High Cholesterol

High Cholesterol or Hypercholesterolemia is a medical condition that can have serious consequences if not seen and treated appropriately. The medical condition is called Hypercholesterolemia.

Cholesterol is a substance or molecule that is found in the fats of your blood. Cholesterol is waxy and required in your body to help build healthy cells.

It occurs when there is an excess level of Cholesterol that is found in the blood. Often there are elevated levels of lipoproteins are seen.

High Cholesterol levels can be dangerous if left untreated and can lead to serious consequences. The problem then arises when “high” amounts can be found.

High Triglycerides is a term used to refer to elevated Triglycerides in the body.

Symptoms:

–  Typically no specific symptoms are seen

  –  Xanthoma – deposits of cholesterol under the skin

Potential Causes:

Primary

–  Excess production of cholesterol by the liver

Secondary

–  Excess consumption of cholesterol
–  Diabetes
–  Kidney problems
–  Hypothyroidism
–  Obesity
–  Decreased exercise
–  Sedentary lifestyle
–  Smoking
–  Large waist circumference
–  others

Complications

–  Atherosclerosis
–  Cardiovascular disease
–  Coronary Artery Disease
–  Myocardial Infarction
–  Stroke
–  Peripheral vascular disease
–  others

Diagnosis

1.)  Blood work to check lipid levels

Includes:

–  Cholesterol
–  Triglycerides
–  LDL
–  VLDL
–  HDL

Interpreting the numbers

1.)  In the United States, cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood.

2.)  In Canada and many European countries, cholesterol levels are measured in millimoles per liter (mmol/L). To interpret your test results, use these general guidelines.

         United States numbers         Canada and most of Europe

Total cholesterol  Total cholesterol   Outcome
Below 200 mg/dL Below 5.2 mmol/L Desirable
200-239 mg/dL 5.2-6.2 mmol/L Borderline high
240 mg/dL and above Above 6.2 mmol/L High
LDL cholesterol  LDL cholesterol Outcome
Below 70 mg/dL Below 1.8 mmol/L Best for people who have heart disease or diabetes.
Below 100 mg/dL Below 2.6 mmol/L Optimal for people at risk of heart disease.
100-129 mg/dL 2.6-3.3 mmol/L Near optimal if there is no heart disease. High if there is heart disease.
130-159 mg/dL 3.4-4.1 mmol/L Borderline high if there is no heart disease. High if there is heart disease.
160-189 mg/dL 4.1-4.9 mmol/L High if there is no heart disease. Very high if there is heart disease.
190 mg/dL and above Above 4.9 mmol/L Very high
HDL cholesterol  HDL cholesterol

 Outcome

Below 40 mg/dL (men)
Below 50 mg/dL (women)
Below 1 mmol/L (men)
Below 1.3 mmol/L (women)
Poor
50-59 mg/dL 1.3-1.5 mmol/L Better
60 mg/dL and above Above 1.5 mmol/L Best
Triglycerides  Triglycerides  

Outcome 

*Canadian and European guidelines differ slightly from U.S. guidelines. These conversions are based on U.S. guidelines.
Below 150 mg/dL Below 1.7 mmol/L Desirable
150-199 mg/dL 1.7-2.2 mmol/L Borderline high
200-499 mg/dL 2.3-5.6 mmol/L High
500 mg/dL and above Above 5.6 mmol/L Very high

Treatment for High Cholesterol

1.)  Lifestyle Changes

–  Exercise
–  Healthy Eating
–  Low Cholesterol diet

2.)   Statins

–  Medication that blocks the “ingredients” in your liver to make cholesterol

–  Also helps remove Cholesterol from your blood.

.         Atorvastatin  (Lipitor)
.         Fluvastatin  (Lescol)
.         Lovastatin  (Altoprev)
.         Pitavastatin (Livalo)
.         Pravastatin (Pravachol)
.         Rosuvastatin (Crestor)
.         Simvastatin (Zocor)

3.)   Cholesterol Absorption Inhibitors

–  Since cholesterol can be absorbed in your intestines from your diet – this medication helps prevent absorption.

.         Ezetimibe  (Zetia)

–  This medication can be combined with a STATIN

4.)  Bile-Acid Binding Resins

–  Lowers cholesterol by indirectly binding to bile acids.

–  This helps increase the use of cholesterol – therefore decreasing its availability and decrease the elevated amount.

.         Cholestyramine  (Prevalite)
.         Colesevelam (Welchol)
.         Colestipol  (Colestid)

5.)  Injectable Medications

–  Absorbs LDL Cholesterol
–  Lower amount of cholesterol available in the bloodstream

.          Alirocumab (Praluent)
.          Evolocumab (Repatha)

Treatment for High Triglycerides

1.)  Lifestyle Changes

–  Exercise
–  Healthy Eating
–  Low Cholesterol diet
–  Low Triglyceride diet

2.)  Fibrates

–  Reduces production by liver of very-low-density lipoproteins (VLDL)
–  Speeds up the removal of Triglycerides from the blood.

.        Fenofibrate  (TriCor, Fenoglide)
.        Gemfibrozil  (Lopid)

3.)  Niacin

–  Decreases the production of LDL and VLDL

4.)  Omega-3 Fatty Acid Supplements

–  Can help lower Triglycerides
–  Available over the counter

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