Exceeding the norm of cholesterol in the blood is defined by medical terminology as hypercholesterolemia. The cause of this condition can be both diseases and culinary traditions associated with the consumption of large amounts of animal fats.
Basic concepts
Genetic predisposition- one of the causes of hypercholesterolemia. The etiology of the disease may be associated with a genetically determined pathology, when a child inherits from his parents a defective gene associated with cholesterol synthesis (the so-called familial, or primary hypercholesterolemia). In children and adolescents, pathology is often not diagnosed, showing its symptoms already in adulthood.
The Frederickson classification of lipid metabolism disorders is generally accepted, which is widely used in hematology and other fields of medicine.
In the etiology of secondary hypercholesterolemia, there are several factors that trigger the onset of the disease. Sometimes a combination of conditions, the manifestation of which is provoked by risk factors, becomes a catalyst for the disease.
According to ICD-10 (international classification of diseases of the tenth revision), pure hypercholesterolemia was assigned the code E78.0, which belongs to the interval of “endocrine system and metabolic dysfunction”.
The forms of the disease are divided on the basis of the etiology of its development, each of them has no specific manifestations and other features:
Primary hypercholesterolemia most often occurs due to a genetic malfunction, so it cannot be prevented. A homozygous familial form of the disease occurs when both mother and father have abnormal genes. The frequency of occurrence is 1 case per million healthy people. The heterozygous hereditary form is caused by a defective gene of one of the parents, it occurs in 90% of cases of the primary form.
Secondary hypercholesterolemia is caused by metabolic disorders, somatic diseases.
Alimentary hypercholesterolemia is caused by unhealthy eating habits.
Factors provoking hypercholesterolemia:
Hypothyroidism;
Nephrotic syndrome;
The use of medicines on an ongoing basis.
Risk factors:
Heredity;
Sedentary lifestyle;
Overweight caused by an improperly composed diet, impaired metabolism;
Pathological eating habits, such as an addiction to cooking with lard;
Frequent drinking of alcoholic beverages, accompanied by a hearty snack;
Several factors coincide.
A lipidogram is a poorly informative laboratory indicator, since an elevated cholesterol level does not mean anything. Total cholesterol is composed of triglycerides, high and low density lipoproteins. It is important to divide this indicator into components by calculating the effect of lipoproteins of various fractions on the walls of blood vessels.
External manifestations that are critical for the diagnosis of secondary or genetically determined hypercholesterolemia by a specialist:
Xanthellasms - dirty yellow formations on the eyelids, located under the upper epithelium, may be invisible to a layman.
Lipoid corneal arch in a patient under 50 years old.
Xanthomas are formations of cholesterol that are located above the tendons.
As the disease progresses, the symptoms become massive.
The most informative is the study of the lipid spectrum, during which there is a division of cholesterol into "good" and "bad", the determination of the coefficient of its atherogenicity.
Additional research methods:
Study of the anamnesis, complaints of the patient, his opinion about the causes of the appearance of xanthomas and xanthellasms;
Determination of probable familial hypercholesterolemia, somatic diseases;
Examination of the patient with blood pressure measurement and auscultation;
General analysis of blood and urine to determine the presence of inflammation;
Biochemistry blood test (determination of sugar, creatinine, uric acid levels);
Lipidogram for the presence increased level lipoproteins;
Study of the immunological status;
Study of the genetic picture of hereditary diseases in all family members.
Potential consequences and complications
The most dangerous consequence of hypercholesterolemia is atherosclerosis, when cholesterol plaques accumulate on the walls of blood vessels, leading to a loss of elasticity, and consequent disruption of the activity of the cardiovascular system. An increase in the size and prevalence of atherosclerotic plaques leads to vasoconstriction and occlusion, the development of heart attack and stroke.
The consequence of chronic dysfunction of the circulatory system is ischemia of the arteries or organs such as the heart and brain.
The most dangerous complication is dysfunction of the circulatory system, in an acute form leading to vasospasm. The consequence of this is a heart attack with rupture of small and large vessels - typical manifestations of diseases associated with hypercholesterolemia.
The disadvantage of using statins is that over time, drugs affect the cells of the liver and muscles, constant monitoring of blood biochemistry is required. Contraindicated in patients with liver pathologies.
Ezetemib and analogues. It prevents the absorption of "bad" cholesterol in the gastrointestinal tract, although this effect is insignificant. Normally, only 20% comes from food, the rest is synthesized in the liver.
Cholic acid sequestrants. They remove cholesterol that enters the body as fatty acids. Side effects- slowing down the rate of digestion processes, influence on taste buds.
Fibrates. Reduce triglyceride levels, increase the concentration of high-density lipoproteins.
Omega-3 polyunsaturated fatty acid. Stimulating the activity of the heart, regulating the level of triglycerides in the blood. Contained in fatty fish, which can be added to the diet in the absence of problems with excess weight.
Cleansing the blood. Used in severe cases of pathology, the purpose of the procedure is to regulate the composition and properties of blood.
Correction of DNA structure. The direction is being developed, it is planned to use it in the treatment of primary hereditary hypercholesterolemia.
Folk remedies. For gene mutations, recipes traditional medicine will not help, an easy correction of the cholesterol level is possible with the acquired form of the disease.
Education: In 2013 he graduated from the Kursk State Medical University and received a diploma "General Medicine". After 2 years, completed residency in the specialty "Oncology". In 2016 completed postgraduate studies at the National Medical and Surgical Center named after N.I. Pirogov.
Hypercholesterolemia - what is it? Translated from Greek - high blood cholesterol. This is the characteristic of the disease. Strictly speaking, hypercholesterolemia is not even a disease - a pathological syndrome, a symptom.
And in fact, it is the cause of many disorders in the activity of the heart and blood vessels. To assess the severity of a symptom disease, one should understand its origin and developmental features. This will help prevent the onset of hypercholesterolemia, and in case of manifestation - in time to identify and determine the optimal treatment methods.
Biochemical disorders
Biological chemistry helps to understand the mechanism of changes caused by this or that pathological process. The biochemistry of hypercholesterolemia is a failure in lipid metabolism. Different types of fats enter the human body. As a result of a complex, multi-step process, they are broken down and "processed" by the appropriate enzymes. Free cholesterol does not dissolve in the blood.
Light fats in a split state are "captured" by erythrocytes, transforming into chylomicrons - transport forms. With the flow of blood and lymph, they move through the body, carrying cholesterol. But to get inside the organs, "transport" needs the help of lipoproteins - complexes of lipids and proteins.
It is lipoproteins that provoke the development of hypercholesterolemia. They are different in density. Low-density lipoproteins (LDL) are responsible for the transfer of cholesterol from the liver to organ tissue. This is mainly cholesterol that enters the body with food. When it increases, a lot of the so-called "bad" cholesterol is transferred into the cells.
High-density lipoproteins (HDL) transport excess cholesterol from cells back to the liver. Hypercholesterolemia occurs with disorders in the activity of lipoproteins.
Types of hypercholesterolemia
The pathological syndrome is classified based on the reasons for its development, but they do not have specific features of the course or external manifestations of its variety. There are three types of hypercholesterolemia:
- Primary - passed on to children "by inheritance" from their parents. It is caused by gene defects and can be:
- Homozygous (damaged genes are obtained from the father and mother);
- Heterozygous (the gene with the defect was passed on by one of the parents).
- Secondary - a consequence of the development of certain diseases, conditions of the body;
- Alimentary - occurs when excessive consumption of animal fats.
The diagnosis of "pure hypercholesterolemia" is made to a patient with a cholesterol level exceeding 5.18 mmol / l. This is already a clear harbinger of atherosclerosis.
Symptoms of pathology
There are no obvious signs of hypercholesterolemia, it does not affect the lifestyle and condition of a person for the time being.
With the course of pathology, its development may be indicated by: 
- Gray stripe along the periphery of the cornea of the eyes;
- Bulges and bumps (xanthomas) on the fingers, elbows, ankles, knees;
- Manifestations of angina pectoris.
In the future, cholesterol, deposited on the walls of the arteries, plaques are formed. The passages of the vessels are narrowed, their elasticity is lost, and the blood flow deteriorates. Cholesterol plaques cause blood clots.
Signs of hypercholesterolemia smoothly "flow" into symptoms of cardiovascular pathologies.
Primary (familial) hypercholesterolemia is a pathology that has not yet been fully investigated. Therefore, there is no such means that would be guaranteed to prevent its appearance.
The main reasons for the appearance of primary hypercholesterolemia are considered to be: 
- Defects in the structural structure of the lipoprotein protein. They are not able to interact with organ cells, cholesterol cannot get into them;
- Decreased production of "transport" enzymes. A lack of cholesterol is formed in one place and its excess in another;
- Disorders in tissue cells. They lose the ability to contact lipoproteins.
The causes of secondary hypercholesterolemia can be:
Excessive consumption of animal fats - main reason the occurrence of hypercholesterolemia in the vast majority of patients.
Hypercholesterolemia therapy
Lowering the concentration of cholesterol in the blood can be achieved through lifestyle changes and the use of drugs. Correction of the usual way of life with hypercholesterolemia is essentially preventive measures to maintain acceptable cholesterol levels.
If they do not help, the doctor takes medication, prescribing:
Treatment of hypercholesterolemia involves an integrated approach. Traditional medicine, affordable and safe, can help solve cholesterol problems.
With hypercholesterolemia, a good effect is given by:
Diet for hypercholesterolemia
At the initial stages of hypercholesterolemia, it is enough to exclude foods with "bad" cholesterol from the diet. This measure will keep its indicator within acceptable limits.
General guidelines for diet for hypercholesterolemia can be summarized in a few simple rules:
- Reduce the number of calories consumed, especially with a sedentary lifestyle;
- Do not overeat at night, control body weight;
- Reduce the amount of animal fat consumed by replacing it with vegetable oils;
- Include in the diet foods containing vitamins and minerals;
- Do not give up eating lean meats;
- Limit salt intake;
- When choosing a dietary table, remember about food addictions and not elevate prevention to the rank of punishment.
The table provides an approximate list of foods recommended and contraindicated by the diet for hypercholesterolemia.
With hypercholesterolemia, all dishes are steamed, boiled or baked.
The diet for hypercholesterolemia is varied and simple. Compilation of the menu should not cause any particular difficulties. The patient cannot do without meat, let him eat with pleasure. The main thing is that it is not greasy and fried.
A one-day meal for him may, for example, contain:
Prevention of hypercholesterolemia
To maintain an acceptable level of cholesterol in the blood, certain preventive measures should be taken.
According to the rules for the primary prevention of hypercholesterolemia (before it occurs), the patient needs:
Secondary prevention (with existing hypercholesterolemia) is designed to prevent the occurrence of vascular pathologies and the development possible complications... Basically, it consists in the conservative pathology of hypercholesterolemia.
The course of hypercholesterolemia is influenced by the concentration of "bad" and "good" cholesterol in the blood and the rate of manifestation of lesions.
The elimination of modifiable risk factors and quality, timely therapy can increase the patient's life and have a beneficial effect on its quality.
13. Hypercholesterolemia, its causes, consequences. Cholesterol-lowering nutrients.
Hypercholesterolemia is the excess of the normal concentration of cholesterol in the blood. The norm is 200 ± 50 mg / dL (5.2 ± 1.2 mmol / L) and, as a rule, increases with age.
Hypercholesterolemia often develops due to excess intake of cholesterol from food, as well as carbohydrates and fats. Proper nutrition throughout life is the most important factor in the prevention of hypercholesterolemia. Hereditary factors play an important role in the predisposition to the development of atherosclerosis.
Reduce cholesterol levels: olive oil; other vegetable oils; marine fish oil; plant foods rich in water-soluble fiber (cereals, wholemeal flour), pectin (apples, berries), soy. Water-soluble fiber or dietary fiber, which is found only in plant foods, reduces the absorption of cholesterol in the intestine and reduces the concentration of total cholesterol by 10% and low density lipoprotein cholesterol by 12% in serum.
14. Atherosclerosis: biochemical causes, metabolic disorders, biochemical diagnostics, complications. Risk factors in the development of atherosclerosis, their mechanisms of action, prevention.
Atherosclerosis is the most common disease of a chronic course that affects the walls of the arteries, resulting from a violation of the processing of fats (cholesterol, lipoproteins) in the body. There is an accumulation of cholesterol, and its deposition in the form of a build-up of "atherosclerotic plaques" in the inner wall of the vessels (intima), as a result of which, the wall of the arteries loses its elasticity, becomes denser, narrows the lumen and as a result, the blood supply to the organs is disrupted.
Risk factors for the development of atherosclerosis:
Poor nutrition. Constant consumption of food with a high content of fats and cholesterol; Obesity leads to the deposition of cholesterol on the walls of blood vessels; Hereditary predisposition (as a result of a congenital deficiency of certain enzymes involved in the breakdown of fats, an increase in their level in the blood and deposition in the walls of blood vessels occurs); Male sex (women are protected to some extent by female sex hormones); Smoking (tobacco contains substances that affect the vascular wall); Diabetes mellitus (violation of fat metabolism); Elderly age(related to lifestyle); Hormonal changes in the body; High blood pressure (damage to the inner wall of the arteries, leading to the deposition of cholesterol in damaged areas); Chronic alcohol use (liver function decreases, where fat breakdown occurs); Psychoemotional stresses (increase the level of cholesterol in the blood, damage to the arterial wall due to its toxic effect and its deposition on it); Ischemic heart disease leads to disruption of the structure of the vascular wall and the loss of cholesterol in it.
Metabolic disorders in atherosclerosis are very diverse and are mainly reduced to hypercholesterolemia, hyperlipoproteinemia, dysproteinemia and the accumulation of coarse proteins.
Complications of atherosclerosis: angina pectoris, myocardial infarction, atherosclerosis of the cerebral vessels (mental damage), trophic ulcers and gangrene of the limb, thrombosis of the mesenteric vessels.
Diagnosis of atherosclerosis- biochemical blood test (lipidogram), Doppler ultrasonography, angiography.
The pathological deviation that will be considered in this article is not a disease, but a deviation from the norm, a serious deviation. Hypercholesterolemia initially does not seem very dangerous, just think of a high level of plasma cholesterol. But with prolonged observation of such values, the situation only gets worse, leading to severe pathologies.
ICD-10 code
As already mentioned, the ailment in question is not a disease, but only a deviation. But the seriousness of the changes they entail is confirmed serious attitude doctors to this problem. After all, hypercholesterolemia in the international classification of diseases has its own personal code. According to ICD 10, pure hypercholesterolemia is coded as E78.0 and is an item in the category of ailments affecting lipoprotein metabolism (subsection code E78).
ICD-10 code
E78.0 Pure hypercholesterolemia
Causes of hypercholesterolemia
A certain pathological syndrome called hypercholesterolemia, a harbinger that speaks of the development of damage to the blood vessels of the entire circulatory system of the human body. Such changes affect the nutrition of the heart and other internal organs, the capillaries of the brain, upper and lower extremities. The malfunction in question is a harbinger of developing atherosclerosis, a complication that can affect any part of the human body, being the impetus for the development of other, more serious diseases.
The causes of hypercholesterolemia are different and have a diverse nature.
- A person is able to receive this deviation by inheritance, with birth. One or both parents can become the source of the altered gene. Defective changes in the gene are associated with a violation of the information responsible for the production of cholesterol.
- The development of violations is practically not preventable if a person abuses food containing a large amount of animal fats.
- Transient manifestations of the disease in question can be observed if the patient ate a lot of fatty foods the day before.
- A constant manifestation can be observed when the high fat content of products is the norm for the patient's diet.
- The source of a malfunction in the normal functioning of the body, leading to the considered clinical picture, can be a disease:
- Hypothyroidism is a condition that develops against the background of a lack of hormones in thyroid gland obtained as a result of surgical intervention or ongoing inflammatory process.
- Diabetes mellitus is a disease in which the ability of glucose to penetrate into cellular structures decreases. Sugar values are higher than 6 mmol / l with normal values of 3.3-5.5 mmol / l.
- Obstructive changes affecting the liver. This pathology is caused by a deterioration in the outflow of bile from the liver, in which it is produced. For example, it can be gallstone disease.
- Long-term intake of some medications... These include immunosuppressants, diuretics, beta-blockers, and some others.
- Modifiable causes of the development of pathological disorders are those that are corrected when the patient revises his lifestyle.
- Leading a sedentary lifestyle, expressed in physical inactivity.
- Food.
- The presence of bad habits: alcohol abuse, drugs, nicotine consumption.
- Hypertension - persistent high rates blood pressure.
- The development of this pathology is also influenced by unmodifiable factors:
- The predominant predisposition is men over 45 years old.
- Complicated by a family history, if in the family the patient's closest male relatives (previously 55 years old) have already been diagnosed with early atherosclerosis.
- The patient has a history of myocardial infarction, the consequences of which are blocking the supply of blood to a certain area of the heart muscle, after which it dies.
- Ischemic stroke, provoking necrotic processes affecting a part of the brain.
Biochemical disorders
In order to understand the causes and consequences of the appearance and development of this or that ailment, it is necessary to understand as best as possible the mechanism of the occurrence of changes that differ from the norm. The biochemistry of hypercholesterolemia is a disorder affecting the lipid metabolism procedure.
Fat structures of various classifications enter the human body with food: complex lipid formations, glycerol esters, free cholesterol, triacylglycerides and others.
After the food has entered the digestive tract, the body begins to process it. The food product is "decomposed" into components, each of which is processed by a certain enzyme. The breakdown of fats also occurs. Moreover, each type of fat structure is processed by its own enzyme. For example, triacylglycerides under the influence of liver and pancreas biocatalysts (bile and pancreatic acid) are broken down into smaller compounds. A similar process occurs with other lipids.
Free cholesterol is adsorbed unchanged, while its derivatives, which have a more complex structure, are primarily modified. Only after that is their adsorption by enterocytes, the cells that make up the mucous membrane of the small intestine.
In these cells, fats undergo further modification, transforming into forms suitable for transport, which have their own name - chylomicrons. They are represented by a fatty droplet of microscopic size, which has a coating in the form of a thin protective shell of phospholipids and active proteins.
In this form, the former fats through the enterocyte barrier enter the lymphatic system, and through it further into the peripheral blood vessels.
It should be noted that without the support of other components, chylomicrons cannot independently penetrate into the necessary systems and organs of the human body. They find such support in blood lipoproteins (complete compounds of lipids and protein formations). Such compounds allow chylomicrons to "get" to the desired organ without dissolving in the blood fluid.
It is lipoproteins that play a dominant role in the development of pathology called hyperlipidemia. This symptom begins to form after there is a disruption in the normal functioning of lipoproteins.
There is a classification of these enzymatic formations depending on their density. It is light and ultra-light lipoproteins that are the cause that provokes the development of the disease. They are produced by the liver, after which they are transported to the enterocytes, where they attach to the chylomicrons. In such a bundle, this tandem enters the tissue layers.
Low density lipoproteins (LDL) are the "transporting organ" for cholesterol, delivering it to organs and systems.
The functional feature of high density lipoproteins (HDL) is to remove excess cholesterol plaques from cellular structures, which makes them the main guardian of the body, endowed with antiatherogenic characteristics.
That is, low-density lipoproteins are transport, and high-density lipoproteins are protection.
Based on this, it can be understood that hypercholesterolemia begins to develop when there is a violation in the normal functioning of low-density lipoproteins, which, for whatever reason, stop spreading chylomicrons to the necessary organs.
Symptoms of hypercholesterolemia
One of the main signs of the appearance of the deviations under consideration is the appearance of "deposits" in the patient's body. There are also symptoms of hypercholesterolemia, which are manifested by the appearance of such factors:
- Areas where the presence of tendons is anatomically justified (the Achilles joint and extensor joints of the phalanges of the upper and lower extremities are especially affected), you can observe swelling and the appearance of bumpy growths - xanthomas. These are, in fact, pockets of cholesterol accumulations.
- Very similar neoplasms can be observed in the lower and upper eyelids, and the inner corners of the eye are also affected. Spots of orange and yellowish hue - xanthelasma - begin to appear.
- If you look closely at the patient's cornea, you will notice a gray strip along the rim.
- Mostly, you can observe secondary symptoms of deviation from the norm, which are caused by more serious lesions of the capillary system, leading to the development of atherosclerosis, strokes, heart attacks, and so on.
The most recognizable signs of the pathology under consideration are symptoms that appear as indicators of the presence of atherosclerotic changes in a person's history. The spectrum of such manifestations is quite wide: from damage to the capillaries of the brain, to the circulatory system, which provides nutrition to the upper and lower extremities. Depending on the place of preferential localization, some individual characteristics manifestations.
It should also be noted that the appearance of noticeable symptoms suggests that pathological changes are neglected, because a real clinic becomes noticeable only when the level of cholesterol in blood serum reaches persistent critical values. Until such a moment occurs, bright pathological symptoms may be invisible.
Hypercholesterolemia and atherosclerosis
Atherosclerosis is a disease referred to as chronic diseases... The basis of its origin is determined by disorders that affect lipid and protein metabolism in the patient's body. In physical manifestation, these changes are expressed by the loss of elasticity of the vessels, they become fragile. The second significant indicator of the presence of atherosclerosis is the proliferation of connective cell tissues.
High cholesterol levels are, in many cases, a precursor to atherosclerosis. Therefore, doctors paid special attention to this fact. After the study, the results showed that in half of the patients diagnosed with atherosclerosis, the cholesterol values remain within the normal range, while the second half has increased numbers.
Analyzing the results of monitoring, experts note that hypercholesterolemia and atherosclerosis go "hand in hand" when the development of pathology occurs quickly enough.
Various sources give such figures for the frequency of joint manifestations of these two diseases - from 60 to 70%. These data were obtained not only by studying the clinical picture of the disease, but also by its comparability with the pathological examination of the state of the vascular walls. Comparative analysis showed that if during life a person had problems with excess cholesterol, then his postmortem histology showed the progressive development of atherosclerotic characteristics, in the form of recently formed cholesterol deposits inside the capillary passages.
If the histology showed regression of atherosclerotic changes, the intravital medical record showed the norm or, conversely, a lowered cholesterol level.
Observations have shown that high cholesterol levels together with atherosclerosis are more often observed with their early manifestation, when the patient has not yet reached 55 years of age. Over time, the clinical picture of the disease changes, "overgrown" with various complications.
Hypercholesterolemia in children
The disease in question can be diagnosed in a baby immediately after birth. Such a pathology can haunt a person throughout his life. Puffiness of Achilles dryness in young patients should alert a qualified doctor for family pathology.
Hyperlipidemia in children is usually indicated by an increase in blood cholesterol levels from 8.0 to 12.0 mmol / L. This indicator can be detected even in the first hours of life.
Classification of hypercholesterolemia
Having different sources of manifestation, the pathology is divided into different groups. The classification of hypercholesterolemia consists of several points:
Primary - pathological changes that are congenital.
- Secondary pathology refers to the provoking factor of which is one of the diseases. That is, a person was born healthy for the factor in question, but acquired it in the process of life.
- The alimentary form of the disease is a secondary sublevel, but it is somewhat taken out separately due to the fact that the impetus for the progression of the disease in question is not a specific disease, but the way of life that a person leads - his habits. These include:
- Smoking.
- Alcohol abuse.
- Addiction to fatty foods.
- "Love" for fast food products, food products, which include all kinds of chemical additives: stabilizers, dyes, and so on.
- Leading a sedentary lifestyle.
- And other.
The most detailed and more extensive classification was made by Fredrickson. This is a generally accepted differentiation of pathology, depending on the reasons that provoked its appearance. Although the specificity of the differences in the failure in the processes of lipid metabolism is fully understood only by a qualified physician.
Types of hypercholesterolemia
The classification of the disease according to Fredrickson presupposes a breakdown of the problem under consideration by etiology, determining its type.
The following types of hypercholesterolemia are distinguished:
- Type I pathology is primary, hereditary. Rare. It progresses with a deficiency of lipoprotein lipase, as well as in case of a violation of the structure of the activating protein lipoprotein lipase - apoC2. Symptomatically defined as a high concentration of chylomicrons. The frequency of manifestation is 0.1%.
- Type II pathology is polygenic or congenital. Shares:
- Type IIa - lack of low density lipoprotein lipases. It may be the result of improper nutrition, or a congenital factor has worked. The frequency of manifestation is 0.2%.
- Type IId - a decrease in the level of low-density lipoprotein lipase receptors and an increase in apoB. The diagnosis rate is about 10%.
- Type III pathology - hereditary dys-β-lipoproteinemia. ApoE defect. The frequency of manifestation is 0.02%.
- Type IV pathology is endogenous. An increase in the intensity of the formation of triglycerides, as well as acetyl coenzyme A and apoB-100. The frequency of manifestation is 1.0%.
- Type V pathology is a hereditary etiology. Increased formation of triglycerides and a decrease in lipoprotein lipase.
Primary hypercholesterolemia
To understand the difference, it is necessary to become more familiar with at least the most common sources of changes leading to the disease in question. The term primary hyperlipidemia has received a violation, the main causes of which are:
- Violation of the structural structure of lipoprotein protein, which leads to a malfunction of the functional viability of low-density lipoproteins, which lose their ability to attach to tissue cells, and, therefore, the chylomicrons transported by them with cholesterol cannot enter the cell.
- There is an inhibition of the production of transport enzymes, which are responsible for the capture of chylomicrons by lipoproteins, for further transfer through the body systems. Such a failure leads to the fact that a shortage of cholesterol is formed in one place and their accumulation occurs where their excess is not needed.
- Structural changes affecting the tissue cell itself, leading to the loss of its contact with lipoproteins. Here we get a situation similar to point 1, but with the difference that the reason for the unsuccessful interaction does not come from the enzyme or representatives of lipoproteins, but, on the other hand, from the "landing" cell.
Secondary hypercholesterolemia
Another, most commonly diagnosed type of cause, is secondary hypercholesterolemia, which was not inherited, but acquired in the course of one's life. The cause of the clinical picture in question can be alcohol, if the patient does not know the measure of its use, a sedentary lifestyle and many other factors that directly depend on the person himself.
Disorders occurring in the endocrine system, pathological changes affecting the work of internal organs are also capable of provoking a problem. After all, the organism is a single mechanism and the failure of one system, invariably entails other changes.
Hyperlipidemia begins to progress if changes have affected the processes of transporting fatty structures from enterocytes to cells, or disturbances have activated the synthesis of lipoproteins, or inhibition of their utilization has occurred.
Hereditary hypercholesterolemia
Autosomal dominant pathology related to diseases of the monogenic group, that is, determined by only one gene. A disorder involving the malfunction of low-density lipids. In this case, the violation occurs at the gene level and is inherited, being congenital.
A person can receive such a defective gene from both one parent and from both, if they have a history of the disease in question.
Risk factors for high cholesterol include:
- Family history, aggravated by this deviation.
- Diagnosis of early-age heart attacks, both in the patient himself and in his relatives.
- A large indicator of low density lipoproteins in at least one of the parents. The burden of the anamnesis may lie in the resistance of the pathogenic situation to drug therapy.
Cholesterol is a natural enzymatic component of many biochemical processes and an essential element of the cell membrane. Cholesterol deficiency leads to a failure in the synthesis of various hormones. Most of them enter the human body with animal fat, a certain amount is produced by the liver.
Exaggerated cholesterol can be divided into one that contributes to the development of atherosclerosis - low density lipoprotein (LDL), and one that keeps its amount under control, on the contrary, protecting against the onset and progression of the disease - high density lipoproteins (HDL). It is high density lipoproteins that reduce the likelihood of cardiovascular abnormalities.
Familial hypercholesterolemia
Familial malaise is referred to as hereditary diseases, which is one of its subspecies. Today, it is responsible for 10% of defects affecting the coronary arteries, which are diagnosed in young people under the age of 55. The source of such disorders is a mutated gene. This pathology occurs quite often, especially among families living in polluted industrial cities. For every 200-300 healthy genes, there is one mutated one.
Familial hypercholesterolemia, according to Fredrickson's classification, belongs to type 2. The essence of this ailment boils down to the fact that due to a failure in genetics, lipoproteins lose their ability to bind to cholesterol and transport it to the desired organ. In parallel with this, there is an increase in the number of synthesized cholesterol plaques, which is also a violation.
And as a result, plaques begin to accumulate in places where they should not be, which leads to the development of cardiovascular diseases, coronary disorders. This is one of the reasons for diagnosing "early" heart attacks.
Familial homozygous hypercholesterolemia
If, during diagnosis, two mutated allelic genes of low density lipoproteins are detected and this ailment is hereditary, then doctors state a hereditary disease denoted by the term.
This mutation provokes a rapid violation of lipid breakdown, as well as the complete absence of receptors. As regrettable as it sounds, but mutational changes of this kind are encountered quite often, one clinical manifestation per hundred thousand people.
The frequency of the pathology encountered is also divided by the type of "destruction":
- In patients with a complete lack of receptors, such activity is shown only 2% of normal work, and the level of low density lipoproteins increases sharply.
- With a defect in receptors, the activity of their work falls within the range of 2-25% of the norm, the amount of low-density lipoproteins is slightly below the norm.
Heterozygous familial hypercholesterolemia
One of the most common types of the disease under consideration, the frequency of which is diagnosed as one clinical picture in five hundred healthy cases.
The essence of pathology is a mutation of one gene, leading to its defective lesion. Symptoms of this manifestation of the disease are:
- An increase in total cholesterol levels.
- An increase in the amount of LDL.
- Triglyceride levels are close to normal.
- Diagnosis of early heart disease.
- Complicated family history.
- The presence of tendon xanthomas, although their absence in the body is not evidence of health. This is especially true for the child's body. These samples are taken in the area of the Achilles tendons. Visually, this situation manifests itself in puffiness and lumpy formations. Another area where bumps and bumps appear is the back of the palms. upper limbs and flexor tendons of the phalanges.
Diagnosis significantly increases the likelihood of a patient developing cardiovascular diseases (for example, coronary heart disease) at a young age.
Such clinical picture it is desirable to recognize it even in infancy, this will allow you to directly control the indicator parameter, preventing pathological changes in the body.
Pure hypercholesterolemia
It is caused by an increase in the quantitative component of cholesterol in the blood. Such a diagnosis is made to the patient if this criterion is determined by a figure of more than 5.18 mmol / l. This is already a pathology, which is the dominant symptom of the development of atherosclerosis.
Medical statistics say that about 120 million of the world's population have serum cholesterol levels of about 5.18 mmol / l or more, and in 60 million this figure is already determined by the figure of 6.22 mmol / l or more.
Diagnostics of the hypercholesterolemia
If the doctor, for some reason, begins to suspect the disease in question in his patient, he prescribes a more detailed directed examination, since it is impossible to make the correct diagnosis visually. Diagnostics includes several mandatory items.
- Analysis of patient complaints.
- Clarification of the limitation period for the appearance of xanthelasma, xanthoma, lipoid corneal arch.
- Taking the patient's anamnesis. The presence of a patient or his close blood relatives of diseases such as a previous heart attack or stroke. Does any of the relatives have the disease in question?
- A physical examination is mandatory.
- The main diagnostic indicator of the disease is the result of the analysis of the specific lipid profile of blood plasma - lipid profile. On its basis, the amount of various lipids (cholesterol, triglycerides, high and low density lipoproteins) is determined. They are directly a criterion for the presence or absence of pathological changes. The coefficient of atherogenicity is determined.
- A general analysis of urine and blood is prescribed. Inflammation, other failures and abnormalities are detected.
- Plasma biochemical analysis is also required, which allows you to determine the quantitative indicators of protein, uric acid, creatinine, sugar and other blood components.
- An immunological study of blood allows you to determine the presence of antibodies to chlamydia and cytomegalovirus, as well as the level of C-reactive protein.
- Modern medical equipment also makes it possible to carry out genetic studies to identify a defective gene that carries information related to lipid metabolism. Such a gene is responsible for the hereditary form of the development of the disease.
- Measurement of blood pressure.
Nutrition and diet for hypercholesterolemia
This is a very important "building block" in the measures that are used to stop the problem that has arisen. By reconsidering his addictions, the patient can significantly change the situation for the better, significantly reducing the volume of cholesterol plaques in the blood.
If the disease hasn't gone too far. Sometimes it is enough to remove “bad” foods from your diet and this small step will allow you to keep this indicator at the permissible values.
The first thing a patient needs to do is to remove fatty animal products from his diet. They can be replaced with herbal counterparts. This can significantly reduce the amount of excess cholesterol plaque. Fatty fish and fish oil, on the contrary, are desirable in the diet of such a patient.
You should not refuse meat and meat products, but they should not be fatty. A more serious limitation concerns offal (liver, brain structure, kidneys). Smoked meats and eggs (yolks) should be minimized. Cholesterol of such products is "off scale".
A diet for hypercholesterolemia allows the consumption of low-fat dairy products (no more than 1-2%), fermented milk products are welcome.
You should remove butter, fast food products, and baked goods from your diet. When purchasing bakery products, it is necessary to ensure that they are from bran, wholemeal flour.
The patient's diet should include all kinds of cereals cooked in water or low-fat milk. Well cleans vessels green tea and nuts. But you should not eat a lot of nuts, because this is a high-calorie product.
Strange as it may sound, but in moderate doses, alcohol helps to inhibit the development of atherosclerosis. But the "therapeutic dosage" should not be higher than the daily norm, corresponding to 20 ml of pure alcohol, which roughly corresponds to 40 ml of vodka, 150 ml of wine, 330 ml of beer. Such dosages are suitable for a man's body; for women, these numbers should be halved. It is about a quality product, not a surrogate. It should not be forgotten that if there is a history of cardiovascular disease, alcohol is contraindicated.
It is worth removing coffee from drinking. Studies have shown that when you quit this drink, the level of cholesterol in the body is reduced by 17%.
In the diet of such a patient, there must be the required amount of legumes, fruits and vegetables so that the body does not feel a lack of vitamins and minerals.
If a person loves seafood, then scallops, mussels and other seafood can significantly diversify the patient's diet.
For these patients, all meals should be steamed, boiled, or baked.
Diet menu for hypercholesterolemia
As the recommendations show, the diet for this disease is simple and quite varied. Therefore, great difficulties in drawing up a menu with hypercholesterolemia should not arise. And if the patient loves meat, even if it is included in his dish, one should only check that the product is not greasy and is cooked in one of the permitted ways.
The menu for one day for such a patient may, for example, be as follows:
- Breakfast: casserole - 150 g, green tea.
- Lunch: orange.
- Lunch: lean borscht - 200 g, fish baked with vegetables - 150 g, apple juice - 200 ml.
- Afternoon snack: rosehip broth - 200 ml, apple.
- Dinner: pearl barley porridge on water with boiled meat - 150 g., Fresh carrot salad - 50 g., Tea with milk.
- Before going to bed - a glass of kefir.
Total daily amount bread - 120g.
Hypercholesterolemia treatment
Therapy of the pathology under consideration includes both medication and non-medication techniques. Non-drug treatment of hypercholesterolemia includes several recommendations:
- Weight control.
- Moderate physical activity, individually calculated for each patient. Physiotherapy, morning jogging, swimming pool and other components of outdoor activities.
- Balance of the diet in compliance with all dietary requirements for the ailment in question.
- Rejection of bad habits. This is especially true for alcohol and nicotine.
If the above methods are "not enough" to maintain cholesterol levels within the normal range, the doctor prescribes drug therapy.
Medicines for hypercholesterolemia
Initially, after analyzing the clinical picture of the disease, the attending doctor prescribes a diet for such a patient, gives recommendations for changing the lifestyle, and prescribes therapeutic physical activity. And if such a complex of changes does not lead to the desired result, the specialist is forced to resort to the help of pharmacology.
Mostly patients with such a diagnosis are prescribed statins (for example, atorvastatin), which effectively reduce the level of cholesterol in the patient's body by inhibiting the enzyme that activates its production.
Atorvastatin is administered orally at any time of the day, along with food. The starting daily dosage is 10 mg to 80 mg. The corresponding figure is assigned by the doctor individually for each patient. During treatment, after two to four weeks, the patient's blood cholesterol levels should be monitored, adjusting the dosage accordingly.
In parallel with statins, fibratams can also be prescribed, which reduce the level of lipids and triglycerides with a simultaneous increase in the concentration of high-density lipoproteins, as well as bile acid sequestrants, which enhance the process of breaking down excess cholesterol.
The specialist can introduce into the treatment protocol omega-3 polyunsaturated fatty acids, which regulate the number of triglycerides, and also have a beneficial effect on the functioning of the heart. Triglycerides are given, such as ezetimibe, which blocks the absorption of cholesterol in the small intestine.
], [- You need to monitor your weight.
- Avoid high-calorie foods.
- Eliminate muffins, fatty, smoked and peppered foods from your diet.
- Increase the amount of fruits and vegetables rich in vitamins, minerals and fiber.
- Remove bad habits: alcohol, nicotine.
- Sports activities with individually selected loads.
- Avoid stress and great emotional stress.
- Periodic monitoring of the amount of cholesterol plaques in the blood is required.
- Blood pressure control.
- Compulsory complete treatment of diagnosed diseases that can provoke high cholesterol levels.
- When the first pathological signs appear, seek the advice of a specialist and, if necessary, undergo drug treatment.
Hypercholesterolemia - with this term, doctors do not mean a disease, but a symptom that can lead to quite serious disorders in the patient's body. Therefore, even a slight violation of its level in the blood should not be ignored. On the early dates development, this pathology can be easily kept normal by an adjusted diet and a recommended diet. If this stage of therapy was ignored, then the person runs the risk of getting more complex and sometimes irreversible diseases in the future, for example, atherosclerosis, heart attack, stroke and others. Only the person himself is able to save his health by a timely visit to a doctor. Therefore, be more attentive to your body and do not dismiss its signals for help. After all, a piece of fatty meat eaten is not worth the spoiled quality of the rest of your life!
Hypercholesterolemia is an exclusively laboratory indicator that is detected by a special blood test - a lipidogram or a simple determination of blood cholesterol.
Special external manifestations of hypercholesterolemia:
- xanthomas - dense nodules containing cholesterol (a fat-like substance) over a patient's tendons (dense structures that attach muscles to bones), such as on the hand
- xanthelasma - deposition of cholesterol under the skin of the eyelids in the form of flat yellow nodules or not differing in color from other areas of the skin;
- lipoid arch of the cornea - a white or grayish-white rim of deposited cholesterol along the edges of the cornea of the eye. The appearance of the lipoid arch of the cornea before the age of 50 indicates the presence of hereditary hypercholesterolemia.
Forms
According to the mechanism of occurrence of hypercholesterolemia, several forms of the disease are distinguished.
- Primary
(not a consequence of any disease). This is hereditary hypercholesterolemia (transmitted from parents to children) associated with disorders in genes (carriers of hereditary information).
- Homozygous hereditary hypercholesterolemia(the patient received defective genes from both parents) is rare - 1 case per 1 million population.
- Heterozygous hereditary hypercholesterolemia(the patient received a defective gene from one of the parents) occurs much more often - 1 case per 500 population.
- Secondary hypercholesterolemia (develops as a result of certain diseases or conditions of the body).
- Alimentary (nutritional) hypercholesterolemia develops with excessive consumption of animal fats.
Causes
- The reason primary hypercholesterolemia is the inheritance from one or both parents of an abnormal gene (a disturbed carrier of hereditary information) responsible for the synthesis of cholesterol.
- The reason secondary hypercholesterolemia
are the following diseases and conditions:
- hypothyroidism (decreased function of the thyroid gland due to its inflammation, surgical removal, etc.);
- diabetes mellitus (a disease in which the supply of glucose is disrupted - simple carbohydrate- into cells);
- obstructive liver disease (diseases in which the outflow of bile from the liver - the fluid secreted by the liver and accumulated in gallbladder), for example, gallstone disease (the formation of stones in the gallbladder);
- taking medications (some of the diuretics, beta-blockers, immunosuppressants, etc.);
- Transient (that is, transient) hypercholesterolemia is noted the next day after eating a large amount of fatty foods.
- Persistent hypercholesterolemia is observed with regular consumption of food with a large amount of animal fats.
- Modifiable (that is, those that can be eliminated or corrected):
- Lifestyle:
- hypodynamia (sedentary lifestyle);
- abuse of fatty, cholesterol-rich foods;
- personality and behavior features - stressful character type (the presence of a violent emotional reaction to various stimuli);
- alcohol abuse;
- smoking;
- arterial hypertension (persistent increase in blood pressure);
- diabetes mellitus (a disease in which the entry into cells of glucose - a simple carbohydrate) with a fasting blood glucose level of more than 6 mmol / l (norm 3.3-5.5 mmol / l);
- abdominal obesity (waist in men more than 102 cm).
- Lifestyle:
- Non-modifiable factors (which cannot be changed) include several factors:
- the age of the man is over 45;
- male gender;
- a family history (in the closest relatives under the age of 55 years - in men) of cases of early atherosclerosis:
- familial hypercholesterolemia (inherited predisposition to increased formation of lipids in the liver);
- myocardial infarction (death of a part of the heart muscle due to the cessation of blood flow to it);
- ischemic stroke (death of a part of the brain due to the cessation of blood flow to it);
- sudden death (non-violent death within 1 hour of the onset of acute symptoms).
Diagnostics
- Analysis of the anamnesis of the disease and complaints - when (how long ago) did xanthomas (dense nodules containing cholesterol above the surface of the tendons), xanthelasias (deposits of cholesterol under the skin of the eyelids in the form of nodules), lipoid arch of the cornea (white or grayish-white rim of deposited cholesterol appear) edges of the cornea of the eye), with which the patient associates their occurrence.
- Life history analysis. It turns out what the patient and his close relatives were sick with, who the patient was by profession (whether he had contact with infectious agents), whether there were infectious diseases. A history may include indications of atherosclerosis of various vessels, myocardial infarction (death of a portion of the heart muscle due to the cessation of blood flow to it) or stroke (death of a portion of the brain due to cessation of blood flow to it) in a patient or his close relatives. Information about familial hypercholesterolemia can be obtained.
- Physical examination. On examination, xanthomas, xanthelasmas, lipoid arch of the cornea may be noted. Hypercholesterolemia is not accompanied by changes in percussion (tapping) and auscultation (listening) of the heart. Blood pressure may be elevated.
- Blood and urine tests. It is carried out to identify the inflammatory process and concomitant diseases.
- Blood chemistry. The level of sugar and total blood protein, creatinine (a protein breakdown product), uric acid (a breakdown product of purines - substances from the cell nucleus) is determined to identify concomitant organ damage.
- Lipidogram. A blood test for lipids - fat-like substances - is the main method for diagnosing hypercholesterolemia. Pro-atherogenic lipids (fat-like substances that contribute to the development of atherosclerosis) are isolated - these are cholesterol, low and very low density lipoproteins, triglycerides. There are also antiatherogenic lipids (fat-like substances that prevent the development of atherosclerosis) - these are high-density lipoproteins. The coefficient of atherogenicity is calculated - the ratio of proatherogenic to antiatherogenic lipids (if it is more than 3, then the risk of atherosclerosis is high).
- Immunological blood test. The content of antibodies (produced by the body special proteins capable of destroying foreign substances or cells of its own body) to cytomegalovirus and chlamydia (microorganisms that are assumed to be the cause of atherosclerosis), as well as the level of C-reactive protein (a protein whose level rises in the blood at any inflammation).
- Genetic analysis to identify genes (carriers of hereditary information) responsible for the development of hereditary hypercholesterolemia is carried out in close relatives of patients with hereditary hypercholesterolemia.
Hypercholesterolemia treatment
- Non-drug treatment of hypercholesterolemia.
- Normalization of body weight.
- Dosed physical activity in conditions of sufficient oxygen supply. The load mode is selected individually, taking into account the localization and severity of atherosclerosis, as well as concomitant diseases.
- A diet with limited intake of animal fats, enriched with vitamins and dietary fiber, the calorie content of which corresponds to the patient's load. Avoiding fatty and fried foods is recommended. It is advisable to replace meat in the diet with fish (preferably sea fish) 2-3 times a week. Vegetables and fruits rich in fiber and vitamins should form the bulk of the diet.
- Limiting alcohol intake. Alcohol increases triglyceride levels ( chemical compounds- esters of triglycerol with fatty acids), promotes weight gain, aggravates the course of gout (impaired uric acid metabolism), provokes muscle damage in patients taking statins (a group of drugs that affect the synthesis of lipids by the liver).
- To give up smoking. Smoking significantly increases the risk of developing cardiovascular disease, especially myocardial infarction and lower limb artery disease. Quitting smoking, on the contrary, is accompanied by an increase in the blood of anti-atherogenic substances (substances that prevent atherosclerotic vascular lesions).
- Drug treatment of hypercholesterolemia.
- Statins - reduce the synthesis of cholesterol by the liver and the intracellular content of cholesterol, increase the destruction of lipids (fat-like substances), have an anti-inflammatory effect, and prevent damage to new areas of blood vessels. Statins increase the life of patients, reduce the incidence of complications of atherosclerosis and the severity of vascular lesions. They can cause damage to the liver and muscles, therefore, when taking statins, it is necessary to regularly monitor blood tests for the appearance in them of products of destruction of the liver (alanine aminotransferase - ALT) and muscles (creatine phosphokinase - CPK). Statins should not be used for active liver diseases (if the ALT level is more than 3 times higher than the norm).
- Inhibitors of absorption of cholesterol in the intestine (a group of drugs that prevent the absorption of cholesterol in the intestine). The effect of this group of drugs is limited, since cholesterol from food makes up about 1/5 of all cholesterol in the body, and 4/5 of cholesterol is formed in the liver.
- Bile acid sequestrants (ion exchange resins) are a group of drugs that bind bile acids containing cholesterol in the intestinal lumen and remove them from the body. May cause constipation, bloating, and taste disturbances.
- Fibrates are a group of drugs that lower the level of triglycerides (small molecules of fat-like substances) and increase the level of high-density lipoproteins (protective substances that prevent atherosclerosis). Can be used in conjunction with statins.
- Omega-3 polyunsaturated fatty acids are a group of preparations derived from fish muscles. They reduce the level of triglycerides, reduce the risk of heart rhythm disturbances, prolong the life of patients after myocardial infarction (death of a part of the heart muscle due to the complete cessation of blood flow to it).
- Extracorporeal treatments (immunosorption of lipoproteins, cascade plasma filtration, plasma sorption, hemosorption, etc.) is a change in the composition and properties of the patient's blood outside the body using special devices. They are used to treat severe forms of hypercholesterolemia.
- Genetic engineering techniques (changes in the hereditary material of cells to obtain the desired qualities) in the future can be used in patients with hereditary hypercholesterolemia.
Complications and consequences
- The main natural consequence and complication of hypercholesterolemia is atherosclerosis (a chronic disease characterized by thickening of the walls of the arteries (vessels that bring blood to the organs) and narrowing of their lumen, followed by a violation of the blood supply to the organs).
- Depending on the location of the vessels containing atherosclerotic plaques (dense thickening of the inner lining of the vessel containing cholesterol), the following forms of the disease are distinguished.
- Atherosclerosis of the aorta (the largest vessel in the human body) leads to arterial hypertension (persistent increase in blood pressure) and can contribute to the formation of atherosclerotic heart defects: stenosis (narrowing) and insufficiency (inability to prevent reverse current blood) of the aortic valve.
- Atherosclerosis of the vessels of the heart is called ischemic heart disease and can lead to the development of:
- myocardial infarction (death of a portion of the heart muscle due to the cessation of blood flow to it);
- heart rhythm disturbances;
- heart defects (structural abnormalities of the heart);
- heart failure (a disease associated with insufficient blood supply to organs at rest and during exertion, often accompanied by blood congestion).
- Atherosclerosis of the cerebral vessels leads to various disorders of mental activity, and with complete closure of the vessel - to ischemic stroke (death of a part of the brain due to the cessation of blood flow to it).
- Atherosclerosis of the renal arteries is usually manifested by arterial hypertension.
- Atherosclerosis of the intestinal arteries can lead to intestinal infarction (death of a section of the intestine due to the complete cessation of blood flow to it).
- Atherosclerosis of the vessels of the lower extremities leads to the development of intermittent claudication (sudden onset of pain in the legs when walking, passing after stopping), the development of ulcers (deep defects of the skin and underlying tissues), etc.
- Chronic complications. Atherosclerotic plaque leads to stenosis (narrowing) of the vessel lumen (stenosing atherosclerosis). Since the formation of plaque in the vessels is a slow process, chronic ischemia (insufficient supply of nutrients and oxygen due to reduced blood flow) occurs in the area of the blood supply of this vessel.
- Acute complications. They are caused by the occurrence of blood clots (blood clots), emboli (blood clots that have come off the site of formation, transferred by the blood stream and closed the lumen of the vessel), spasm (compression) of the vessels. There is an acute closure of the vascular lumen, accompanied by acute vascular insufficiency (acute ischemia), which leads to the development of heart attacks (death of a part of the organ due to the cessation of blood flow to it) of various organs (for example, myocardial, kidney, intestinal infarction, ischemic stroke, etc.). Sometimes a rupture of the vessel can be observed.
- the level of pro-atherogenic (causing atherosclerosis) and anti-atherogenic (preventing the development of atherosclerosis) lipids (fat-like substances) in the blood;
- the rate of development of atherosclerotic changes;
- localization of atherosclerosis. The most favorable course of atherosclerosis of the aorta, the least favorable - atherosclerosis of the own arteries of the heart.
Prevention of hypercholesterolemia
- Primary prevention
hypercholesterolemia (that is, before its appearance).
- Non-drug exposure to modifiable (which can be changed) risk factors:
- normalization of body weight;
- adherence to a diet low in fat and table salt (up to 5 g per day), enriched with vitamins and fiber;
- quitting alcohol and smoking;
- individually selected level of physical activity;
- limiting emotional overload;
- normal blood glucose (simple carbohydrate) levels;
- blood pressure below 140/90 mm Hg
- Timely complete treatment of diseases that can lead to dyslipidemia, for example, diseases of the thyroid gland and liver.
- Non-drug exposure to modifiable (which can be changed) risk factors:
- Secondary prevention
(in people with existing hypercholesterolemia) is aimed at preventing the appearance and progression of atherosclerotic vascular changes and the development of complications:
- non-drug exposure to modifiable (which can be changed) risk factors;
- drug treatment of hypercholesterolemia.
Additionally
- increasing its synthesis (combining) in the body;
- elimination disorders;
- increased intake of cholesterol from food (insignificant part, not more than 1/5 of blood cholesterol).
The disease occurs only with a significant long-term increase in the level of cholesterol in the body.
Hypercholesterolemia is very common. In various countries, it is detected from every fifteenth to every third inhabitant.
