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High cholesterol (Hypercholesterolemia)

Posted Sep 30 2010 12:00am



High cholesterol level is becoming an increasing threat to many people. This is because many changes have involved our daily lifestyle that had lead to a partial sedentary life. Exercising, which is an important factor in preventing high cholesterol level, is being practiced by less individuals. All of these events had caused an increase in the incidence of hypercholesterolemia.

Hypercholesterolemia refers to a blood cholesterol measurement > 200 mg/dl. The normal total cholesterol level is 150-199 mg/dl. Cholesterol is not a harmful substance. It is only harmful when it's level is higher than normal. Cholesterol has the following functions in the human body:
1. It enters in the structure of many important body hormones as sex hormones.

2. It is important for production of bile acids, which digests fats.

3. It is an important constituent of the cell membrane of each cell.

4.  Cholesterol is a part of the myelin sheath which covers the nerves. This sheath insulates the axon, which helps transmission of nerve impulses efficiently.
 
Now let's talk about hypercholesterolemia.
The problem of high cholesterol lies in increased risk for arteriosclerosis and heart disease.



What causes hypercholesterolemia ?
It can be primary due to: 1.Hereditary
                                        2. Obesity
                                        3. Dietary intake
Or it can occur secondarily due to:
1. Diabetes mellitus (if poorly controlled)
2. Hypothyroidism
3. Renal impairment
4. Drugs as oral contraceptive pills and steroids



Hypercholesterolemia is asymptomatic and is only detected by a blood test.


Is there a good cholesterol and a bad one ?

Yes there is. HDL cholesterol is the good one because it removes excess cholesterol from the blood vessels and carries it to the liver where it is broken down. Thus high level of HDL reduces the risk of atherosclerosis and heart disease.
VLDL, LDL and IDL are called bad cholesterol because they can deposit on the walls of blood vessels and form a plaque which can block arteries.


What can we do to prevent high cholesterol ?
A well-balanced low-fat diet and maintenance of healthy body weight are the best ways to prevent high cholesterol. Saturated (animal) fats, including egg yolks and whole-milk dairy products, increase LDL. Monounsaturated fats—such as olive, canola, or peanut oils—and fiber can lower cholesterol levels. Besides exercising daily for 30 minutes will increase the level of HDL and lower LDL and triglycerides.


What is the treatment of hypercholesterolemia ?
Lines of management includes the change of lifestyle and diet (as explained above). Drugs used are:
1. Statins (most common)
2. Bile acid sequestering resins
3. Cholesterol absorption inhibitors
4. Fibrates
5. Niacin

Important values: 
Total cholesterol (normal): 150-199 mg/dl
Total cholesterol (borderline elevated): 200- 239 mg/dl
Total cholesterol (elevated): > 240 mg/dl

HDL (normal): > 40 mg/dl
HDL (borderline depressed): 35- 39 mg/dl
HDL (depressed): < 35 mg/dl

LDL (normal): <130 mg/dl
LDL (borderline elevated): 131- 159 mg/dl
LDL (elevated): > 160 mg/dl

Triglycerides (normal): < 160 mg/dl

Bottomline, a fasting lipoprotein profile is recommended every five years. 
I hope this article was beneficial and that it included the enough information to get the best awareness to you. 


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