Hypercholesterolemia is the presence of high levels of cholesterol in the blood. It is a form of "hyperlipidemia" (elevated levels of lipids in the blood) and "hyperlipoproteinemia" (elevated levels oflipoproteins in the blood).
Cholesterol is a sterol, a sort of fat, see the diagrammatic structure at the right. It is one of three major classes of lipids which all animal cells utilize to construct their membranes. It is also the precursor of the steroid hormones, bile acids and vitamin D and can be manufactured by all animal cells.
Since cholesterol is essentially insoluble in water, it is transported in blood in protein particles (lipoproteins). Low density lipoprotein (LDL) is the major carrier of cholesterol in humans. Elevated levels of cholesterol-containing lipoproteins in the blood may be a consequence of diet, obesity, inherited (genetic) diseases (such as LDL receptor mutations in familial hypercholesterolemia), or the presence of other diseases such as diabetes and an underactive thyroid.
Reducing dietary fat intake reduces total blood cholesterol and LDL cholesterol in adults and it is recommended in people with familial hypercholesterolemia, although dietary change alone is usually insufficient to achieve adequate lowering of cholesterol and medications which reduce cholesterol production or absorption are usually required. If necessary other treatments, including LDL apheresis or even surgery (for particularly severe subtypes) are performed.
Diagnosis:
There is not an absolute cutoff between normal and abnormal cholesterol levels and interpretation of values needs to occur in relation to other health factors. The ideal cholesterol level should be less than 4 mmol/l with a LDL cholesterol less than 2 mmol/l in those at high risk of cardiovascular disease.
Higher cholesterol levels lead to increased risk of several diseases, most notably cardiovascular diseases. Specifically, high levels of small LDL cholesterol particles are associated with increased risk. Larger LDL particles do not carry the same risk.
When measuring cholesterol, it is important to measure its subfractions before drawing a conclusion as to the cause of the problem. The subfractions are LDL, HDL and VLDL. In the past, LDL and VLDL levels were rarely measured directly due to cost concerns. VLDL levels are reflected in the levels of triglycerides (generally about 45% of triglycerides is composed of VLDL). LDL was usually estimated from the other fractions using the equation LDL 
total cholesterol - HDL - (0.2 x triglycerides). This formula is known as the Friedewald calculation
Signs and Symptoms:
total cholesterol - HDL - (0.2 x triglycerides). This formula is known as the Friedewald calculationSigns and Symptoms:
•Atheromatous plaques
(EYES)
•Stenosis (LITTLE)
•Occlusion
(ALL)
•Dizziness
•Paresis (
LOOSE OF POWER)
•Chest pain
Treatment:
Recommendations for both primary prevention and secondary prevention have been published. For those at high risk a combination of lifestyle modification and statins has been shown to decrease mortality.
Mortality Rate:
A recent study shows that high serum cholesterol in young adults is a risk for all cause mortality. Stamler and colleagues analyzed just over 11,000 men, middle-aged (40 to 64 years), who took as dosage baseline cholesterol values obtained from at least 15 years ago in the context of other population studies, ie when they had aged between 18 and 39. Those patients who had elevated levels of plasma cholesterol (200 to 240 mg%) showed a significantly higher mortality risk compared with those with levels below 200 mg%. Moreover, those whose cholesterol was above 240 mg% had a risk of 2 to 4 times more likely to suffer cardiovascular death or heart and 1.4 times more likely to suffer death from all causes. On the other hand, those who had a baseline cholesterol within normal limits, ie less than 200 mg%, had a life expectancy of 3.8 to 8.7 years older than those with levels above this value.
More information about Hyperchilesterolemia:
Why cholesterol is important in this disease?
ResponderEliminarBecause hyperchilesterolemia is high levels of cholesterol in the blood
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