Diagnosis
Various laboratory parameters are determined in the course of a GP examination. The blood is taken in the morning and fasting. In the diagnosis of hypercholesterolemia, the level of LDL and HDL cholesterol plays an important role in addition to the total cholesterol value.
If the total cholesterol and/or the LDL cholesterol is above a certain limit, all other possible triggers must be excluded first. The risk of a cardiovascular event, such as a heart attack or stroke, is assessed by means of other diagnostic tools. These include the measurement of blood pressure and blood sugar, as well as the preparation of an ECG and, under certain circumstances, a stress ECG.
In this way, the attending physician obtains an assessment of the overall risk. Other risk factors such as smoking, alcohol abuse, overweight and concomitant diseases are also recorded. The target values of total cholesterol and LDL cholesterol are determined in relation to the overall risk.
Therapy
Just like the diagnosis of hypercholesterolemia, the therapy depends on the individual risk profile of the patient. The aim is to reduce cholesterol levels. In addition to the reduction of risk factors, the treatment of triggers and a healthy lifestyle are in the foreground.
All these measures reduce the probability of possible cardiovascular events. A healthy lifestyle is achieved through a sufficient level of physical activity and a conscious diet with low saturated fatty acids and trans fatty acids. If the cause is hypothyroidism, diabetes mellitus or kidney disease, it should be treated.
Further it applies to minimize factors of risk. Clearly reduced consumption of alcohol, nicotine renouncement and weight reduction with predominance play an important role. Medicines for the lowering of the Cholesterinspiegels are used with unchanged high values despite conservative measures and the family hypercholesterolemia.
The most common drugs used to lower cholesterol levels are statins. They have been shown to reduce the risk of heart attacks and contribute to a reduction in overall mortality. Their mode of action is based on the inhibition of an enzyme involved in the formation of LDL cholesterol.
Representatives of statins include atorvastatin and simvastatin. Other drugs for lowering LDL cholesterol are the so-called anion exchange resins, for example colestyramine, and fibrates, which promote the breakdown of fatty acids. If the sole therapy with statins is not sufficient, a nicotinic acid derivative can additionally lower the cholesterol level. In the familial form, the administration of ezetimib, which inhibits the absorption of cholesterol in the intestine, together with a statin can achieve the desired therapeutic success.
