol/L and HDL cholesterol above 1.0 mmol/L for men and 1.3 mmol/L for women. Risk factors for high cholesterol among Canadians include:
Elevated cholesterol levels can lead to atherosclerosis, increasing the risk of heart attack, stroke, and peripheral artery disease. Adults should have their cholesterol checked every five years starting at age 20, or more frequently if risk factors are present. Early detection and management are essential for preventing serious cardiovascular complications.
Canada offers a comprehensive range of prescription medications to effectively manage elevated cholesterol levels. These medications work through different mechanisms to reduce cholesterol production, enhance cholesterol removal, or prevent cholesterol absorption, providing healthcare providers with multiple treatment options tailored to individual patient needs.
Statins remain the most commonly prescribed cholesterol-lowering medications in Canada, working by blocking an enzyme your liver needs to make cholesterol. Popular statins available include Atorvastatin (Lipitor), Rosuvastatin (Crestor), and Simvastatin (Zocor). These medications are highly effective at reducing LDL cholesterol by 25-55% and have proven cardiovascular benefits backed by extensive clinical research.
For patients who cannot achieve target cholesterol levels with statins alone or cannot tolerate them, several alternative medications are available through Health Canada approval:
Combination medications that include Ezetimibe with statins are also available, offering enhanced cholesterol reduction in a single tablet. These advanced therapies provide additional options for achieving optimal cholesterol management when lifestyle modifications and standard treatments are insufficient, ensuring comprehensive care for Canadian patients with varying cholesterol management needs.
Canadian pharmacies offer a variety of natural health products that may help support healthy cholesterol levels. These over-the-counter options can be valuable additions to a comprehensive cholesterol management plan, though they should be used under professional guidance.
Plant sterols and stanols are naturally occurring compounds that can help block cholesterol absorption in the digestive system. Health Canada has approved health claims for these products, recognizing their ability to help reduce LDL (bad) cholesterol when consumed as part of a healthy diet.
Red yeast rice products contain naturally occurring compounds that may help maintain healthy cholesterol levels. Omega-3 fatty acid supplements, particularly those containing EPA and DHA, can support cardiovascular health and may help improve cholesterol profiles. Fiber supplements, including psyllium husk and beta-glucan, work by binding to cholesterol in the digestive tract.
When selecting over-the-counter cholesterol management products, consider the following factors:
Always inform your healthcare provider about any natural health products you're taking, as some may interact with prescription cholesterol medications or affect blood clotting.
Lifestyle modifications remain the cornerstone of effective cholesterol management and cardiovascular health. These evidence-based approaches can significantly impact cholesterol levels and overall heart health when implemented consistently.
Canada's Food Guide emphasizes eating plenty of vegetables and fruits, choosing whole grain foods, and including protein foods regularly. For cholesterol management, focus on foods high in soluble fiber, such as oats, beans, and apples. Limit saturated and trans fats while incorporating healthy fats from sources like avocados, nuts, and olive oil.
The Canadian Society for Exercise Physiology recommends at least 150 minutes of moderate-intensity aerobic activity weekly for adults. Regular physical activity can help raise HDL (good) cholesterol while lowering LDL (bad) cholesterol and triglycerides. Activities like brisk walking, cycling, swimming, and strength training all contribute to improved cholesterol profiles.
Effective cholesterol management involves multiple lifestyle factors:
Regular monitoring and professional guidance are essential for successful cholesterol management. Work with your family physician, pharmacist, and potentially a registered dietitian to develop a personalized plan. Regular lipid panel testing helps track progress and adjust strategies as needed.
Regular cholesterol monitoring is essential for effective treatment management. Your healthcare provider will typically order a lipid panel that measures total cholesterol, LDL (bad cholesterol), HDL (good cholesterol), and triglycerides. In Canada, target levels generally include total cholesterol below 5.2 mmol/L, LDL below 3.5 mmol/L for most adults, and HDL above 1.0 mmol/L for men and 1.3 mmol/L for women.
Most patients require cholesterol testing every 6-12 weeks when starting new medications, then every 3-6 months once stable. Common side effects of cholesterol medications may include muscle pain, digestive issues, or elevated liver enzymes. Contact your healthcare provider immediately if you experience unexplained muscle pain, weakness, or dark-coloured urine.
Medication adherence tips include:
Track your progress by keeping a medication diary and noting any side effects. Many provincial health plans cover cholesterol medications, and your pharmacist can help navigate coverage options and generic alternatives to reduce costs.
Pregnant and breastfeeding women typically discontinue statin medications due to safety concerns, focusing instead on dietary management. Children and adolescents may require cholesterol screening if they have family history of early heart disease or other risk factors. Seniors often need adjusted dosing due to increased sensitivity to medications and potential drug interactions with other treatments.
Always inform your healthcare providers about all medications, supplements, and herbal products you're taking. Some cholesterol medications interact with blood thinners, certain antibiotics, and grapefruit juice. Never stop cholesterol medications abruptly without consulting your healthcare provider.
Heart and Stroke Foundation of Canada provides excellent educational resources and support programs. Seek immediate medical attention for chest pain, shortness of breath, or signs of stroke. Your local pharmacist offers valuable consultation services, including medication reviews, blood pressure monitoring, and guidance on managing side effects. Many pharmacies across Canada provide specialized cardiovascular health programs to support your treatment journey.
