Hypercholesterolemia : definition, causes, complications ...
The cholesterol is one of body fat essential to the body that is present in every cell of the body. It serves as a basic material for the synthesis of a large number of hormones, contributes to the maintenance and stability of cell membranes.
The blood cholesterol is mainly synthesized by the liver and the intestine, it is then brought into the blood by transporters. Transporters are lipoproteins, there are two types, low density lipoproteins and high density lipoproteins, it is these two types of lipoproteins that correspond to "bad" and "good" cholesterol . Cholesterol needs to be associated with these molecules because it is not soluble either in water or in the blood.
Low density lipoproteins
Called LDL , for Low Density Lipoprotein, they transport cholesterol from the liver to the tissues. When there is too much cholesterol associated with LDL lipoproteins, it accumulates on the artery walls, thus increasing the risk of developing cardiovascular diseases. This is why it is called " bad cholesterol ".
High density lipoproteins
Called HDL , for High Density Lipoprotein, they transport cholesterol from the tissues to the liver for elimination and to prevent its accumulation in the tissues. They make it possible to clean the arteries of poor quality lipid deposits and thus reduce the risk of the appearance of an atheromatous plaque, that is to say a plaque of fat lining the wall of the blood vessels. This is why it is called " good cholesterol ".
The total cholesterol level depends on the LDL cholesterol and HDL cholesterol levels. This rate is calculated by blood dosage taken on an empty stomach and must be less than 2g / L. During this assay, the HDL cholesterol level is also measured, which must be greater than 0.6 g / L, and the limit LDL cholesterol level can thus be calculated, which must be less than 1.6 g / L.
If the cholesterol level is greater than 2g / L, then we speak of hypercholesterolemia .
Definition of hypercholesterolemia
The hypercholesterolemia is a disorder of lipid metabolism, which corresponds to an increase of cholesterol levels in the blood. This disorder is more precisely due to an increase in the level of LDL cholesterol, which is found in large quantities in the blood. The liver can then no longer eliminate all the cholesterol - LDL which accumulates and is deposited on the vascular walls which increases the risk of atherosclerosis and consequently that of cardiovascular diseases.
High cholesterol is often accompanied by an increase in triglyceride levels in the blood. Triglycerides are lipids which make up most of the fatty tissue in the human body, and which represent the body's greatest store of energy. They are provided by an unbalanced diet and excessive alcohol consumption. A high level of triglycerides in the blood promotes the occurrence of cardiovascular disease and contributes to the development of atherosclerosis. A normal triglyceride level is less than 1.7 mmol / L.
Causes of high cholesterol
The causes of hypercholesterolemia are congenital or acquired. In 80% of cases, hypercholesterolemia is linked to genetic factors.
Familial hypercholesterolemia
It is characterized by a mutation of the gene encoding the cholesterol receptor -LDL on cells. If the receptor is absent from the cells, LDL-cholesterol remains in the blood and accumulates, which causes the appearance of deposition of "bad" cholesterol. This type of hypercholesterolemia can appear from childhood, and causes the appearance of xanthomas, these are small balls of yellow cholesterol that are deposited on the tendons and on the skin.
Medical conditions
Certain conditions can lead to an increase in the level of cholesterol in the blood, such as hypothyroidism, diabetes or kidney failure.
Environment, age and lifestyle
Everyone's lifestyle obviously affects health and can lead to an increase in cholesterol , this is a risk factor that is often associated with a genetic factor. Indeed, a diet rich in fats and sugars as well as an absence of physical activity lead to overweight and thus an increase in LDL cholesterol . Men over 45 and postmenopausal women over 55 have a higher risk of high cholesterol.
Complications related to hypercholesterolemia
As mentioned above, high cholesterol increases the risk of cardiovascular disease , stroke, and fatty body deposits in arteries or tissues.
This fatty deposit forms a plaque on the blood vessels, and can also clog arteries, including the coronary artery that irrigates the heart. This phenomenon is called atherosclerosis , it is a hardening of the arteries that increases the risk of chest pain and heart attacks.
There are no symptoms of hypercholesterolemiastrictly speaking, we speak of a "silent" disorder. In general, when you realize this disorder, the arteries have already lost 75% to 90% of their functionality. This is why it is important to regularly check your total cholesterol and blood triglyceride levels in order to take the necessary measures as quickly as possible.
How to lower your cholesterol level?
The goal of cholesterol lowering therapy is to reduce the occurrence of cardiovascular disease and stroke . It depends on the lipid values obtained during the blood test and on the presence or absence of other risk factors for heart and vascular diseases. There are two types of treatments:
Non-drug therapy
When one suffers from hypercholesterolemia the first step to take is to review one's diet and frequency of physical activity. Indeed, a balanced diet with a minimum of lipids and foods high in cholesterol can reduce excess weight and limit the intake of saturated fat. Endurance sports activities, such as long-distance running, brisk walking, and swimming, lower LDL-cholesterol levels by slightly increasing HDL-cholesterol levels.
Medical treatment
Drug therapy should be considered if the improvement of lifestyle is not enough to reduce the levels of cholesterol , or the present risk factors of patient cardiovascular disease (family history, cardiovascular disease already established age , arterial hypertension, smoking…). In this case, treatments based on the following components may be prescribed:
Statins : lower LDL cholesterol levels. Statins inhibit the action of an enzyme that participates in the synthesis of cholesterol
Fibrates: reduce LDL cholesterol levels
Inhibitors of intestinal cholesterol absorption: colestyramine and ezetimibe bind cholesterol from food and eliminate it in the stool.
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