Cholesterol is a substance of a fat-like nature, which is localized in the shell of every cell in the body. Most of it is formed in the liver (about 80%), the rest of its amount comes with food.
The role of cholesterol
The normal level of this compound is important for the optimal functioning of many organs and well-being.
In addition to the fact that cholesterol is part of the cell walls, it performs a number of the following functions:
- provides strength of cell membranes;
- regulates the permeability of cell membranes by activating the appropriate enzymes;
- participates in the exchange of fat-soluble vitamins and in other metabolic processes;
- is a compound that affects the synthesis of adrenal hormones and androgens;
- contained in the myelin sheaths of nerve fibers;
- takes part in the formation of vitamin D;
- protects red blood cells from the negative effects of hemolytic toxins;
- takes part in the formation of bile and bile acids in the liver, which are responsible for the absorption of alimentary fats in the intestine;
- affects the functioning of serotonin receptors, responsible for a good mood and a sense of satisfaction.
Quantitative and qualitative norm of cholesterol
Total cholesterol is elevated if its level is more than 5 mmol / L. If a person has concomitant diabetes mellitus or heart disease, then this indicator should be no more than 4.5 mmol / L.
It should be noted that one should take into account not only the quantitative content of cholesterol in the blood, but also qualitative indicators - the ratio of its various fractions. So, low-density cholesterol is increased if its content is more than 100-130 mg / dl. The amount of HDL and triglycerides is also taken into account.
I must say that low density lipoproteins are called "bad" because they carry most of the cholesterol throughout the body. In this case, oxidation processes occur, which are accompanied by the synthesis of antibodies and the formation of unstable compounds, which are able to penetrate the walls of arteries and cause an inflammatory process in them.
High density lipoproteins are considered “good” because they take cholesterol from the blood vessels and return it to the liver, as well as prevent oxidation processes.
Causes of Hypercholesterolemia
In the etiology of a high concentration of cholesterol, a hereditary factor may lie. This form of pathology is defined as primary or family. When it reveals elevated cholesterol in children. The disease is caused by the fact that the baby receives a defective gene from its parents, which is responsible for lipid synthesis, therefore, in its body, a pathological concentration of fat-like compounds is diagnosed.
It should be noted that quite often elevated cholesterol in children is not detected, since everything goes without clinical symptoms. The problem becomes noticeable at a more mature age.
Secondary forms of the disease develop when exposed to certain factors that act as catalysts or risk factors:
- disturbances in the liver;
- stress and nervous strain;
- age after 55 years;
- gender (total cholesterol is increased more often in men);
- smoking;
- nutritional factor - excessive consumption of fatty and high-calorie foods;
- lack of exercise.
Pathologies accompanied by hypercholesterolemia. The mechanism of its development
Most often, elevated cholesterol levels are observed with liver damage, diabetes mellitus, hypothyroidism. Nephrotic syndrome is also characterized by a high concentration of this compound.
It should be noted that the systematic administration of certain drugs, the presence of arterial hypertension and overweight also provoke hypercholesterolemia.
If we talk about the mechanism of development of this pathology, then it is worth knowing that the accumulation of cholesterol in cell membranes is a natural defense against their dehydration. That is why hypercholesterolemia indicates the passage of reactions aimed at not passing water through the cell membrane, ensuring their normal functioning. So, in non-nuclear cells, fatty acids can tolerate a lack of water.
If we conclude, we can call another important etiological factor of high cholesterol - dehydration of cells and the body as a whole.
How is hypercholesterolemia detected?
To make the correct diagnosis, only the symptoms of high cholesterol are an unreliable criterion. It is recommended to undergo a comprehensive examination and pass a number of tests.
Diagnostics, as a rule, include the following:
- collection of anamnesis and its full analysis, taking into account the complaints of the patient;
- establishing the possibility of developing familial hypercholesterolemia or other concomitant health problems;
- examination with auscultation and blood pressure measurement;
- general analysis of urine and blood to exclude inflammatory pathologies;
- biochemical blood test with determination of the concentration of creatinine, glucose and uric acid;
- lipid profile, which allows you to detect a high content of lipoproteins;
- immunological tests;
- additional genetic examination of immediate relatives to identify a genetic defect.
During the diagnosis, it is important to find out the nutritional characteristics of the patient, his lifestyle, the presence of bad habits. You also need to determine the time when the last medical examination was conducted, the nature of the complaints and the features of their occurrence.
What are the symptoms of high cholesterol?
It should immediately be said that hypercholesterolemia itself is not clinically manifested. Certain complaints appear in the patient when appropriate pathologies arise, associated with impaired lipid metabolism.
The main symptoms of high cholesterol include the following:
- the patient has chest pains, a heart attack or heart attack may develop, which is associated with damage to the coronary vessels;
- if excessive cholesterol is detected in men, then impotence or erectile dysfunction may occur at the same time, which is associated with blockage of the corresponding arteries with cholesterol;
- atherosclerosis and cerebral stroke are life-threatening symptoms of high cholesterol;
- if the walls of peripheral vessels are affected against the background of hypercholesterolemia, then obliterating diseases of the legs, as well as vein thrombosis with the development of thrombophlebitis, can develop;
- indirect signs of high cholesterol include pain in the lower extremities, memory impairment and discomfort in the heart.
External manifestations of cholesterolemia
In addition to complaints indicating damage to the blood vessels, patients may experience external signs of high cholesterol. Among them should be called the appearance of a lipoid corneal arch. This symptom testifies, as a rule, to the development of familial hyperlipidemia and is detected in patients whose age is not more than 50 years.
Another important manifestation of high cholesterol is xanthelasma. These formations look like dirty yellow nodules that are localized under the upper layer of the eyelid epithelium. Sometimes they are small in size, can go unnoticed, therefore, often only detected by specialists. With hypercholesterolemia, the appearance of xanthomas, cholesterol nodules that are located above the tendons, is also characteristic.
It should be noted that the described manifestations appear only with the progression of the pathological process, when the disease has a severe course, is characterized by various concomitant lesions and cholesterol, which rises to significant figures.
Cholesterol and pregnancy
During the gestation, the female body is radically rebuilt in order to ensure the normal development of the child. During this period, lipid metabolism changes. So, elevated cholesterol during pregnancy can be considered the norm, because at this time the body of the expectant mother needs more of this compound in order to undergo optimal synthesis of steroid hormones.
It should be noted that such physiological hypercholesterolemia should have certain boundaries and not exceed the norm by more than 2 times. In addition, it is interesting that high cholesterol during pregnancy has various indicators depending on the age of the woman. So, if the pregnant woman is no more than 19 years old, it is 3.08-5.18 mol / l. If she is 40 or more, then the level of cholesterol is 6.94. In both cases, such indicators are the norm.
The highest concentration of fat in the blood of pregnant women is observed in the third trimester. After birth, cholesterol levels return to normal within 4-6 weeks.
Pharmacological treatment of hypercholesterolemia
When diagnosed with high cholesterol and the clinical manifestations associated with this impaired fat metabolism, it is recommended to take the following groups of drugs:
- Statins They block the synthesis of enzymes that are involved in the formation of cholesterol, are the most popular drugs for hypercholesterolemia. Depending on the characteristics of the course of the disease and the individual reaction of the body, these drugs can reduce the concentration of cholesterol by almost 60%. In addition, they reduce triglycerides and increase HDL levels. The most commonly prescribed drugs are Mevacor, Baykol and Leskol.
- Fiber acids - reduce the amount of triglycerides and HDL, promote the oxidation of fatty acids in the liver. This group includes Atromed-S, Tricor and Lopid.
- Pharmacological agents that are able to bind to bile acid and reduce the synthesis of cholesterol in the liver (drugs "Colistin", "Questran").
Supplements That Reduce Cholesterol
Pharmacotherapy is carried out in severe or complicated course of hypercholesterolemia. With its milder forms, the following apply:
- Vitamin E - a strong antioxidant, prevents the formation of cholesterol plaques and reduces the risk of developing cardiovascular pathologies;
- Omega-3 fatty acids - are found in large quantities in fish oil, primrose oil, flax and rapeseed; they reduce triglycerides and prevent thrombosis, protect against inflammation, which is a good prevention of atherosclerosis;
- large doses of nicotinic acid, which mobilizes fatty acids in all tissues, reduces triglycerides and LDL, increases HDL by 30%;
- folic acid and vitamin B12 - if they are deficient, homocystine levels decrease, which significantly increases the risk of atherosclerotic vascular changes and coronary heart disease.
It should be noted that taking certain medications does not exclude the need for a healthy lifestyle. Symptoms of high cholesterol will not develop if you eat right, monitor your weight, move more, do not smoke and regularly undergo preventive examinations.
Diet for hypercholesterolemia
The goal of dietary nutrition is an antisclerotic effect and the removal of excess cholesterol from the body through an appropriate set of products.
What principles should be followed?
Be sure to reduce the amount of fat, eliminate high cholesterol foods from the diet, limit the intake of saturated fatty acids and increase the amount of polyunsaturated. They recommend consuming less salt, more plant fiber, and it is useful to replace animal fats with vegetable fats.
Healthy foods include fish, lean meats, nuts and soybeans, cereals and bran, as well as green tea, which is not only an antioxidant, but also a drink that improves lipid metabolism.
The use of raw minced garlic has a positive effect. It is able to thin the blood, prevent blood clots and reduce cholesterol due to the presence of alliin in its composition.
When elevated cholesterol is detected, symptoms, treatment and the presence of concomitant pathologies depend on the etiology of this disorder. This should also be considered when prescribing therapy, which should be comprehensive and aimed at normalizing lipid metabolism.