Hypercholesterolemia

Despite its solid name, hypercholesterolemia is not always a separate disease, but a specific medical term for the presence of large amounts of cholesterol in the blood.Often - due to concomitant diseases.

Experts associate the extent of the problem with the cultural and culinary traditions of different regions.The data of medical statistics show that in countries whose national cuisine is focused on dishes with a low content of animal fats, such cases are much less common.

Hypercholesterolemia: basic concepts

The causes of the development of the disease can be hidden in the genes.This form of the disease is classified as primary hypercholesterolemia, or SG (familial hypocholesterolemia).Receiving from the mother, father or both parents a defective gene responsible for the processes of cholesterol synthesis, a child can have this disease.In children, SG is practically not diagnosed, as the problem becomes noticeable only at a more mature age, when the symptoms become more noticeable.

A classification according to Fredrickson is generally accepted, although the specifics of various violations of lipid processes from it will be understood only by a specialist.

The secondary form develops in the presence of certain factors that are catalysts of the disease.In addition to the causes and conditions, the combination of which is likely to lead to a problem, there are also certain risk factors.

According to the ICD 10 - the generally accepted medical classification of diseases - pure hypercholesterolemia has the code E78.0, and refers to the dysfunction of the endocrine system and metabolism.

Classification of the disease is based on the causes of its development, but the specific features of the course or external manifestations of its form do not have:

• The primary form has not been fully studied, nor is there a 100% reliable means of preventing it.Homozygous familial hypercholesterolemia develops when abnormal genes - in both parents.Heterozygous hereditary hypercholesterolemia (when the gene is in one of the parents) occurs in 90% of patients, while homozygous SG is one case per million.
• Secondary (develops in connection with diseases and disorders of metabolic processes);
• Alimentary is always associated with the lifestyle of a particular person, and develops because of unhealthy eating habits.

When is hypercholesterolemia manifested?

In most cases, hypercholesterolemia is provoked :

1. Diabetes ;
2. Diseases of the liver;
3. Hypothyroidism;
4. Nephrotic syndrome (NS);
5. Systematic intake of certain drugs.

The risk factors include:

• Genetic (SG);
• Arterial hypertension ;
• Excess body weight, which often comes from food addictions and disturbances in the process of metabolism;
• Hypodinamy;
• Constant stress;
• Unhealthy eating habits, excessive use of foods that increase cholesterol, for example, eggs fried in fat;
• The constant use of alcohol, where not alcohol itself leads to the deposition of plaques, since it does not contain lipids, but "snack", which it requires.

In the event that several of the above conditions coincide, one must be particularly careful about one's health, and if possible, eliminate existing problems.

External signs and symptoms

As a specific indicator, which is revealed by using laboratory diagnostic methods (lipidogram), hypercholesterolemia reveals elevated blood cholesterol, the general index of which is generally of little informative, since it consists of high and low density lipoproteins and triglycerides .The task of laboratory diagnostics is to divide the total cholesterol into components and to calculate what effect lipoproteins of low and very low density have on the walls of arterial vessels.

In some (far-reaching) cases, the disease has external manifestations, according to which the expert can make a fairly accurate diagnosis.There are specific signs that indicate secondary or hereditary hypercholesterolemia:

1. Lipoid corneal arc is considered a testimony of the presence of SG if the patient's age is up to 50 years;
2. Xanthelasms are dirty yellow nodules under the upper layer of the epithelium of the eyelids, but they may not be noticeable to the inexperienced eye;
3. Xanthomas - cholesterol nodules, localized over the tendons.

The bulk of the symptom appears only as a consequence of the progress of the disease, which gradually acquires a severe character and a variety of concomitant diseases.

Diagnostic Methods

The correct and reliable diagnosis can be made after the lipid spectrum is investigated, where the total cholesterol is divided into fractions (useful and harmful) with the calculation of the atherogenic coefficient.And to determine the type of hypercholesterolemia may be assigned additional studies:

• Full analysis of the anamnesis (taking into account current complaints about health), it is equally important to know the patient's opinion about the cause of the manifestation of specific signs (xanthomas, xanthelasm);
• Establishment of the presence of hypertension (familial hypercholesterolemia) and other health problems not considered before;
• Inspection, which includes auscultation and measurement of blood pressure;
• A standard analysis of blood and urine makes it possible to exclude the possibility of inflammation;
• Deep (biochemical) blood test, which determines the level of creatinine , sugar and uric acid ;
• Lipidogram, allowing to establish the presence of hyperlipidemia (high level of lipoproteins);
• Immunological analysis;
• Additional genetic analysis of blood among family members to identify a genetic defect.

Possible consequences and complications

The most unpleasant consequence of hypercholesterolemia is atherosclerosis - the deposition of cholesterol plaques on the walls of the vessels, which, accumulating, lead to pathological changes in the wall, it loses its elasticity, which affects the work of the entire cardiovascular system.Eventually, atherosclerotic plaques cause a constriction of the vessel and its occlusion, which may result in a heart attack or stroke.

Chronic nature of complications with certain consequences of the disease is due to dysfunction of the circulatory system, as a result of which ischemia of organs or vessels develops.

Vascular insufficiency is the most dangerous complication, and its acute character is determined by vasospasm .Infarction and rupture of small or large vessels are typical manifestations of consequences and accompanying hypercholesterolemia of diseases.

f the blood test shows a high cholesterol ( cholesterol in the blood - less than 5.2 mmol / l or 200 mg / dl ), then it makes sense to examine the entire lipid spectrum.And when the total cholesterol is increased due to "harmful" fractions (low and very low density lipoproteins), then later it will be necessary to revise the way of life, radically changing the usual way towards a healthier and more useful one.

Features of nutrition in hypercholesterolemia

The diet for hypercholesterolemia is designed to have an antisclerotic effect, removing excess cholesterol from the body with a specific set of products.

General rules of nutrition are aimed at the normalization of metabolism and the development of healthy eating habits.

Principles of nutrition in hypercholesterolemia:

1. Reducing the amount of fat in your daily diet.
2. Partial or complete exclusion of high cholesterol products.
3. Restriction of intake of all saturated fatty acids.
4. Increase the proportion of polyunsaturated fatty acids in the daily diet.
5. Consumption of a large number of slow (complex) carbohydrates and vegetable fiber.
6. Limit the amount of salt - no more than 3-4 grams per day.
7. Replacement of animal fats with vegetable.

Nutrients, trace elements and vitamins should form the basis of the diet to lower cholesterol in the blood.But this process is quite long, and the dietary scheme will have to adhere to more than one month.Nutrition experts and doctors insist on a variety of foods and dishes so that the body can function normally.

From what to form a diet?

Among useful products, fish can be separately placed, since even the most fatty varieties of it will only benefit, but the reception of fish oil should be started only after consultation with the attending physician.

Meat for cooking is better to choose lean, otherwise with a piece it is necessary to cut off the fatty layer.Fillet and tenderloin are considered to be the most suitable parts for therapeutic nutrition.Sausages, sausages and similar products should be completely excluded from the menu.

Almost all dairy products are not recommended , only a small amount of skim milk is permissible.

Products that reduce cholesterol in the blood, in some cases, can lead to the appearance of excess weight.A typical example is the nuts , which although considered useful in the fight against cholesterol plaques, are still excessively high in calories.Green tea will also help clear the vessels, but will not lead to an increase in body weight.

Do not abuse hot drinks with a diet, since even moderate hypercholesterolemia (a cholesterol in the blood of not more than 6.5 mmol / L or 300 mg / dL) requires compliance with the scheme of therapeutic nutrition, which is very discouraged by alcohol.It is believed that the amount of alcohol per day should not exceed 20 ml.With diseases of the heart and circulatory system, alcohol should be excluded as such.

Bran and coarse flour in the diet scheme completely replace the flour of the highest grade, and this rule should be guided when choosing bread products.Buns, biscuits and other sweets are not recommended, as the basis of most recipes is high cholesterol products.

Cereals and cereals are a fundamental component of the diet;doctors and nutritionists allow the preparation of cereals with skim milk.

egetable and fruit fiber is the third pillar of the diet, as the substance normalizes the activity of the gastrointestinal tract, contains a large number of trace elements and facilitates the purification of blood vessels by removing cholesterol.

All the forms and types of hypercholesterolemia listed above do not have the features of dietary regimens.The assortment of dishes and the grocery set of therapeutic diets is also identical, as are the ways of cooking products.

Cook better for a couple, and cook, stew or bake any food .In case of weight problems, doctors recommend that you follow the glycemic index of the dishes.

Standard therapies

Non-pharmacological bases of treatment of hypocholesterolemia:

• Weight loss;
• The distribution of physical activity in relation to the level of oxygen supply (individual selection of the program taking into account all accompanying diseases and the degree of their severity);
• Normalization of the diet, strict control of the amount of incoming substances in accordance with the volume of loads (rejection of fatty and fried, replacement of fatty proteins with less calories, increasing daily portions of fruits and vegetables);
• Refusal to take alcohol (helps to slow down the mass gain, uric acid exchange is normalized, the probability of side effects when taking medications is reduced);
• Restriction on tobacco smoking (allows to lower the risk of cardiovascular pathology development, the concentration of anti-atherogenic substances increases);

Medication Therapy
Statins

Their goal is to reduce cholesterol inside cells and slow down its synthesis by the liver.In addition, drugs contribute to the destruction of lipids, have an anti-inflammatory effect and reduce the risk of damage to healthy areas of the vessels.According to statistical data, patients taking statins live longer and are less likely to experience complications of atherosclerosis.However, taking medication should be strictly controlled , because over time statins can lead to damage to liver tissues and certain muscle groups, so laboratory studies of both the lipid spectrum and other biochemical parameters during treatment are conducted regularly.Statins are not prescribed for patients who have liver problems (significant deviation from the norm of functional liver tests).

Ezetimibe and similar preparations

This group should prevent the absorption of cholesterol in the intestine, but has only a partial effect.The fact is that only 20% of the cholesterol comes from food, the rest of its amount is formed in the liver tissues.

Sequestants of cholic acids

This group of substances contributes to the removal of cholesterol, which is part of fatty acids.Side effects from their reception relate mainly to the rate of the course of digestive processes, but taste buds can also be affected.

Fibrates

The action of the drugs is aimed at lowering the level of triglycerides while simultaneously increasing the concentration of high-density lipoproteins.

Omega-3 polyunsaturated fatty acids

The substances regulate the amount of triglycerides, and also stimulate the work of the heart.As you know, omega-3 is found in most types of fatty fish, which, if there are no problems with weight, can be safely introduced into the diet.

Cleansing the blood

In the treatment of severe cases of hypercholesterolemia, there is often a need to regulate the composition and properties of blood, removing it from the body.

Correction of the structure of DNA

At the moment it can only be considered in the future, but in the future it will be used to treat the hereditary form of the disease.

Folk remedies

Traditional medicine is also ready to offer its help, and treatment with folk remedies is aimed at lowering the level of cholesterol in the blood.If with an acquired form of the disease this approach can still help to cope, then with gene mutation all sorts of broths and tinctures certainly will not have a positive effect.In any case, the reception of folk remedies can be carried out only after an agreement with the doctor.Examples of suitable recipes can be found in the material for cleaning the vessels of cholesterol .