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Hypercholesterolemia - Types, Symptoms, Causes, Diagnosis and Treatment

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Hypercholesterolemia - Types, Symptoms, Causes, Diagnosis and Treatment

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High cholesterol levels have been one of the leading contributing factors to death in recent years. This article explains the impact of high cholesterol levels.

Medically reviewed by

Dr. Rajiv Kumar Srivastava

Published At October 9, 2021
Reviewed AtOctober 5, 2023

What is Cholesterol?

Cholesterol is a kind of fatty substance or lipid that circulates within the human body and the blood. It is waxy in appearance and an inherent part of all the cells in the human body. Our human body itself produces cholesterol, and the liver is the site of cholesterol synthesis. Apart from this, human beings gain cholesterol from animal-based foods and food products, such as poultry, meat, dairy products, and also from oils, such as palm oil, coconut oil, hydrogenated oils, and vegetable ghee. Lipoproteins are the substances that carry cholesterol in circulation. These lipoproteins are of two types,

  • High-density lipoproteins (HDL).

  • Low-density lipoproteins (LDL).

HDL is also known as good cholesterol, and LDL is known as bad cholesterol.

Cholesterol is essential for normal bodily functions. It performs vital functions like,

  • Aids in producing sex and stress hormones.

  • Aids in bile production.

  • Provides insulation.

  • Aids in vitamin D production.

  • Helps in the formation and maintenance of cell membrane and its structure.

If Cholesterol Is Vital, Why Is It Bad?

“Too much of anything is good for nothing,” and the same applies to cholesterol too. Cholesterol is vital and is not bad until it is maintained within its limits. Both high and low cholesterol levels cause adverse health effects, but the latter condition is relatively rare to occur.

What Is Hypercholesterolemia?

Hypercholesterolemia is simply high blood cholesterol levels. But it is not as simple as it is defined. High blood cholesterol levels could be life-threatening. It is a lipid disorder and is also known as hyperlipidemia. Though it is undeniably needed by the body to perform certain vital functions, cholesterol beyond its normal range can pose a danger to health. The normal range of types of cholesterol in healthy individuals is tabulated below.

Blood cholesterol levels

What Are The Different Types of Cholesterol?

The cholesterol in our body is differentiated into four types based on its positive and negative effects on our health. These cholesterol types are the ones that are frequently assessed in the lipid profile blood tests. They include,

  • Total cholesterol.

  • High-density lipoproteins (HDL) or good cholesterol.

  • Low-density lipoproteins (LDL) or bad cholesterol.

  • Very low-density lipoproteins (VLDL)

Total Cholesterol: As the name suggests, it measures the total cholesterol levels (HDL+LDL) in the blood. They give an overall outlook on a person’s cholesterol levels.

High-Density Lipoproteins (HDL): Lipoproteins are substances that are composed of both fat and protein, and these lipoproteins carry the cholesterol in the bloodstream. When a lipoprotein contains more protein and less fat, it is known as high-density lipoprotein. These are termed good cholesterol because they are not associated with heart diseases. In fact, they are protective against heart diseases and stroke as they help reduce LDL levels by carrying them from the arteries to the liver, from where the LDL is further broken down and eliminated from the body. Hence, having high levels of HDL can prevent the risk of heart diseases.

Low-Density Lipoproteins (LDL): The LDL cholesterol is termed bad cholesterol because high LDL levels are associated with an increased risk of heart diseases and stroke. The bad cholesterol builds up in the inner walls of the arteries and remains as fatty deposits lining the arterial wall. These are known as plaque. Such a condition is known as atherosclerosis. These plaques make the arterial passage narrow, thereby obstructing the blood flow. The two types of LDL cholesterol-associated fats that are bad for health are,

  • Saturated fats.

  • Trans fats.

Saturated fats are present in meat, poultry, dairy, and oils. Fast foods, deep-fried oily foods, processed foods, and foods with added preservatives contain trans fats.

Very Low-Density Lipoprotein (VLDL): These are also a type of low-density lipoprotein that are bad for health. The higher the VLDL level, the higher is the risk for heart problems. These carry triglycerides.

Triglycerides: These are not cholesterol but are actually the fat formed due to excessive calorie intake. Triglycerides are the stored form of excessive unused dietary calories. Triglycerides also occupy a place in the lipid profile tests. Even high levels of triglycerides are associated with health risks.

Triglyceride levels

What Signs And Symptoms Do Hypercholesterolemia Cause?

Hypercholesterolemia usually does not produce any sign or symptom until some life-threatening event like a heart attack or stroke happens. Most people with high cholesterol levels do not even know about it. And some people incidentally get to know about their cholesterol levels during a routine blood test or blood tests ordered for other conditions.

What Causes Hypercholesterolemia?

There are a multitude of factors causing high blood cholesterol levels. They include,

  1. A Diet High In Fat: Consuming a high-fat diet directly causes hypercholesterolemia.

  2. Lack of Exercise: Along with unhealthy eating, lack of physical exercise can contribute to reduced HDL levels and high cholesterol.

  3. Obesity: Sedentary lifestyle is a leading cause of increased incidence of obesity. Obese individuals have high LDL and too low HDL levels. Increased body weight is directly proportional to an increased risk of heart diseases.

  4. Smoking: Smoking increases the clogging tendencies of LDL cholesterol and decreases good cholesterol levels predisposing to a heart attack.

  5. Familial History: High cholesterol levels can run in families, and people with a family member with hypercholesterolemia have high chances of developing the same.

  6. Diabetes: Diabetes and hypercholesterolemia are related to each other and often occur together. High blood sugar levels increase LDL cholesterol and triglycerides. Sometimes high cholesterol levels are found even in controlled blood sugar levels in type 2 diabetic individuals.

  7. Pregnancy: Increased cholesterol levels during pregnancy are normal so as to satisfy the requirements of the growing fetus and to aid in the production of hormones like estrogen and progesterone. Pregnancy-induced hypercholesterolemia is a temporary condition and subsides with delivery. However, pregnant women with preexisting hypercholesterolemia can experience a dramatic increase in cholesterol levels which could cause adverse health effects.

  8. Menopause: Women in the menopausal age group tend to have an increased risk of high LDL and triglycerides and low HDL due to the falling estrogen levels. This elevates their risk of cardiovascular diseases.

  9. Kidney and Liver Diseases: Kidney and liver diseases increase cholesterol levels. In liver diseases, the liver is unable to break down the cholesterol resulting in the accumulation of the cholesterol in the blood.

  10. Polycystic Ovarian Syndrome: PCOS increases the risk of high cholesterol levels. PCOS women tend to be obese due to hormonal fluctuations, and the extra fat and calories contribute to increased LDL and triglyceride levels and low HDL levels.

  11. Thyroid Disorders: In thyroid disorders like hypothyroidism or other conditions causing an underactive thyroid (removal of thyroid gland or damage to the pituitary gland), low levels of thyroid hormones or high levels of thyroid-stimulating hormones (TSH) can increase the bad cholesterol levels as the body does not efficiently break down LDL cholesterol as before.

  12. Medications: Intake of certain drugs like corticosteroids, anabolic steroids, and progestins can also increase the levels of bad cholesterol and decrease good cholesterol levels.

What Adverse Health Effects Do High Blood Cholesterol Levels Cause?

High blood cholesterol levels pave the way to cardiovascular diseases. Whenever the low-weight bad cholesterol travels through the bloodstream, they tend to stick to the inner walls of the arteries. More and more lipids get accumulated on the walls resulting in plaques. These plaques make the arteries narrow and rigid, and difficult for the oxygenated blood to pass through it to different parts of the body. This can lead to high blood pressure.

These plaques can at times dislodge and obstruct the blood vessels of the heart and the brain. In such conditions, it becomes life-threatening. Hypercholesterolemia causes the following adverse health conditions:

What is Familial Hypercholesterolemia?

Familial hypercholesterolemia is an autosomal dominant inherited genetic disorder responsible for high LDL cholesterol levels in the blood. It happens due to a defect on chromosome 19, making it difficult for the body to remove the LDL cholesterol from the blood. Such high levels of LDL from a young age can predispose to heart attacks at any age.

How Is Hypercholesterolemia Diagnosed?

Diagnosis of hypercholesterolemia is primarily through blood tests called a lipid profile or lipid panel. For this, your blood might be drawn usually in the morning before food. The lipid profile gives the details on levels of the following:

  • Total cholesterol.

  • LDL levels.

  • HDL levels.

  • VLDL levels and triglycerides.

  • Non-HDL cholesterol.

  • The ratio between cholesterol and HDL.

Your doctor might order a lipid profile as a part of routine blood work, or if you have one or more of the following risk factors,

  • Diabetes.

  • Aging.

  • High blood pressure.

  • Smoking.

  • Obesity.

  • Lack of physical activity.

  • High saturated fat diet.

Also, it is advisable to get your blood cholesterol levels checked once in five years after 20 years of age. The following table lists the concerning levels of cholesterol.

How Is Hypercholesterolemia Treated?

Based on your cholesterol levels, your doctor might advise lifestyle changes and medications. For people with borderline values, lifestyle modifications are the preferred approach to reduce cholesterol levels. It includes,

  • Stop smoking.

  • Start exercising regularly.

  • Stay active.

  • Eat healthy and nutritious foods.

  • Maintain a healthy weight and body mass index (BMI).

  • Include heart-healthy foods.

If your cholesterol levels are too high to be reduced with lifestyle changes, your doctor will prescribe you certain medications such as,

  • Lipid-Lowering Agents:

1. Statins - Statins are lipid-lowering drugs. Some of the prescription statins include,

  • Atorvastatin.

  • Rosuvastatin.

  • Fluvastatin.

  • Pravastatin.

  • Lovastatin.

Do not stop taking statins once you are prescribed without your physician’s consent.

2. Non-Statins - Apart from statins, there are other medicines to treat high cholesterol levels such as,

  • Fibrates.

  • Niacin.

  • Resins.

  • Selective cholesterol absorption inhibitors.

Tips To Lower And Prevent Cholesterol Levels:

Certain risk factors could be controlled and prevented to prevent hypercholesterolemia. The following measures are beneficial.

  • Consume limited calories.

  • Stop smoking.

  • Exercise for at least 30 minutes a day and every day.

  • Reduce sitting time and start moving.

  • Include heart-healthy foods such as,

  • Tofu.

  • Oatmeal.

  • Walnuts.

  • Salmon.

  • Sardines.

  • Vegetables and fruits.

  • Fiber-rich foods.

  • Seeds.

  • Avocados.

  • Nuts and seeds.

  • Olive oil.

  • Whole grain bread.

  • Legumes.

  • Avoid foods rich in saturated and trans fats such as,

  • Deep-fried foods.

  • Oily foods.

  • Junk foods.

  • Meat.

  • Eggs.

  • Dairy products.

  • Bakery foods.

  • Packed and processed foods.

  • Salty and sugary foods.

Conclusion:

Hypercholesterolemia is a highly treatable condition. Like how the cholesterol levels do not increase overnight, their treatment also takes some time. Consistently following good lifestyle habits, regularly tracking cholesterol levels, and taking medications (if prescribed) can help decrease the health complications due to high cholesterol.

Frequently Asked Questions

1.

What Are the Common Causes for Hypercholesterolemia?

Hypercholesterolemia is most commonly caused due to intake of more saturated and trans fats, smoking, alcohol intake, poor dietary habits, lack of exercise, etc.

2.

What Are the Best Treatment Modalities for Hypercholesterolemia?

The best treatment for hypercholesterolemia is having a healthy fiber-rich diet, doing regular exercise, taking statins and selective inhibitors of cholesterol, etc.

3.

Is Hypercholesterolemia Different From High Cholesterol?

The other name for high cholesterol in the body is hypercholesterolemia. Hence hypercholesterolemia and high cholesterol are both the same and are defined as increased cholesterol levels in the body.

4.

What Are the Foods That Help in Reducing Hypercholesterolemia?

A heart-healthy dietary habit helps in reducing the cholesterol level in the body. Some of the foods that help in reducing cholesterol are oats, beans, fatty fish, nuts, etc.

5.

Is Hypercholesterolemia Considered as a Disability?

A condition is considered a disability if it prevents the individual from performing a gainful activity. Hypercholesterolemia is not a disability as it will not prevent the individual from performing gainful activities.

6.

How to Reduce Cholesterol Level Quickly?

Cholesterol levels can be reduced quickly by having a good diet including fruits, vegetables, beans, whole grains, and protein-rich foods and decreasing the intake of refined grains, processed foods, and fat (especially animal fats).

7.

Is Hypercholesterolemia Hereditary?

Hypercholesterolemia can run in the family. In that case, it is known as familial hypercholesterolemia. It is caused due to genetic mutation, which results in hampering the body's ability to regulate and remove cholesterol from the blood.

8.

What Are the Effects of Hypercholesterolemia on the Body?

Hypercholesterolemia leads to the deposition of cholesterol in the blood vessels, which might lead to blockage of blood vessels resulting in heart problems, stroke, etc.

9.

What Is Pure Hypercholesterolemia?

Pure hypercholesterolemia, alias familial hypercholesterolemia, is a condition where high cholesterol is caused due to genetic mutation. The mutation of the gene affects the body’s ability to regulate and remove cholesterol from the blood.

10.

Can Familial Hypercholesterolemia Be Controlled Naturally?

Yes, familial hypercholesterolemia can be controlled naturally by having a heart-healthy diet and regular exercise. A diet with a reduced intake of cholesterol and saturated fat is beneficial.

11.

Is Hypercholesterolemia Curable?

Certain types of hypercholesterolemia are curable, but familial hypercholesterolemia can only be treated and cannot be cured completely.
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Dr. Rajiv Kumar Srivastava
Dr. Rajiv Kumar Srivastava

Cardiology

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