High cholesterol level (hypercholesterolaemia)

The cholesterol level provides information about the amount of cholesterol in the blood. A increased cholesterol or Hypercholesterolemia thus denotes a pathological or abnormal amount of cholesterol in the blood. Cholesterol is a fatty substance that is important for the structure of the cell membranes surrounding every cell, for a number of hormones and for the production of bile acid.

What is high cholesterol?

HDL cholesterol ("good cholesterol"), a certain type of cholesterol, removes fat from the blood vessels. LDL cholesterol ("bad cholesterol"), on the other hand, supplies the blood vessels with fatty substances, which can form deposits that are harmful to health. When speaking of an increased cholesterol level (hypercholesterolemia), the harmful LDL cholesterol is meant.

Which LDL cholesterol level is still acceptable for the individual person depends on whether there are other risk factors that can promote arteriosclerosis. Such risk factors are, for example, diabetes, high blood pressure, obesity and smoking.

With a medium risk profile, an LDL cholesterol level of up to 115 milligrams per deciliter is considered harmless. If the risk is increased, the cholesterol level should not exceed 100 mg / dl. People with diseases of the coronary arteries, diabetes mellitus or at least moderate, chronic kidney damage should have a cholesterol level of no more than 70 mg / dl.

causes

An elevated cholesterol level is partly due to genetic predisposition. But the individual way of life also has an influence on the cholesterol level: Overweight, a diet that is too high in fat and too little physical activity all promote the development of high cholesterol levels.

Over 50% of people living in the western hemisphere today have high cholesterol levels. In patients with hypercholesterolemia (familial hypercholesterolemia) from birth - exclusively hereditary - the cholesterol level must be lowered with medication and by following a diet.

The predisposition to an increased cholesterol level is noticeable in the fact that the body's cells are less able or unable to absorb fatty substances from the blood because they lack a sufficient number of so-called receptors that are ready to absorb fat. The LDL cholesterol therefore remains in the blood with harmful effects on health.

Symptoms, ailments & signs

A high cholesterol level does not usually cause any clear symptoms or complaints. The imbalance in blood lipid levels can only be determined through blood tests. In the long term, however, an elevated cholesterol level can lead to hardening of the arteries. Atherosclerosis manifests itself as pain in arms and legs, numbness, dizziness and tightness of the chest. Some people have recurrent heart pain or irregular heartbeat.

In addition, fainting spells can occur, accompanied by palpitations, sweats and severe malaise. If elevated blood lipid levels are not treated, further symptoms can develop over the course of months or years. In addition to the increasing feeling of illness caused by pain and sensitivity disorders in the limbs and the permanently high blood pressure, various diseases of the cardiovascular system can occur.

Outwardly, an elevated cholesterol level is not clearly recognizable, but changes that indicate a serious illness can occur in the long term.These include protruding veins on the arms and neck, excessive sweating, premature hair loss and noticeably reddened skin on the face and limbs. Usually there is also nervousness, inner restlessness and inexplicable panic attacks. If the symptoms mentioned occur together, a medical diagnosis is required.

Diagnosis & course

The effects of high cholesterol are not felt in the short term. In the long run, however, serious health consequences can arise.

Hypercholesterolemia increases the risk of hardening of the arteries, which can then lead to serious coronary artery disease and also trigger a heart attack.

The risk of blood vessels constricting when the cholesterol level is increased due to increasing calcification can, in addition to the heart, e.g. B. also affect the legs. If a blood vessel responsible for supplying the brain is dangerously narrowed, a stroke will result.

If the increased cholesterol level reaches a value of 250 mg / dl, the risk of a heart attack is increased by 100%. At 300 mg / dl the risk has already quadrupled.

Hypercholesterolemia can also manifest itself in the form of yellowish cholesterol deposits, for example on tendons, eyelids and in the skin.

Complications

Too much cholesterol in the blood can cause the cholesterol to build up on the walls of the arteries. This can accelerate atherosclerosis. Blood vessels are transformed into stiff, calcified tubes that support blood transport increasingly poorly. As a result, the heart has to pump harder and blood pressure rises.

The blood supply decreases where vessels are severely narrowed by deposits. As a result, the kidneys, brain cells, heart muscles, muscles in the legs and cells in the eyes may lack oxygen. Their functions decrease.

Further complications can be dementia, pain in the legs when moving or in the heart when exercising. In addition, deposits can become detached from the vessel walls. The lumps are carried away by the bloodstream and can completely block vessels in other places. If this happens to the heart muscle, it can lead to a life-threatening heart attack.

If the brain is affected by a vascular occlusion, a stroke with serious consequences can occur. Affected people can lose many body functions and also die from a stroke. Heart failure and / or heart failure can also be associated with an increased cholesterol level. In addition, the kidneys can be affected, for example in the form of kidney weakness or renal insufficiency. Cholesterol can also build up in the skin and tendons.

When should you go to the doctor?

A doctor's visit should take place as soon as the person concerned is suffering from severe weight gain. Overweight or obese causes concern and a medical evaluation should be initiated. A doctor should be consulted if sweating, reduced mobility or high blood pressure occur.

In the event of sleep disorders, changes in heart rhythm, general malaise or a racing heart, a doctor's visit is necessary. If there are bone and joint problems, a doctor should be consulted. A doctor is required in the event of pain, muscle problems or shortness of breath. If the person is suffering from circulatory disorders, there is cause for concern.

A doctor should be contacted if there are hormonal problems, mood swings, or irritability. If there are malfunctions in individual systems or if attention is impaired, a doctor should be consulted. A medical examination is necessary in the event of impaired consciousness, dizziness or forgetfulness.

Erectile dysfunction, vision or hearing problems are worrying and should be treated by a doctor. A feeling of pressure inside the body, a feeling of illness or general weakness should be presented to a doctor. See a doctor for pain in the arms or legs. Skin irritation, tingling in the limbs, or numbness of the body should also be examined and treated.

Doctors & therapists in your area

Treatment & Therapy

Before starting therapy for an elevated cholesterol level, it must first be determined whether there are other risk factors that favor hardening of the arteries, such as: B. Obesity, high-fat diet, smoking, lack of exercise, high blood pressure or diabetes. This overall picture results in the target value to which the cholesterol level must be reduced.

The first step is to change your diet to low-cholesterol and high-fiber foods. It is also important to reduce the high cholesterol level through physical activity. Other diseases, such as diabetes, which promote hypercholesterolemia, are treated in parallel.

So-called cholesterol absorption inhibitors, when the cholesterol level is increased, prevent the cholesterol in food from being absorbed by the small intestine. Nicotinic acid suppresses the release of fatty acids from adipose tissues, which causes a reduction in high cholesterol levels. At the same time, the HDL cholesterol is increased.

So-called exchange resins prevent the bile acid released from the liver into the intestine from getting back into the body. As a result, the liver replaces the bile acid that is now missing with the help of the cholesterol in the blood, so that the hypercholesterolemia is reduced.

Herbal ingredients such as B. Garlic are used as a supplement against increased cholesterol levels. If hypercholesterolemia is diagnosed, regular lipid tests are recommended.

Outlook & forecast

The prognosis of an increased cholesterol level is to be assessed according to the individual circumstances. For many of those affected, a change in lifestyle and optimization of food intake are sufficient. Sufficient exercise, sporting activities and the avoidance of obesity are necessary to bring about relief from the symptoms. If possible, the food should not contain excessive animal fats and pollutants such as nicotine and alcohol should be avoided. If there are no other illnesses, the measures described give a good prognosis.

If the underlying disease is present, the prognosis depends on the time of diagnosis and the treatment options for the disease. A cure is not expected in the case of a chronic or congenital disorder. In the case of diabetes or a metabolic disease, lifelong therapy is used in most cases. Check-ups must be carried out at regular intervals. The cholesterol level is measured and the dose of the medication is adjusted to the current values.

Although most of the patients do not recover, the herbs provide significant relief from the symptoms. The affected person can have a good quality of life despite the high cholesterol level and lead a life with the disease. Without treatment, there is a risk of calcification of the arteries. A life-threatening condition can develop as the blood vessels slowly clog.

prevention

A healthy lifestyle should be observed to avoid high cholesterol levels. This includes a diet with low-fat mixed foods. Fish and poultry contain only a small amount of saturated fatty acids.

A diet rich in fiber (e.g. bread, fruit and vegetables) should also be preferred. Olive oil and sunflower oil have a positive effect on increased cholesterol levels. Even red wine consumed in moderation is said to lower hypercholesterolemia and increase positive HDL cholesterol.

High-fat dairy products, butter, cream, egg yolks, nuts and confectionery, on the other hand, should be avoided. Exercise in the form of regular endurance training is recommended. Smoking should be avoided as it multiplies the risk of heart attack.

Aftercare

A slightly elevated cholesterol level does not necessarily have to be the subject of aftercare. Those affected still have to keep an eye on it - especially in connection with obesity, type 2 diabetes and high blood pressure. Hypercholesterolemia should always be monitored. It can show up through so-called xanthomas.

Since the organism produces the cholesterol itself, an increased cholesterol level does not necessarily indicate that you are consuming too much eggs and meat products. In the follow-up care, a diet is usually not necessary - unless it is used for weight loss. In addition, the patient can be at greater risk for any consequences of arteriosclerosis. Appropriate preventive examinations are advisable.

However, hypercholesterolemia in transplant patients requires close monitoring and follow-up. The fact is that practically all immunosuppressants lead to hypercholesterolemia. Here, however, aftercare primarily includes the transplant and immune functions. The cholesterol levels only become important in the second instance.

In the follow-up care of hypercholesterolemia, weight loss and plenty of exercise, as well as dietary adjustments, are the most common approaches. Alcohol and nicotine consumption should be avoided. Drug treatment with CSE inhibitors (cholesterol synthesis enzyme inhibitors), so-called statins, anion exchangers such as colestyramine, fibrates or nicotinic acid, is only undertaken if the cholesterol level is persistently high. If necessary, a blood purification is carried out on the affected person.

You can do that yourself

In many cases, a change in lifestyle already contributes significantly to lowering high cholesterol levels. When it comes to nutrition, emphasis should be placed on a low-fat, high-fiber diet with plenty of fresh vegetables and fruits as well as whole grain products. It is better to avoid fatty meat altogether, poultry and fish are a good alternative to hearty home cooking.

For preparation, we recommend using vegetable fats that are rich in polyunsaturated fatty acids, such as olive, sunflower or walnut oil. Many vegetable oils as well as salmon, herring and mackerel have high levels of omega-3 fatty acids, which can help lower the “bad” LDL cholesterol. In order to reduce excess weight, the consumption of sugar and alcohol should also be restricted: the moderate consumption of red wine (a maximum of one or two glasses per day) can increase the level of HDL cholesterol in the blood and inhibit the harmful effects of LDL cholesterol.

Regular exercise, preferably in the fresh air, can also help lower blood lipid levels: Exercising endurance sports such as running, swimming or cycling also has a positive effect on fitness and body weight. Smoking in conjunction with hypercholesterolemia increases the risk of heart attack and other cardiovascular diseases, so nicotine consumption should be avoided completely.