Hypercholesterolemia: Difference between revisions – Physiopedia


 

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== Introduction ==

== Introduction ==

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If you/your client is concerned that they could have familial hypercholesterolemia or hereditary heart disease, the first step is to collect your family health history of heart disease and share this information with your doctor.<ref>CDC Heart Disease, Family Health History, and Familial Hypercholesterolemia Available:https://www.cdc.gov/genomics/disease/fh/FH.htm (accessed 5.3.2022)</ref>

If you/your client is concerned that they could have familial hypercholesterolemia or hereditary heart disease, the first step is to collect your family health history of heart disease and share this information with your doctor.<ref>CDC Heart Disease, Family Health History, and Familial Hypercholesterolemia Available:https://www.cdc.gov/genomics/disease/fh/FH.htm (accessed 5.3.2022)</ref>

== Further Information ==

== Further Information ==

See our great page on [[Hyperlipidemia]] and [[Atherosclerosis]]

See our great on  

#

 

[[Hyperlipidemia]]

[[Atherosclerosis]]

== References  ==

== References  ==

Plasma bags: Left from person with hypercholesterolemia.

Hypercholesterolemia is a specific type of hyperlipidemia[1]. Hypercholesterolemia can be defined as a LDL-cholesterol greater than 190 mg/dL, greater than 160 mg/dL with one major risk factor, or greater than 130 mg/dL with two cardiovascular risk factors.[2]

Hypercholesterolemia

  • Can be inherited, but it’s often the result of unhealthy lifestyle choices, which make it preventable and treatable. A healthy diet, regular exercise and sometimes medication can help reduce high cholesterol[3].
  • Increases the risk of heart disease. Elevated levels of circulating cholesterol cause deposits to form inside blood vessels. These deposits, called plaque, are composed of fats deposited from the bloodstream. When the deposits become sufficiently large, they block blood vessels and decrease the flow of blood. These deposits result in a disease process called atherosclerosis, which can cause blood clots to form that will ultimately stop blood flow.[4]
  • Is silent. There are no symptoms that are obvious to the naked eye. It is diagnosed by a blood test or after a heart attack or stroke occurs.[4]
Stop! do you know your cholesterol number (6944338085).jpg

Cholesterol circulates in the blood stream and is an essential molecule for the human body. eg Hormones and steroids are made of cholesterol molecules; Cholesterol molecules maintain neurons.

Between 75 and 80% of the cholesterol that circulates in a person’s bloodstream is made in that person’s liver with the remainder being acquired from outside sources. Cholesterol is found in animal sources of food, not in plants sources.[4]

Cholesterol has been divided into two major categories: low-density lipoprotein (LDL), the so-called “bad” cholesterol, and high-density lipoprotein (HDL), the so-called “good” cholesterol. Diet, exercise, smoking, alcohol, and certain illnesses can affect the levels of both types of cholesterol. Eating a high fat diet will increase one’s level of LDL cholesterol. Exercising and reducing one’s weight will both increase HDL cholesterol and lower LDL cholesterol[4].

Reverse Cholesterol Transport[edit | edit source]

Reverse cholesterol transport is a mechanism by high-density lipoprotein that works as the atheroprotective effect, means protects from atherosclerosis formation.[5]

Familial Hypercholesterolemia[edit | edit source]

Familial hypercholesterolemia (FH) is a genetic disorder that affects about 1 in 250 people and increases the likelihood of having coronary heart disease at a younger age.

If you/your client is concerned that they could have familial hypercholesterolemia or hereditary heart disease, the first step is to collect your family health history of heart disease and share this information with your doctor.[6]

The primary treatment of hypercholesterolemia, as a lipid disorder, is a healthy lifestyle;[7]

  • an optimum weight,
  • no smoking,
  • exercising for 150 minutes per week, exercise may not lower LCL-C but aerobic exercise may improve insulin sensitivity, lower triglyceride levels and increase HDL.
  • and a diet low in saturated and trans-fatty acids and enriched in fiber, fruit, and vegetables and fatty fish. Plant stanols at a dose of 2 g/d can help reduce LDL-C levels.

Cardiovascular disease is the leading cause of morbidity and mortality worldwide, and Hypercholesterolemia is one of the risk factors. In recent decades, there has been growing interest in raising HDL cholesterol levels as a potential therapeutic approach for preventing and managing atherosclerotic cardiovascular disease (ASCVD). However, a closer examination of accumulating clinical data reveals that increasing HDL cholesterol levels does not demonstrate a significant positive impact on cardiovascular outcomes. In fact, there is evidence to suggest that it may even elevate the risk of non-cardiovascular diseases.[8]

Currently, statins are choice number one for LDL cholesterol lowering. Ezetimibe and hypertime, the Niemann-Pick C1-Like 1 (NPC1L1) inhibitors, have generally been used as complement therapies to statins when patients cannot meet their treatment goals. However, some patients cannot achieve an ideal LDL cholesterol concentration with the use of statin treatments, even in combination with NPC1L1 inhibitors. Also, statins can cause muscle-related side effects in a certain some patients.[8]

You can find here the most updated guideline known as PEER simplified lipid guideline 2023 update, Prevention and management of cardiovascular disease in primary care.

See our great pages on

  1. Healthline What’s the Difference Between Hyperlipidemia and Hypercholesterolemia? Available: https://www.healthline.com/health/cholesterol/hyperlipidemia-vs-hypercholesterolemia(accessed 5.3.2022)
  2. Ibrahim MA, Asuka E, Jialal I. Hypercholesterolemia. [Updated 2021 Nov 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:https://www.ncbi.nlm.nih.gov/books/NBK459188/ (accessed 5.3.2022)
  3. Mayo Clinic High cholesterol Available:https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/symptoms-causes/syc-20350800 (accessed 5.3.2022)
  4. 4.0 4.1 4.2 4.3 The Free Medical Dictionary Hypercholesteremia Available: https://medical-dictionary.thefreedictionary.com/hypercholesterolemia (accessed 5.3.2022)
  5. Poznyak AV, Kashirskikh DA, Sukhorukov VN, Kalmykov V, Omelchenko AV, Orekhov AN. Cholesterol transport dysfunction and its involvement in atherogenesis. International Journal of Molecular Sciences. 2022 Jan 25;23(3):1332.
  6. CDC Heart Disease, Family Health History, and Familial Hypercholesterolemia Available:https://www.cdc.gov/genomics/disease/fh/FH.htm (accessed 5.3.2022)
  7. Ibrahim MA, Asuka E, Jialal I. Hypercholesterolemia. InStatPearls [Internet] 2023 April 23. StatPearls Publishing.
  8. 8.0 8.1 Du Z, Qin Y. Dyslipidemia and Cardiovascular Disease: Current Knowledge, Existing Challenges, and New Opportunities for Management Strategies. Journal of Clinical Medicine. 2023 Jan 3;12(1):363.

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