What Questions Should I Ask My Doctor
- Do I need to make lifestyle changes, take medication or both?
- If I do what you tell me to do, how quickly can my numbers improve?
- How often do I need to check in with you?
A note from Cleveland Clinic
Hyperlipidemia, or high cholesterol, can let plaque collect inside your blood vessels and put you at risk of a heart attack or stroke. The good news is that you have the power to reduce your risk of heart attack and stroke. Exercising more and eating healthier are just two of the ways you can improve your cholesterol numbers. Taking medicine your provider orders makes a difference, too.
Last reviewed by a Cleveland Clinic medical professional on 08/09/2021.
What Medications Are Used For Hyperlipidemia
People who need medicine to treat their high cholesterol usually take statins. Your provider may order a different type of medicine if:
- You cant take a statin.
- You need another medicine in addition to a statin.
- You have familial hypercholesterolemia, a genetic problem that makes your bad cholesterol number extremely high.
Enhancing Healthcare Team Outcomes
Enhancing healthcare outcomes for patients with dyslipidemia has to involve a multidisciplinary treatment team, including clinical physicians such as cardiologists or endocrinologists, nurses, and pharmacists. Clinicians have to be aware of up to date guidelines on lipid screening, indication for treatment, and goals LDL-C levels. Nurses should adhere to the same awareness as physicians but also aid in maintaining close follow up with these patients to help improve adherence to medications. Pharmacists can assist in watching for drug interactions, counseling regarding potential adverse effects, and providing dosing instruction.
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Causes And Risk Factors
Hyperlipidemia is an imbalance of cholesterol in your blood caused by a combination of having too much LDL cholesterol and not enough HDL cholesterol to clear it up.
There are two main classifications of hyperlipidemia: familial and acquired. The familial type stems from genes you inherit from your parents.
The acquired type is the result of:
- underlying health conditions
What Is The Difference Between High Cholesterol And Familial Hypercholesterolemia
Is Hypercholesterolemia Hereditary?Risk Genetics vs LifestyleSymptoms
- Bumps or lumps around the knuckles, elbows, and knees, called xanthomas. These are formed when excess cholesterol deposits on tendons or under the skin and may be noticed by a dermatologist.
- Swollen or painful Achilles tendons . Excess cholesterol may deposit in the tendons, which makes them enlarged and may cause pain.
- Yellowish areas around the eyes .
- A white or grey arc near the colored part of the eye . This may be noticed by an ophthalmologist.
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Elevated Ldl Cholesterol In Children
Childhood risk factors besides family history and diabetes include cigarette smoking, hypertension, low HDL cholesterol , obesity, and physical inactivity.
For children, the American Academy of Pediatrics recommends dietary treatment for children with LDL cholesterol > 110 mg/dL .
Drug therapy is recommended for children > 8 years and with either of the following:
Poor response to dietary therapy, LDL cholesterol â¥ 190 mg/dL , and no family history of premature cardiovascular disease
LDL cholesterol â¥ 160 mg/dL and a family history of premature cardiovascular disease or â¥ 2 risk factors for premature cardiovascular disease
Drugs used in children include many of the statins. Children with familial hypercholesterolemia may require a second drug to achieve LDL cholesterol reduction of at least 50%.
Who Should Be Tested
Your GP may recommend that you have your blood cholesterol levels tested if you:
- have been diagnosed with coronary heart disease, stroke or mini-stroke , or peripheral arterial disease
- are over the age of 40 people over 40 should have their estimate of CVD risk reviewed regularly
- have a family history of early cardiovascular disease for example, if your father or brother developed heart disease or had a heart attack or stroke before the age of 55, or if your mother or sister had these conditions before the age of 65
- have a close family member who has a cholesterol-related condition, such as familial hypercholesterolaemia
- are overweight or obese
- have high blood pressure or diabetes
- have another medical condition, such as kidney disease, an underactive thyroid, or an inflamed pancreas these conditions can cause increased levels of cholesterol or triglycerides
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Nutrition And Dietary Supplements
In addition to eating a healthy diet, low in saturated fat, with plenty of whole grains, fruits, and vegetables, some specific foods and supplements may help lower cholesterol.
Fiber: Several studies show that soluble fiber lowers LDL cholesterol and triglycerides. Fiber can also help you lose weight because it makes you feel full. Your doctor will encourage you to get more fiber in your diet. You may also take a fiber supplement. Men should get 30 to 38 g of fiber per day. Women should get 21 to 25 g per day.
Beta-glucan is a type of soluble fiber found in oat bran and other plants. It slightly reduces LDL cholesterol, which is why oat bran is touted as a cholesterol-lowering food.
Soy: Many studies have shown that eating soy protein , rather than animal meat, helps lower blood cholesterol levels, especially when you eat a diet low in saturated fat. One study found that as little as 20 g of soy protein per day is effective in reducing total cholesterol, and that 40 to 50 g shows faster effects . Another study found that soy can help reduce triglyceride levels. The AHA recommends that people with elevated total and LDL cholesterol add soy to their daily diet, and that soy is safe when consumed as part of your regular diet. But talk to your doctor before you take soy supplements. Soy isoflavones may have estrogen-like effects in the body, which might lead to an increased risk of breast and other cancers.
Can I Pass Fh To My Kids
If you inherited FH from one parent, theres a 50% chance youll pass it on to your children. If both of your parents passed the FH trait to you, your children will definitely have FH. Thats why its crucial to get children with a family history tested at an early age and begin cholesterol-reducing treatment for those with FH.
People with FH are usually not diagnosed until their 30s or 40s or later. Unfortunately, far too few are diagnosed as children. But early treatment can significantly impact a persons lifetime cardiovascular health by lowering their long-term exposure to high cholesterol levels, Martin advises. The treatment keeps their arteries healthier and prevents premature heart attacks and strokes.
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Are There Any Treatments For High Cholesterol Levels Caused By Genetics
Usually, the first line of treatment for high cholesterol is lifestyle modification, but if you have FH youll need more advanced treatment. Its always important to eat a low-fat diet, exercise and control your weight. Having a healthy lifestyle is crucial for heart health and for overall health, says Martin. However, people with FH could eat an extremely low-fat diet and still not be able to control their cholesterol because theyre genetically unable to handle it. For them, cholesterol is going to build up in the bloodstream regardless of what they eat.
Fortunately, there are medications that can substantially lower LDL cholesterol levels. The most common treatment for FH is statin drug therapy. Statin drugs work by blocking an enzyme that produces cholesterol in the liver and increases your bodys ability to remove cholesterol from the blood. They can lower your LDL cholesterol levels by 50 percent or more. Statins have been safely used to reduce the risk of heart disease for 30 years and continue to be the number one option when it comes to helping people with FH.
Other treatment options include medications that block cholesterol from being absorbed from your intestines into your bloodstream, or drugs that block an enzyme called PCSK9, which reduces the amount of LDL cholesterol in your blood.
Diagnosis Index entries containing back-references to Z13.220:
Consequently, what is pure hypercholesterolemia unspecified?
What is DX code e7800?
Deterrence And Patient Education
As discussed above, patients need to recognize and adhere to specific health behaviors that can maintain and lower lipid levels. These include, but are not limited to, weight control, which includes a heart-healthy diet and exercise as well as avoidance of tobacco. Patients should also engage in conversation with their primary care providers on when to start getting screened or when to initiate treatment, as stated above.
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Diagnosis Of Cardiovascular Diseases
The occurrence of CVD among participants at follow-up was ascertained by taking a detailed medical history, followed by a physical examination by a specialist Cardiologist. Electrocardiograms were checked by the cardiologist for the evidence of alterations in P, QRS, T and especially Q wave by using the Minnesota Code . If the cardiologist suspected a diagnosis of CVD, further examinations were undertaken that included echocardiography, stress echocardiography, radioisotope, angiography, Computed Tomography angiography, and Exercise Tolerance Test . The definitive diagnosis was based on the consensus agreement of a panel of experts among 235 subjects including 120 subjects with unstable angina, 75 subjects with stable angina, and 40 subjects with myocardial infarction. Finally, we excluded 2 CVD patients due to missing data regarding lipid profile .
Why Should I Lower My Cholesterol
Evidence strongly indicates that high cholesterol can increase the risk of:
- narrowing of the arteries
- transient ischaemic attack often known as a âmini strokeâ
- peripheral arterial disease
This is because cholesterol can build up in the artery wall, restricting the blood flow to your heart, brain and the rest of your body. It also increases the risk of a blood clot developing somewhere in your body.
Your risk of developing coronary heart disease also rises as your bloodâs cholesterol level increases. This can cause pain in your chest or arm during stress or physical activity .
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Is Dyslipidemia A Heart Condition
Dyslipidemia is not heart disease or condition. It is a metabolic disorder that tends to cause blood vessel or vascular disease, which ends up directly affecting the heart. Therefore, dyslipidemia is a disease that causes complications, and they are mostly found in this organ, among others.
Importantly as we just saw, dyslipidemia, among other diseases, plays a significant role in promoting and the progression of atherosclerosis, which is in direct relation to coronary artery disease, hence heart disease.
Atherosclerotic cardiovascular disease yields awful complications. Coronary artery disease could end on a heart attack and overall heart dysfunction and illness.
A thorough description of the cardiovascular and other complications of dyslipidemia will be in the complications question.
What Is The Difference Between Good Cholesterol And Bad Cholesterol
Good cholesterol is known as high-density lipoprotein . It removes cholesterol from the bloodstream. Low-density lipoprotein is the bad cholesterol.
If your total cholesterol level is high because of a high LDL level, you may be at higher risk of heart disease or stroke. But, if your total cholesterol level is high only because of a high HDL level, youre probably not at higher risk.
Triglycerides are another type of fat in your blood. When you eat more calories than your body can use, it turns the extra calories into triglycerides.
Changing your lifestyle can improve your cholesterol levels, lower LDL and triglycerides, and raise HDL.
Your ideal cholesterol level will depend on your risk for heart disease.
- Total cholesterol level less than 200 is best, but it depends on your HDL and LDL levels.
- LDL cholesterol levels less than 130 is best, but this depends on your risk for heart disease.
- HDL cholesterol levels 60 or higher reduces your risk for heart disease.
- Triglycerides less than 150 milligrams per deciliter is best.
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General Information About The Privacy Of Information
What is personal data? It is any information related to you, for example, your name, telephone, address, photograph, or fingerprints, as well as any information for your identification.
What is sensitive personal data? It is the data that, if unduly disclosed, would affect the most intimate sphere of the human being for example origin, health status, genetic information, sexual preferences, religious, philosophical, moral beliefs, union affiliation, political opinion, among others.
How do we guarantee the protection of your data?
- Appointing a responsible person in charge who will attend your requests for access, rectification, cancellation, and opposition of your personal data.
- With the necessary security measures to guarantee your data against misuse or illicit use, unauthorized access, or against the loss, alteration, theft, or modification of your personal information.
- Training staff.
- Informing you about how it will be used for your information.
What are the guiding principles of personal data protection? They are a series of minimum rules that should be observed by private entities that process personal data , ensuring the proper use of personal information. These principles are:
What are ARCO Rights? Access, Rectification, Cancellation, and Opposition
What Are The Symptoms
You could have dyslipidemia and never know it. Like high blood pressure, high cholesterol doesnt have obvious symptoms. Its often discovered during a routine blood test.
However, dyslipidemia can lead to cardiovascular disease, which can be symptomatic. High LDL cholesterol levels are associated with coronary artery disease , which is blockage in the arteries of your heart, and peripheral artery disease , which is blockage in the arteries of your legs. CAD can lead to chest pain and eventually a heart attack. The main symptom of PAD is leg pain when walking.
Several behaviors can lead to dyslipidemia. They include:
- cigarette smoking
- obesity and a sedentary lifestyle
- consumption of foods high in saturated fat and trans fat
Excessive alcohol consumption may also contribute to higher triglyceride levels.
Youre at a higher risk of primary dyslipidemia if one or both of your parents had dyslipidemia.
Advancing age is also a risk factor for high cholesterol. Women tend to have lower LDL levels than men until menopause. Thats when womens LDL levels start to rise.
Other medical conditions that can raise your dyslipidemia risk include:
- type 2 diabetes
- chronic kidney disease
Also, a low HDL cholesterol level is associated with a high LDL level, though the two numbers dont always move in tandem.
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Lab Artifacts That May Interfere With Readings Of Levels Of This Substance
Lipemia can predispose to artifactual hemolysis during blood sample collection. Lipemia interferes with many laboratory tests. It is likely to cause artifactually high results for hemoglobin and mean corpuscular hemoglobin concentration on a complete blood count . It is likely to cause artifactually high estimates of the plasma protein level as determined by refractometry. Lipemia may have adverse effects on many serum/plasma biochemical tests. Specific effects depend upon the methodology used, the severity of the lipemia, and the laboratory’s success in clearing lipemia prior to specimen analysis.
Shlomo Melmed MB ChB, MACP, inWilliams Textbook of Endocrinology, 2020
Symptoms Of High Blood Cholesterol And Triglycerides
High cholesterol typically doesnt cause any symptoms. Symptoms may only appear after the increased cholesterol has caused significant damage.
For instance, symptoms may come in the form of heart disease symptoms, such as chest pain or nausea and fatigue. A heart attack or stroke may result from uncontrolled cholesterol, among other things.
S To Lower Cholesterol And Risks Of Related Diseases
A few simple changes can lower your cholesterol and cut your risk for conditions linked to high cholesterol.
Elevated Ldl Cholesterol Treatment
For all individuals, the prevention of ASCVD requires an emphasis on a heart-healthy lifestyle, particularly diet and exercise. Other options to lower LDL cholesterol in all age groups include drugs, dietary supplements, procedural interventions, and experimental therapies. Many of these options are also effective for treating other lipid abnormalities.
Dietary changes include
PCSK9 monoclonal antibodies are available as subcutaneous injections given once or twice per month. These drugs keep PCSK9 from attaching to LDL receptors, leading to improved function of these receptors. LDL cholesterol is lowered by 40 to 70%. Cardiovascular outcomes trials with evolocumab and alirocumab showed a decrease in cardiovascular events in patients with prior atherosclerotic cardiovascular disease , or both, or a low high-density lipoprotein cholesterol level that contributes to the development of atherosclerosis… read more ).
Dietary supplements that lower LDL cholesterol levels include fiber supplements and commercially available margarines and other products containing plant sterols or stanols. Fiber supplements decrease cholesterol levels in multiple ways, including decreased absorption and increased excretion. Oat-based fiber supplements can decrease total cholesterol by up to 18%. Plant sterols and stanols decrease cholesterol absorption by displacing cholesterol from intestinal micelles and can reduce LDL cholesterol by up to 10% without affecting HDL or TGs.
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