High cholesterol (hypercholesterolemia)

The ratio of both forms of cholesterol (LDL and HDL) is what actually influences the appearance of atherosclerosis and its complications early ages (what is called cardiovascular risk for developing thrombosis in the heart , brain, etc.). .

LDL cholesterol can be reduced with a low fat diet and, if necessary, drugs.HDL cholesterol level can be increased by exercise, reducing excess weight and stopping smoking .

What is cholesterol measurement?
It is done through a blood test , preferably after fasting for 12 hours, and to calculate the levels of all forms of cholesterol. It is difficult to say what normal cholesterol levels, and that increase with age. Women also tend to have higher levels of HDL than men until menopause .

Furthermore, the importance of a high cholesterol is very different, as well as by the ratio between LDL and HDL, as the existence of other risk factors for atherosclerosis, such as smoking, diabetes and high blood pressure (hypertension), or a history familiar with cases of cardiovascular disease.It is possible, for example, that a person has a high cholesterol level and cardiovascular risk in the end, is relatively low in the absence of other risk factors and family history.

Despite differences between normal cholesterol levels for each sex and age, as a general guideline, you can give the following categories, depending on the levels of total cholesterol:

However, if a person has any symptoms of cardiovascular disease, such as angina or myocardial infarction, or you have had angioplasty or bypass operation on his heart, should receive medical treatment to maintain their LDL cholesterol below 100 mg / dL.

– Ideal level: less than 200 mg / dL .
– Slightly high cholesterol: 200 to 240 mg / dL .
– Moderately elevated cholesterol: between 240 and 300 mg / dL .
– Very high cholesterol: above 300 mg / dL .

What causes the elevation of cholesterol?
In cholesterol levels involving diverse factors: race, geographic origin, diet, lifestyle, etc., And in southern European countries like Spain, mean cholesterol levels are lower than those from the north or U.S..

The main factor is, however, influence or heredity.This is the reason that there are several people with high cholesterol in the same family.There is an inherited form that produces slight elevations in levels, but when there are many families with high cholesterol should be suspected serious metabolic disease, such as familial hypercholesterolemia (FH) or familial combined hyperlipidemia (HFC), in which triglycerides are too high.In some cases, the cholesterol is high as a result of other diseases, such as thyroid hormones defect, kidney disease or diabetes. A very common cause of elevated triglycerides is excessive intake of alcoholic .

What are the symptoms of high cholesterol?
Most people with high cholesterol have no symptoms or alteration to allow suspect.In some cases you can see cholesterol deposits in the eyes, skin and tendons.As said before, the true importance of hypercholesterolemia is that, along with other risk factors favors the premature development of atherosclerosis and cardiovascular disease.

Atherosclerosis is a slow process, so that, along the years, cholesterol and fat is deposited on the walls of the arteries (atherosclerotic plaques).This results in narrowing and hardening, which reduces the amount of blood that can pass through them and decreases the necessary irrigation for different organs.Eventually, the artery may become clogged and thereby cause a stroke-dependent areas of blood flow (which results in the death of these tissues).

Therefore, when the symptoms are caused by arterial disease.These depend on the degree of obstruction and the body supplied by the affected arteries.A further problem is the possibility that the plates are broken, causing a blood clot (thrombus) which abruptly blocks the artery and total.

It is very common for people with atherosclerosis have affected both arteries in different parts or organs.Besides those already mentioned, are the great aorta sick (from the heart and is distributing the blood to the body), the arteries of the kidney and bowel (mesenteric arteries).
– In the brain can obstruct an arterial branch by a thrombus, leaving a free zone brain blood flow, leading to a stroke.At other times, it can break the artery and results in bleeding.Either of these conditions can cause similar symptoms and are called stroke or cerebrovascular accident (CVA). There may also be small clots forming in the arteries of the neck and brain to reach the clog for a short time a small branch vessel (transient ischemic attack or TIA). However, when repeated latter must fear the possibility of a stroke.

– In the heart, the coronary artery narrowing cause angina, and plaque rupture of fat (atheroma) produces coronary thrombosis leading to myocardial infarction.If a significant amount of damaged cardiac tissue, there may be a reduction of the heart’s ability to pump blood (heart failure).

– Partial obstruction of the arteries of the legs produce a typical pain during walking that stops when you stop and is known as intermittent claudication.If you get to produce a very rapid or complete obstruction of an artery, lack of irrigation results in the death of all tissues (acute ischemia), forcing the amputation.

All studies clearly show that men and middle-aged women who smoke have a much higher risk of suffering a heart attack. Al dejar de fumar, este riesgo va disminuyendo de forma progresiva. By quitting smoking, this risk decreases progressively.

Diet is another important factor and its potential benefits are greater than indicated by producing variations in cholesterol levels.It recommends that a Mediterranean diet rich in bread, legumes, fruits, vegetables, oily fish and olive oil, and limit consumption of whole milk (not low fat), meat and meat products that are high in unhealthy fats.

Very moderate consumption, especially wine, increases HDL cholesterol and may reduce the negative effect of LDL cholesterol. However, produces both an increase in blood pressure and can damage the liver and other organs.

It is very beneficial even if it is too strong, and has been shown to reduce the risk of coronary heart disease.The vigorous and regular exercise promotes clot removal.

Excess body weight
The obesity and overweight, especially when fat is concentrated in the abdomen, favor the development of cardiovascular diseases. Loss is beneficial, albeit slight, of that excess weight.

What can be done to prevent vascular disease?
Arteriosclerosis (with complications) is a complex disease that does not have a single origin.  The elevated cholesterol level, although it is one of the most important risk factors, usually not by itself determine its appearance.Typically, several factors coincide, producing a marked increase risk.Therefore it is essential to recognize and correct as many of these.

How does the doctor make the diagnosis?
Analyzing a blood sample after a fasting period of at least 12 hours (can drink only water), to measure the level of total cholesterol, LDL and HDL cholesterol and triglycerides.To avoid errors need to know that some drugs and pregnancy produce elevations in cholesterol and which, on the contrary, there is a transient decrease during many diseases, such as myocardial infarction.

In some patients with severe hereditary hypercholesterolemia can be found outside of cholesterol deposits above.Whenever you find high cholesterol, your doctor should look for possible signs of cardiovascular disease by measuring blood pressure and heart auscultation and check arterial pulses (voltage measurement).It is also desirable to measure the amount of glucose in blood , assess renal function and an electrocardiogram ( ECG ).

When to treat high cholesterol drugs?
The first measures to treat hypercholesterolemia are proper diet (lipid lowering), reduce excess weight and exercising regularly.When these changes in diet and lifestyle are not feasible or have failed a sufficient reduction of cholesterol level, must be made, if necessary, treatment with medications.

This decision depends on the overall cardiovascular risk due to the presence or absence of other factors, or if you have symptoms of heart disease.As the case of each person chooses a specific figure for total cholesterol and LDL from which should be treated with drugs and sets targets to be achieved.In any case, it is important to know that when you really need drug treatment, usually forever.

The most effective drugs for lowering cholesterol is now called statins, which, although they are expensive, have relatively few side effects.Fibrates may also be used with resins and powders.