Hypercholesterolemia causes its occurrence. Hypercholesterolemia - what it is, symptoms, causes and types of disease, diagnosis and treatment methods
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Despite its solid name, hypercholesterolemia is not always a separate disease, but a specific medical term denoting the presence of a large amount of cholesterol in the blood. Often due to concomitant diseases.
Experts attribute the prevalence of the problem to the cultural and culinary traditions of different regions. 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 reasons for the development of the disease may be hidden in genes. This form of the disease is classified as primary hypercholesterolemia, or FH (familial hypocholesterolemia). Having received from the mother, father, or both parents a defective gene responsible for the processes of cholesterol synthesis, a child may have this disease. In children, HS is practically not diagnosed, since the problem becomes noticeable only in adulthood, when the symptoms become more noticeable.
The Fredrickson classification is considered generally accepted, although the specifics of various disorders of lipid processes from it will only be clear to a specialist.
The secondary form develops in the presence of certain factors, which are catalysts for the disease. In addition to the causes and conditions that are likely to combine to cause a problem, there are also certain risk factors.
According to ICD 10 - the generally accepted medical classification of diseases - pure hypercholesterolemia has code E78.0, and refers to dysfunctions of the endocrine system and metabolism.
The classification of the disease is based on the reasons for its development, but its form does not have specific features of the course or external manifestations:
- Primary form has not been fully studied, nor is there a 100% reliable means of preventing it. Homozygous familial hypercholesterolemia develops when abnormal genes are present in both parents. Heterozygous hereditary hypercholesterolemia(when the gene is in one of the parents) occurs in 90% of patients, while homozygous FH is one case in a million.
- Secondary(develops in connection with diseases and metabolic disorders);
- Nutritional is always associated with the lifestyle of a particular person, and develops due to unhealthy eating habits.
When does hypercholesterolemia appear?
In most cases, hypercholesterolemia is caused by :
Video: how to keep cholesterol normal?
Main symptoms:
- White rim around the edges of the cornea
- Flat nodules under the skin of the eyelids
- Dense nodules over tendons
- Grayish rim around the edges of the cornea
Hypercholesterolemia is not an independent nosological entity, but a condition of the body in which the level of cholesterol in the bloodstream increases. Typically, the cause of the progression of such a pathological process is various chronic ailments in the human body. For example, diabetes.
With a slight increase in cholesterol levels, hypercholesterolemia does not pose a threat to human health. If the level rises to critical levels, then this is already very dangerous, since there is a high risk of development.
Pure hypercholesterolemia according to ICD 10 has code E78.0. It is classified as a group of dysfunctions of the endocrine system and metabolism. Most often, this pathological condition is observed in middle-aged and older people. But such frameworks are not always clear-cut. Hypercholesterolemia can occur in any person whose diet contains large quantities of animal fats.
Etiology
The main reasons for the progression of hypercholesterolemia are ailments already existing in the human body, such as:
- nephrotic syndrome;
- . This disease in most situations is the main cause of increased cholesterol concentrations in the bloodstream;
- liver pathologies, mainly of a chronic nature.
Risk factors for progression of hypercholesterolemia:
- hereditary predisposition. In this case, the sick person develops familial or hereditary hypercholesterolemia;
- frequent stressful situations;
- large body weight, often caused by an unbalanced diet rather than a metabolic disorder;
- regular consumption of alcoholic beverages in large quantities;
- poor nutrition and unhealthy food habits. For example, a person regularly eats eggs fried in lard. All this significantly contributes to an increase in cholesterol levels in the bloodstream.
Varieties
Depending on the etiological factors, clinicians divide hypercholesterolemia into:
- primary. It is also called familial hypercholesterolemia. The main reason for its development is a hereditary factor. Homozygous familial hypercholesterolemia is diagnosed if the abnormal genes are present in both parents at the same time. Heterozygous familial hypercholesterolemia occurs in 90% of patients. This form of primary hypercholesterolemia develops when only one parent has the abnormal gene;
- secondary hypercholesterolemia. It progresses only in the presence of factors that are catalysts for the disease. Usually develops against the background of chronic pathologies or metabolic disorders;
- alimentary. The reason for its progression is a person’s unhealthy lifestyle and harmful food addictions.
Symptoms
Hypercholesterolemia is not a disease, but a specific laboratory indicator. It is possible to detect an increase in cholesterol levels in the bloodstream only through certain laboratory tests, a lipid profile in particular. Usually, in the case of a slight increase in cholesterol, a person does not experience any external symptoms. They begin to appear only when the pathological condition becomes more advanced. It is worth noting that the symptoms of hypercholesterolemia are quite specific, so it will not be difficult for a doctor to make an accurate diagnosis.
Main symptoms of the pathology:
- xanthomas. This symptom is characterized by the appearance of dense nodules on the human skin, which contain cholesterol inside. Usually localized above the human tendons, for example, on the hand;
- xanthelasma. In this case, there is a deposition of excess cholesterol under the skin of the eyelids. Visually they look like small flat nodules. They may have a yellow color, but in most cases they are difficult to distinguish from previous areas of the skin;
- lipoid corneal arch. A characteristic symptom of high cholesterol. Upon visual examination, the doctor can see that a pathological rim has formed along the edges of the cornea, having a white or grayish tint. This is excess cholesterol. This symptom usually occurs in patients over 50 years of age. But if a lipoid arc on the cornea appeared before this age, then this indicates the presence of a hereditary form of pathology in a person.
Diagnostics
An increase in blood cholesterol levels can only be detected through laboratory research methods. Most often, a person does not even suspect that this substance accumulates in large quantities in his body. Usually, an increase in its concentration is detected by chance, for example, during a preventive examination.
The standard diagnostic plan for this pathological condition includes:
- collecting anamnesis of the disease and patient complaints. Sometimes the patient complains of the appearance of pathological formations on the skin - xanthoma and xanthelasma;
- analysis of the patient's life;
- physical examination;
- lipidogram;
- immunological blood test;
- genetic analysis.
Therapeutic measures
All treatment methods for this pathological condition can be divided into the following groups:
- non-drug treatment;
- drug treatment;
- genetic engineering methods;
- extracorporeal treatment methods;
- folk remedies.
Non-drug therapy includes the following activities:
- normalization of weight;
- to give up smoking;
- limiting the consumption of drinks containing high doses of alcohol;
- physical activity (moderate). The lesson plan for each patient is drawn up strictly individually;
- Diet for hypercholesterolemia is also very important. It is necessary to reduce the consumption of animal fats, but at the same time enrich your diet with dietary fiber and vitamins. You should also completely avoid eating fried and fatty foods.
Medicines for the treatment of pathology:
- statins;
- inhibitors of cholesterol absorption in the human intestine. The main task of these drugs is to reduce the absorption of cholesterol in the intestine;
- bile acid sequestrants;
- fibrates;
- omega-3 polyunsaturated fatty acids. These treatment agents are necessary because they significantly reduce the risk of heart rhythm disturbances and also prolong the life of patients who have previously suffered a myocardial infarction.
Extracorporeal methods of therapy are used only for severe forms of pathology. Their essence is that with the help of special innovative devices the composition of the blood changes, as well as its properties (outside the human body).
Folk remedies for the treatment of pathology should be used only with the permission of your attending physician and in tandem with the methods of official medicine. The most effective folk recipes are from:
- Dioscorea nipponensis root;
- rosehip berries;
- immortelle sandy;
- three-leaf leaves;
- milk thistle seed powder (an effective folk remedy);
- cyanosis blue roots;
- grass Tribulus creeping;
- celandine;
- prickly artichoke.
Prevention
Prevention of hypercholesterolemia can be divided into primary and secondary. Primary prevention is the methods that should be used to prevent cholesterol levels in the bloodstream from increasing. Such events include:
Hypercholesterolemia is a pathological symptom that is a prerequisite for the development of other diseases. Cholesterol is a substance that is produced by the liver and enters the body with food. Cholesterol takes part in the synthesis of bile acids, sex hormones, and adrenal hormones. But in excess quantities this substance leads to the development of atherosclerosis, diabetes mellitus and coronary heart disease.
Causes of the disease
To understand the causes of hypercholesterolemia, it is necessary to study the process of lipid metabolism in the human body. Normally, different types of fats enter the human body, which have different breakdown mechanisms. Thus, free cholesterol is absorbed in a free state, and more complex compounds are exposed to enzymes. Light split fats are absorbed into red blood cells, where they are converted into transport forms - chylomicrons.
Then they enter the lymphatic system and with the flow of lymph and blood to other organs. To get into the desired organ, chylomicrons need the help of special substances - lipoproteins (a complex consisting of blood lipids and protein). Lipoproteins come in different types:
- with very low density;
- with low density;
- with intermediate density;
- with high density.
It is the dysfunction of lipoproteins (or lipoproteins - both names are equivalent) with low density that can lead to hypercholesterolemia. Lipoproteins of this type carry large amounts of fat to cells and tissues, as a result of which a pathological condition called hypercholesterolemia develops. Depending on the causes of occurrence, there are several types of hypercholesterolemia:
- primary;
- secondary.
Among all the causes of hypercholesterolemia of the first type (hereditary hypercholesterolemia), three main ones can be distinguished:
- defects in the protein part of lipoproteins;
- impaired tissue sensitivity to lipoproteins;
- disturbances in the synthesis of transport enzymes.
Secondary hypercholesterolemia, in contrast to primary hypercholesterolemia, develops as a result of acquired pathologies that lead to impaired fat transport. The following violations cause:
- alcoholism, smoking;
- dietary irregularities;
- endocrine diseases;
- genetic predisposition;
- acute and chronic diseases of the liver and kidneys.
Doctors distinguish another type of this pathology separately under the name familial hypercholesterolemia.
Familial hypercholesterolemia is a genetic disease that develops due to mutations in the low-density lipoprotein receptor genes.
This pathology occurs in 1 in 500 people. Familial hypercholesterolemia sometimes manifests itself immediately after birth; in such children, the amount of total cholesterol in the umbilical cord blood is 2-3 times higher. Treatment of this pathology is very long and difficult.
Despite the fact that hypercholesterolemia is not an independent disease, it is classified as a separate form according to the international classification of diseases (ICD 10) and has its own code. Pure hypercholesterolemia has a code according to ICD 10 E 78.0. This pathology refers to disorders of lipoprotein metabolism (ICD 10 code E78).
Diagnostics
The main method for diagnosing this disease is a detailed biochemical blood test, which determines:
- determination of cholesterol level (normally does not exceed 5.18 mmol/l);
- determination of low-density lipoproteins, high-density lipoproteins and triglycerides on an empty stomach;
- To exclude hypothyroidism, the level of thyroxine and TSH is determined.
Clinic
Symptoms of hypercholesterolemia are various accumulations of cholesterol in the tissues of the body. Cholesterol tumors – xanthomas – appear on the tendons. Orange pigmentation may appear on the eyelids and in the area of the wings of the nose. Such spots are also cholesterol depots and are called xanthelasmas. A grayish stripe may appear along the edge of the cornea of the eye, and this is also a cholesterol deposit.
Secondary symptoms of this disease are coronary heart disease, stroke, atherosclerosis, damage to the heart muscle. Although, it is worth noting that atherosclerosis is an advanced stage of hypercholesterolemia. After all, clinical manifestations occur when the level of cholesterol in the blood reaches critical values.
Treatment
Treatment of hypercholesterolemia is of great importance for the patient’s future life and the prevention of complications. For patients with hereditary hypercholesterolemia, medications that lower blood cholesterol levels are necessary. For this purpose, drugs from the statin group are prescribed, which by blocking an enzyme that enhances cholesterol synthesis, reduce the level of this substance in the blood.
The use of fibrates and bile acid sequestrants, which intensively break down excess cholesterol, is also indicated. But, it is worth noting that not always drug treatment is more effective than diet therapy. A diet with an excess of cholesterol provides for the exclusion of all fatty, fried, smoked, butter, sour cream and cream, yolks, pastries and sweets. A good example of healthy eating is the “plate model”, where:
- ½ – salad of vegetables and root vegetables;
- ¼ – side dish;
- ¼ – lean meats or poultry.
In the case of elevated blood cholesterol levels, a healthy lifestyle, exercise and a healthy balance of work and leisure work wonders. This is the basis of treatment, without which medications are ineffective.
In addition to pharmaceuticals, this ailment is well treated with folk remedies. One of the affordable and useful methods of traditional medicine is a rosehip decoction, which will not only lower cholesterol, but also saturate the body with vitamins. It is recommended to take it in the morning and evening, 100-150 ml.
Folk remedies can also improve lipid metabolism in the body. To this end, it is recommended to take a vice from the seeds of milk thistle in a teaspoon with meals.
In folk medicine, tinctures from licorice root are used. You can also prepare another useful infusion. Pour 10 g of crushed licorice root into a glass of boiling water and leave in a water bath for 40 minutes. After cooling, take 15 ml 5 times a day for 10 days. After a week's break, the course can be repeated.
To prevent the development of many diseases and reduce cholesterol levels to normal levels, you need to: adhere to a healthy lifestyle, exercise, eat healthy fortified foods, give up nicotine and alcohol, then no cholesterol will threaten your health.
Hypercholesterolemia - what is it? Translated from Greek - high cholesterol in the blood. This is a characteristic of the disease. Strictly speaking, hypercholesterolemia is not even a disease - a pathological syndrome, a symptom.
But in fact, it is the cause of many disorders in the activity of the heart and blood vessels. To assess the severity of a disease-symptom, you need to understand its origin and development features. This will help prevent the occurrence of hypercholesterolemia, and if it does occur, identify it in time and determine the optimal treatment methods.
Biochemical disorders
Biological chemistry helps to understand the mechanism of changes caused by one or another pathological process. The biochemistry of hypercholesterolemia is a failure in lipid metabolism. Different types of fats enter the human body. As a result of a complex, multi-step process, they are broken down and “processed” by appropriate enzymes. Free cholesterol does not dissolve in the blood.
Light fats in the split state are “captured” by red blood cells, transforming into chylomicrons - transport forms. With the flow of blood and lymph, they move throughout the body, carrying cholesterol. But in order to penetrate inside the organs, “transport” needs the help of lipoproteins - complexes of lipids and proteins.
It is lipoproteins that provoke the development of hypercholesterolemia. They differ in density. Low-density lipoproteins (LDL) are responsible for transporting cholesterol from the liver to organ tissues. This is mainly cholesterol that enters the body with food. When it increases, a lot of so-called “bad” cholesterol is transferred into the cells.
High-density lipoproteins (HDL) transport excess cholesterol from cells back to the liver. Hypercholesterolemia occurs when there are disturbances in the activity of lipoproteins.
Types of hypercholesterolemia
The pathological syndrome is classified based on the reasons for its development, but its varieties do not have specific features of the course or external manifestations. There are three types of hypercholesterolemia:
- Primary – transmitted to children “inherited” from parents. It is caused by gene defects and can be:
- Homozygous (damaged genes received from father and mother);
- Heterozygous (a gene with a defect was passed on by one of the parents).
- Secondary – a consequence of the development of certain diseases, conditions of the body;
- Nutritional – occurs with excessive consumption of animal fats.
The diagnosis of “pure hypercholesterolemia” is made to a patient when the cholesterol level exceeds 5.18 mmol/l. This is already a clear harbinger of atherosclerosis.
Symptoms of pathology
Hypercholesterolemia has no obvious signs and does not affect a person’s lifestyle and condition for the time being.
As the pathology progresses, its development may be indicated by: 
- Gray stripe along the periphery of the cornea of the eyes;
- Swellings and bumps (xanthomas) on the fingers, elbows, ankles, knees;
- Manifestations of angina pectoris.
Subsequently, cholesterol deposited on the walls of the arteries forms plaques. The passages of blood vessels narrow, their elasticity is lost, and blood flow deteriorates. Cholesterol plaques cause blood clots.
Signs of hypercholesterolemia smoothly "flow" into the symptoms of cardiovascular pathologies.
Primary (familial) hypercholesterolemia is a pathology that has not yet been fully investigated. Therefore, there is no such tool that would be guaranteed to prevent its occurrence.
The main causes of primary hypercholesterolemia are considered to be: 
- Defects in the structural structure of lipoprotein proteins. They are not able to interact with organ cells, cholesterol cannot get into them;
- Decreased production of “transport” enzymes. A lack of cholesterol is formed in one place and its excess in another;
- Disturbances in tissue cells. They lose the ability to contact lipoproteins.
The causes of secondary hypercholesterolemia can be:
Excessive consumption of animal fats is the main cause of hypercholesterolemia in the vast majority of patients.
Therapy for hypercholesterolemia
Lowering the concentration of cholesterol in the blood can be achieved by changing lifestyle and using medications. Adjusting your usual lifestyle with hypercholesterolemia is essentially preventive measures to maintain acceptable cholesterol levels.
If they do not help, the doctor takes medication measures, prescribing:
Treatment of hypercholesterolemia requires an integrated approach. Traditional medicine, affordable and safe, can help solve problems with cholesterol.
For hypercholesterolemia, a good effect is given by:
Diet for hypercholesterolemia
In the initial stages of hypercholesterolemia, it is enough to exclude foods with “bad” cholesterol from the diet. This measure will help keep its indicator within acceptable standards.
General guidelines regarding diet for hypercholesterolemia can be summarized in a few simple rules:
- Reduce the amount of calories consumed, especially with a sedentary lifestyle;
- Don’t overeat at night, control your body weight;
- Reduce the amount of animal fat consumed by replacing it with vegetable oils;
- Include foods containing vitamins and microelements in your diet;
- Do not give up eating lean meats;
- Limit salt intake;
- When choosing a dietary table, remember about food preferences and do not elevate prevention to the rank of punishment.
The table provides an approximate list of foods recommended and contraindicated in the diet for hypercholesterolemia.
With hypercholesterolemia, all dishes are steamed, boiled or baked.
The diet for hypercholesterolemia is varied and simple. Creating a menu should not cause any particular difficulties. The patient cannot do without meat, let him eat with pleasure. The main thing is that it is not greasy and fried.
A one-day meal for him may, for example, contain:
Prevention of hypercholesterolemia
To maintain an acceptable level of cholesterol in the blood, certain preventive measures should be taken.
According to the rules for the primary prevention of hypercholesterolemia (before it occurs), the patient needs:
Secondary prevention (with existing hypercholesterolemia) is designed to prevent the occurrence of vascular pathologies and the development of possible complications. Basically, it consists of the conservative pathology of hypercholesterolemia.
The course of hypercholesterolemia is affected by the concentration of "bad" and "good" cholesterol in the blood and the rate of manifestation of lesions.
The exclusion of modifiable risk factors and high-quality timely therapy can increase the patient's life expectancy and have a beneficial effect on its quality.
13. Hypercholesterolemia, its causes, consequences. Cholesterol-lowering nutrients.
Hypercholesterolemia is an excess of normal cholesterol concentration in the blood. The norm is 200 ± 50 mg / dl (5.2 ± 1.2 mmol / l) and, as a rule, increases with age.
Hypercholesterolemia often develops due to excess intake of cholesterol from food, as well as carbohydrates and fats. Proper nutrition throughout life is the most important factor in the prevention of hypercholesterolemia. Hereditary factors play an important role in predisposition to the development of atherosclerosis.
Reduce cholesterol levels: olive oil; other vegetable oils; marine fish oil; plant products rich in water-soluble fiber (cereals, wholemeal flour), pectin (apples, berries), soy. Water-soluble fiber, or dietary fiber, which is found only in plant-based foods, reduces the absorption of cholesterol in the intestine and reduces the concentration of total cholesterol by 10% and low-density lipoprotein cholesterol by 12% in the blood serum.
14. Atherosclerosis: biochemical causes, metabolic disorders, biochemical diagnostics, complications. Risk factors in the development of atherosclerosis, their mechanisms of action, prevention.
Atherosclerosis is the most common chronic disease that affects the walls of the arteries, resulting from a violation of the processing of fats (cholesterol, lipoproteins) in the body. Cholesterol accumulates and is deposited in the form of a build-up of “atherosclerotic plaques” in the inner wall of blood vessels (intima), as a result of which the arterial wall loses elasticity, becomes denser, the lumen narrows and, as a result, the blood supply to organs is disrupted.
Risk factors in the development of atherosclerosis:
Irrational nutrition. Constant consumption of foods high in fat and cholesterol; Obesity leads to the deposition of cholesterol on the walls of blood vessels; Hereditary predisposition (as a result of a congenital deficiency of certain enzymes involved in the breakdown of fats, there is an increase in their level in the blood and deposition in the walls of blood vessels); Male gender (women are protected to a certain extent by female sex hormones); Smoking (tobacco contains substances that damage the walls of blood vessels); Diabetes mellitus (fat metabolism disorder); Old age (related to lifestyle); Hormonal changes in the body; High blood pressure (damage to the inner wall of the arteries, leading to the deposition of cholesterol in damaged areas); Chronic alcohol use (decreased liver function, where fat is broken down); Psycho-emotional stress (increases cholesterol levels in the blood, damage to the arterial wall due to its toxic effect and its deposition on it); Coronary heart disease leads to disruption of the structure of the vascular wall and the loss of cholesterol into it.
Metabolic disorders in atherosclerosis are very diverse and mainly come down to hypercholesterolemia, hyperlipoproteinemia, dysproteinemia and the accumulation of coarse proteins.
Complications of atherosclerosis: angina pectoris, myocardial infarction, cerebral atherosclerosis (mental damage), trophic ulcers and gangrene of the limb, thrombosis of mesenteric vessels.
Diagnosis of atherosclerosis- biochemical blood test (lipidogram), Dopplerography, angiography.