Hypercholesterolemia: Symptoms and Treatment Methods
The excess of 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
- When is it manifested
- External signs and symptoms
- Diagnostic methods
- Potential consequences and complications
- Power features
- What to form a diet from
- Standard treatments
- Drug therapy
Genetic predisposition is one of the causes of hypercholesterolemia. The etiology of the disease may be associated with a genetically determined pathology, when the child inherits from the 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 and 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 the 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. The 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.
When is it manifested
Factors provoking hypercholesterolemia:
- Liver disease;
- Nephrotic syndrome;
- The use of medicines on an ongoing basis.
- Sedentary lifestyle;
- Excess body weight 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.
External signs and symptoms
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 its 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, can be invisible to a non-specialist.
- Lipoid corneal arch in a patient under 50.
- 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 cholesterol is divided into "good" and "bad", and the coefficient of its atherogenicity is determined.
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 of an increased level of 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 norm for the content of cholesterol in the blood is not more than 5.2 mmol / l (200 mg / dl). Exceeding these indicators is a reason for studying the entire lipid spectrum. With increased levels of "bad" cholesterol of low and very low density, a lifestyle correction is required.
Prescribing a diet for hypercholesterolemia is one of the important therapeutic measures designed to eliminate "bad" cholesterol, to provide anti-sclerotic action using a specially selected diet.
The goal of observing the general rules of nutrition is getting used to new eating habits, normalizing metabolism.
Basic nutritional principles:
- Decrease in the total amount of fat in the menu;
- Avoiding foods high in cholesterol from the diet;
- Increase in the proportion of polyunsaturated fatty acids in the menu;
- Replacement of animal fats with vegetable oils;
- Use of salt to a minimum (up to 3-4 g per day);
- The inclusion of complex carbohydrates and a large amount of fiber in the diet;
- Minimal intake of saturated fatty acids.
A diet designed to lower cholesterol must include vitamins, trace elements and nutrients. This diet will have to be followed for at least a month, maximizing the variety of the diet.
Liver, veal, beef brains, red and granular caviar, tongue, butter, mackerel and hard cheese, that is, foods high in cholesterol, are excluded from the menu.
Video: cholesterol-lowering foods:
What to form a diet from
Assessment of the usefulness of products:
- A fish. Even fatty varieties are beneficial, although you should consult your doctor about using fish oil.
- Meat. It is better to cook lean fillets and tenderloin, from which the fat layer has been removed. The use of sausages, sausages, sausages is excluded.
- Milk products. Skimmed milk is recommended, other milk products are not recommended to be included in the diet.
- Nuts. Reduces cholesterol levels, but increases excess weight.
- Green tea. It has an anti-sclerotic effect, but does not affect body weight.
- Bran and wholemeal flour. They substitute premium flour, you cannot eat pastries, cookies, sweets, as they contain a large amount of "bad" cholesterol.
- Cereals and cereals from them. Prepared with skim milk, often included in the diet.
- Vegetables and fruits. Fiber is extremely useful, as it has a positive effect on the state of the gastrointestinal tract, removes cholesterol, fills the body with microelements.
Any alcohol is prohibited, even with a moderate form of hypercholesterolemia (up to 6.5 mmol / l). More than 20 ml of alcoholic beverages should not be consumed per day, or it should be completely excluded from the diet for diseases of the heart and blood vessels.
The best cooking methods are boiling, stewing, or baking. With increased body weight, it is necessary to control the hypoglycemic index of dishes.
Non-drug methods used in the treatment of hypercholesterolemia:
- Correction of body weight.
- An individually designed plan of physical activity, taking into account the existing pathologies, the flow of oxygen.
- Normalization of the diet: increasing the proportion of vegetables and fruits, avoiding fatty and fried foods, reducing the calorie content of the diet.
- Refusal to use alcohol to slow down weight gain, reduce the side effects with the systematic use of drugs.
A ban on smoking, since nicotine increases the risk of developing pathologies of the heart and blood vessels, lowers the concentration of antiatherogenic substances.
Statins. Purpose of statin use:
- Reducing the level of intracellular cholesterol, slowing down its synthesis by the liver;
- Breakdown of fats;
- Anti-inflammatory action;
- Reducing the risk of damage to healthy blood vessels;
- Increased life expectancy;
- Reducing the risk of complications of atherosclerosis.
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 assimilation of "bad" cholesterol in the digestive 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 entering the body as fatty acids. Side effects - slowing down the rate of digestion processes, impact on taste buds.
Fibrates. Reduce triglyceride levels, increase the concentration of high-density lipoproteins.
Omega-3 polyunsaturated fatty acids. 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.
DNA structure correction. The direction is being developed, it is planned to use it in the treatment of primary hereditary hypercholesterolemia.
Folk remedies. With gene mutations, traditional medicine recipes will not help; an easy correction of the cholesterol level is possible with the acquired form of the disease.
The author of the article: Shutov Maxim Evgenievich | Hematologist
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.