Hypercholesterolemia: types, causes, symptoms and treatment
Being responsible for 15 million of the 56 million deaths registered annually in the world, cardiovascular diseases, that is, all those pathologies that affect the heart and / or blood vessels, are the leading cause of death.
There are many factors that lead to developing cardiovascular disorders, from being overweight to physical inactivity, through alcoholism, poor diet, genetic inheritance, sedentary lifestyle (physical inactivity) and, of course, high cholesterol levels.
In this sense, hypercholesterolemia, which is defined as an increase in cholesterol levels sufficient to affect health, is one of the main risk factors for these life-threatening diseases: heart attacks, strokes, heart failure , hypertension, strokes ...
Taking into account that it opens the doors to many pathologies and that, according to estimates, until the 55% of the adult population suffer from some form (more or less severe) of hypercholesterolemia, it is essential to understand its causes, symptoms, prevention and available treatments. And this is precisely what we will do in today's article.
What is hypercholesterolemia?
Hypercholesterolemia is a physiological condition (it is not a disease as such, but it is a risk factor for developing many) in which the amount of cholesterol in the blood is over of the levels considered "normal", that is, those that do not increase the risk of suffering from cardiovascular health problems.
But what is cholesterol? Is it true that there is a “good” and a “bad” one? Let's see it. Cholesterol is a type of lipid (commonly known as fat) that is found naturally in our bodies. In the form of lipoprotein (lipid + protein), cholesterol is absolutely necessary for the proper functioning of the body.
Their presence in the blood is vital, since the body needs these fats to form the membrane of all our cells, as well as to form hormones, absorb nutrients, metabolize vitamins and maintain a good fluidity of the blood.
The problem is that there are two forms of cholesterol. On the one hand, we have HDL cholesterol (high-density lipid, for its acronym in English), popularly known as "good" cholesterol, because being high-density, it fulfills the biological functions that we have seen and does not accumulate in the blood vessel walls.
On the other hand, we have the LDL cholesterol (low-density lipid, for its acronym in English), known as “bad” cholesterol, which, although it also carries fat particles necessary for the body, due to its density, it can accumulate on the walls of Blood vesels. And this is when the problems come.
In this sense, hypercholesterolemia is the situation in which an increase in the levels of LDL or "bad" cholesterol is observed, which is usually accompanied by a decrease in the levels of HDL or "good" cholesterol, since the latter, if it is in the right amounts, it is capable of collecting excess "bad" cholesterol and taking it to the liver to be processed.
Therefore, hypercholesterolemia is linked to an increase in "bad" cholesterol levels and a decrease in "good" cholesterol. Be that as it may, we speak of hypercholesterolemia when total cholesterol values are above 200 mg / dl (milligrams of cholesterol per deciliter of blood) and those of "bad" cholesterol, above 130 mg / dl.
Types and causes
Hypercholesterolemia, which we have already seen is a situation in which cholesterol levels are too high, can be due to different factors. And depending on it, we will be facing one type of hypercholesterolemia or another. So let's see how we classify it.
1. Primary hypercholesterolemia
Primary hypercholesterolemia encompasses all those cases in which high cholesterol levels are not due to the symptoms of another disease, but are the problem themselves. That is, the increase in cholesterol is not associated with another pathology. Is the most usual way. In this sense, hypercholesterolemia can be mainly due to two things: genetic inheritance or lifestyle.
1.1. Familial hypercholesterolemia
Familial hypercholesterolemia includes all those cases of high cholesterol whose appearance is due to a genetic predisposition of hereditary origin, that is, it comes from the genes received from the parents. It is estimated that there are about 700 possible genetic mutations that affect the gene responsible for the synthesis of "bad" cholesterol, which explains its high incidence. Having a genetic origin, prevention is more difficult. And people have to always fight and adopt very healthy lifestyles to prevent the problem from getting worse.
1.2. Polygenic hypercholesterolemia
As its name suggests, polygenic is that form of hypercholesterolemia in which many different genes are involved, but there is no hereditary component. In people with this type of hypercholesterolemia, there may be a genetic predisposition (not inherited), but what most determines the appearance of the disorder it's the lifestyle.
Not practicing sports, eating a bad diet (with a lot of saturated fats), not sleeping the necessary hours, drinking, smoking, not controlling weight ... All this leads to an increase in cholesterol levels and / or the expression of genes associated with hypercholesterolemia.
2. Secondary hypercholesterolemia
Secondary hypercholesterolemia refers to all those cases in which the increase in the amount of cholesterol in the blood it is the symptom of another disease. Endocrine (such as hypothyroidism or diabetes), liver (liver disease) and kidney (kidney disease) disorders usually have, as a symptom or as a side effect, an increase in cholesterol levels. As we can see, determining the cause is very important to correctly approach the treatment.
Symptoms and complications
The main problem of hypercholesterolemia is, unless it is secondary and there are clinical signs of the disease causing the increase in cholesterol, which does not give symptoms. Until complications appear, there is no way to know that blood cholesterol levels are too high.
Therefore, it is very important, especially if you are in the risk population (overweight, elderly, poor diet, smoker, sedentary ...), there is a family history of hypercholesterolemia or you suffer from endocrine, liver or kidney disease, to check periodically cholesterol levels by blood tests.
And is that if it is not controlled, the "bad" cholesterol can accumulate on the walls of the blood vessels, causing an accumulation of fats and other substances with aggregating capacity in the arteries. These plaques reduce blood flow and get bigger and bigger, which can lead to very dangerous complications. This situation is known clinically as atherosclerosis.
Among the complications we have chest pain (because the arteries that supply blood to the heart are damaged), but the real problem comes when these plaques break off, thus transforming into a clot that travels through the bloodstream until it reaches an artery that they can plug. Depending on whether this tamponade obstructs blood flow to the heart or part of the brain, you will have a heart attack or stroke, respectively.
Both complications are among the most serious medical emergencies (and, unfortunately, common), because even offering medical assistance quickly, there is a high probability that the patient will die or be left with sequelae. 6 million people die each year from heart attacks. And, although it is not the only cause, hypercholesterolemia is behind many of these deaths.
Prevention and treatment
Obviously, there is treatment for hypercholesterolemia, but it is usually pharmacological in nature and linked to side effects that can sometimes be serious. Therefore, treatment should be the last resort. The best treatment is prevention.
And it is that despite the fact that cases of familial hypercholesterolemia are of a Hereditary, even these people can (usually) avoid cholesterol problems by adopting healthy lifestyle habits. The environmental (lifestyle) factor is the most determining factor.
Maintain a healthy weight, play sports, eat a diet low in processed and animal fats, do not smoke (or quit), drink alcohol in moderation, manage stress, get enough sleep, reduce salt intake, eat plenty of fruits , vegetables and cereals ...
However, if these lifestyle changes do not seem to work or the necessary reduction in cholesterol levels is not achieved, a doctor may prescribe some medications. In any case, these are reserved for severe cases (when there is a real risk of developing the complications that we have seen) in which healthy habits do not work, either due to the weight of the hereditary component or because the person does not respond well.
Combined with a balanced diet and physical exercise, there are drugs that help lower cholesterol levels. One of the most prescribed is Simvastatin, a drug that inhibits the synthesis of an enzyme present in the liver that is linked to the release of lipids and cholesterol.
There are other treatments, but always of a pharmacological nature, with associated side effects (blurred vision, digestive problems, headache, hair loss, loss of appetite ...), so it is the last resort when there is a high risk of developing a cardiovascular disease. As we have said, the best treatment (and the one usually works almost always) is to adopt a healthy lifestyle.