Hypercholesterolemia

Hypercholesterolemia

    What is Hypercholesterolemia?

    Hypercholesterolemia refers to the high level of cholesterol in the blood. Cholesterol is a waxy substance produced by the liver and is a component of all cells found in the body. Hypercholesterolemia is more commonly, but not exclusively, defined as elevated levels of low-density lipoprotein cholesterol (LDL-C) or low-density lipoprotein cholesterol (HDL-C); the alternative term is dyslipidemia, which includes elevated triglycerides, low HDL-C levels, and qualitative lipid abnormalities.

    Hypercholesterolemia is an important risk factor for atherosclerotic cardiovascular disease, including cerebrovascular disease, coronary artery disease, and peripheral artery disease; it is usually symptomatically quiet until significant atherosclerosis has occurred.

    What causes Hypercholesterolemia?

    Excessive cholesterol present in the blood forms fatty deposits in the walls of the coronary arteries, the blood vessels that supply the heart with blood. As cholesterol accumulates, atherosclerotic plaques form, which narrows and hardens the walls of the artery. It is referred to as atherosclerosis. Eventually, these plaques may block the arteries and limit the amount of oxygen-rich blood that can reach the heart. If the artery that supplies blood flow to the brain (carotid artery) is narrowed and hardened, there is an increased risk of stroke.

    Family hypercholesterolemia is the most common of these conditions. Although high cholesterol levels can be inherited, they are usually the result of a diet high in saturated fat and a low level of physical activity. Healthy lifestyle choices, such as regular exercise and low-fat diets, can therefore often prevent this. If diet and exercise do not lower cholesterol levels, it may be recommended to reduce cholesterol.

    Cholesterol circulates in the blood bound to transport proteins, a combination referred to as lipoproteins. These lipoproteins are classified according to the type of cholesterol they carry. Low-density lipoprotein helps in carrying cholesterol from the liver to different parts of the body. If there is an excess of LDL, cholesterol may accumulate in the walls of the arteries and lead to atherosclerosis.

    High-density lipoprotein helps in carrying excess cholesterol from the cells to the liver, where it is broken down and treated as a waste product.

    Symptoms of Hypercholesterolemia

    Most common symptoms of hypercholesterolemia are:
    • Chest pain
    • Small bumps on the skin
    • Xanthomas (it’s a waxy cholesterol deposit in skin or tendon)
    • Small, yellow deposits of cholesterol which build up under the eyes or around the eyelids

    Diagnosis

    Hypercholesterolemia is not usually present with any symptoms and the only way to check the condition is to check the level of blood cholesterol referred to as the lipid profile. Typically, this test includes total cholesterol, LDL cholesterol, HDL cholesterol and triglyceride levels.

    Total cholesterol levels above 200 mg/dL are generally considered to be high and HDLs below 40 is generally considered to be poor. However, whether or not a lipid profile is considered safe depends on whether or not a person is at risk of heart disease.

    Treatment

    Patients diagnosed with hypercholesterolemia are advised to change their diet and to engage in regular physical activity. Examples of recommended dietary changes include avoiding foods rich in saturated fats such as cheese, butter, cream and high-fat meats. Saturated fat intake should be limited to a maximum of 30 grams per day for males and 20 grams per day for females.

    If the blood cholesterol level remains high after a few weeks, medication may be prescribed to the patient. The chosen drug or drug combination depends on several factors, including age, current health, potential side effects and individual risk factors.

    Hypercholesterolemia Familial

    Familial hypercholesterolemia affects how the body processes cholesterol. As a result, people with Familial hypercholesterolemia have a higher risk of heart disease and a higher risk of an early heart attack. The condition has been present since birth. Treatments, including medicines and healthy lifestyle behaviours, can help to reduce risk.

    Risk factors

    The risk of family hypercholesterolemia is higher if one or both of your parents have a gene defect that causes it. Most of the people who have the condition have had one gene affected. In rare cases, however, a child can get the affected gene from both parents

    Complications

    People need a small amount of cholesterol in their body to maintain healthy cell function and to produce hormones. However, excessive levels of cholesterol can be harmful to overall health and increase the risk of certain complications. Excess cholesterol can begin to build up in the arteries, making them narrower. If the cholesterol deposit breaks down, it can lodge itself in the arteries around the heart, causing a heart attack.

    How is familial hypercholesterolemia treated?

    Like normal high cholesterol, FH is treated with a diet. But, unlike other forms of high cholesterol, drug treatment is also a must. A combination of both is needed to successfully reduce cholesterol and delay the onset of heart disease, heart attack, and other complications. Your doctor will usually ask you to modify your diet and increase your exercise, along with prescribing medication. If you smoke, quitting smoking is also a critical part of your treatment.

    Lifestyle Changes

    • Increase lean proteins such as soya, chicken, and fish
    • Decrease in red meat and pork
    • Use olive oil or canola oil instead of lard or butter.
    • Switch from full-fat to low-fat dairy products
    • Add more fruit, vegetables and nuts to your diet.
    • Limit Sweet Drinks and Soda
    • Limit alcohol to not more than one drink per day for women and two drinks per day for men

    Prevention of familial hypercholesterolemia

    Because FH is genetic, the best chance to prevent it from happening is to seek genetic counselling before conceiving. Based on your family history, a genetic counsellor may be able to determine whether you or your partner are at risk for FH gene mutations. Having the condition doesn’t guarantee that your children will have it, but it’s important to know your risks and the risks to future children.

    FAQ's

    Excessive cholesterol present in the blood forms fatty deposits in the walls of the coronary arteries, the blood vessels that supply the heart with blood. As cholesterol accumulates, atherosclerotic plaques form, which narrows and hardens the walls of the artery.

    Yes, hypercholesterolemia is the same as high cholesterol.
    Patients diagnosed with hypercholesterolemia are advised to change their diet and to engage in regular physical activity.
    Most common symptoms of hypercholesterolemia are:
    • Chest pain
    • Small bumps on the skin
    • Xanthomas (it’s a waxy cholesterol deposit in skin or tendon5)
    • Small, yellow deposits of cholesterol which build up under the eyes or around the eyelids
    Foods that are good for hypercholesterolemia are fruits, vegetables, whole grains, fish and nuts.