A B C D E F G H I J K L M N O P R S T U V W

CHOLESTEROL PROBLEMS - HYPERCHOLESTEROLAEMIA

What are Cholesterol Problems ?

Cholesterol and triglycerides are the names of two important fats found in the blood. Some of these fats come from what you eat, and some manufactured by your liver. Too much fat in the blood is known to be harmful to the arteries of most people. There are two main types of cholesterol: most of it is of the less desirable type, called LDL (low density lipoprotein). Some is the good type, called HDL (high density lipoprotein); this type actually protects arteries. When cholesterol and triglyceride levels in the blood are high, they seep into the walls of the arteries in all parts of the body. Here they cause thickening and hardening so that the artery walls narrow down and don't let the blood through quite so easily. This condition is called arteriosclerosis . The lining of the artery also becomes roughened. Blood cells will then tend to stick to the inside wall of the artery and a blood clot can form. This clot can block the artery or be dislodged and slide further down the artery directly into the organ which it is supposed to be supplying with fresh blood. This is called embolism. If the organ is the brain, then the result of narrowing or blockage will be a stroke. If the organ is the heart, it will produce angina or a heart attack. It can also affect the arteries of the legs causing pain on walking and even gangrene. All arteries of the body seem to share the risk, but some more so than others. If the fat levels in the blood are really high, they get deposited in the skin. This can take the form of little yellow lumps on the eyelids and tendons of the hands and knees. Sometimes the deposit takes the form of a white ring (called an arcus) on cornea of the eye.

How do Cholesterol Problems occur ?

Some foods such as egg yolk and fatty meats are very rich in cholesterol. Big eaters of these foods can have very high cholesterol levels. However, most types of animal fat will help to raise the cholesterol level. People who are overweight, have diabetes, eat lots of sweets and fried food, or drink too much alcohol tend to get high triglyceride levels. These are somewhat less dangerous to the arteries, but still quite harmful.

Why do Cholesterol Problems occur ?

Not everyone who eats the unhealthy foods mentioned above gets a rise of their blood fat levels to the same degree. Furthemore, some people are born with a tendency to make too much of these fats in their own liver. They may not need much fatty food to cause high levels in the blood. A few people make so much of their own fats that their cholesterol and triglyceride levels are extremely high even when they eat a perfectly healthy diet. This last group of people have often inherited this tendency and can pass it on to the next generation. They are also the ones who are most likely to develop artery blockage troubles.

Treatment Involved for Cholesterol Problems

Your doctor may have found your abnormal cholesterol or triglyceride level by a routine screening test, or it may have been done because you already have some artery problem. In either case, extra tests will probably be done to confirm the exact type of chemical abnormality. Apart from measuring the different cholesterols, your doctor may measure another chemical called Lp(a). If raised, this is a further reason for really trying to lower your cholesterol as much as possible. An underactive thyroid gland is occasionally a cause of a high blood cholesterol, and your doctor will check for this, too. We know that lowering fat levels reduces the risk of blockage, and may actually reverse the "hardening" of the arteries and allow them to widen again. We do not know whether it is worth lowering blood fats in people over age 65: the damage may be permanent! Most doctors agree that certainly up to age 65, fat levels should be made as normal as possible. If you have already had a heart attack it becomes even more important. Your doctor or dietitian will first want to know exactly what you eat and drink, what you weigh and what your blood pressure is. Losing weight to a normal level is always desirable. You will be given diet advice by your doctor or a dietitian. Regular exercise will also help to lower the fat levels. If you have diabetes, better blood sugar control will also help. If the level of fat has not fallen after trying these approaches for 2 or 3 months, your doctor may suggest one of the available drugs. Some drugs work by interfering with the way fats are taken in from the bowel: others work by stopping your liver from making fats. Once these drugs are started, they usually must be taken for all of your life. Blood tests will be checked regularly to make sure that they have brought your blood fat levels as close as possible to normal: a cholesterol of no more than 5.6 mmol per litre (215 mg per 100 ml) and a triglyceride of no more than 1.8 mmol per litre (160 mg per 100 ml) is desirable. Your problem may be that you have too little of the "good" (HDL) type of cholesterol: one group of drugs called fibrates are quite good at raising your HDL level. It is important to realize that high fat levels are only one cause of hardening of the arteries. Smoking, stress and high blood pressure all need seeing to; otherwise you could be wasting your time!

During Treatment for Cholesterol Problems

Blood tests will be done regularly to check whether your fat levels are reducing. They also show if there is any damage to the liver from the drugs that are being used, although this is uncommon. Please tell your doctor if you get leg cramps, indigestion or any other unusual symptom: these may be due to the fat-lowering drugs. Do not expect to feel better as a result of your treatment: your diet and drugs are there to provide long-term investment in better health.

If Cholesterol Problems are Left Untreated

Your life expectancy may be reduced. Broadly speaking, bringing down your fat levels to normal if you are under age 60 could reduce your chance of having a heart attack or stroke by as much as about 30 to 40%.

Effects on Family of Cholesterol Problems

Your whole family should follow the same diet: it is easier for you, and healthier for them! Find out from your doctor if you have the inherited type of fat problem: it is then worth checking your family: the younger they are when abnormalities are found, the better will be the preventive effect of diet and possibly drugs.