Hypercholesterolemia: Therapy

General measures

  • Adjustment of existing underlying diseases to optimal levels
  • Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program.
  • Nicotine restriction (refrain from tobacco use).
  • Regular alcohol consumption increases HDL cholesterol but also triglycerides and VLDL; for these reasons, alcohol consumption should be limited (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day)
  • Review of permanent medication due topossible effect on the existing disease.
  • Avoidance of psychosocial stress:
    • Sleep deprivation
    • Stress

Conventional non-surgical therapy methods

  • Lipid apheresis (extracorporeal LDL cholesterol apheresis; LDL apheresis; heparin-induced extracorporeal LDL precipitation (HELP); lipoprotein apheresis) for:
    • Homozygous familial hypercholesterolemia (hoFH).
    • In hypercholesterolemia, when the target LDL cholesterol (LDL-C) level cannot be adequately lowered with diet and maximal pharmacotherapy documented for 12 months
    • With isolated Lp(a) elevation > 60 mg/dl (ie, with normal LDL-C) but progressive cardiovascular disease (documented clinically and by imaging)

Regular checkups

  • Regular medical checkups

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Observance of the following specific nutritional recommendations:
    • Reduce intake of saturated fatty acids, cholesterol and trans fatty acids (contained in baked goods, breakfast cereals with added fat, French fries, dry soups, convenience foods, confectionery, snacks). Instead of animal saturated fatty acids increased intake of vegetable monounsaturated or polyunsaturated fatty acids.
    • Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • Plant stanol and plant sterol esters – mainly available in spreadable fats – lower LDL cholesterol levels by circa 10-15%.
    • Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruits).
    • Replacement of quickly usable carbohydrates (mono- and disaccharides) with complex carbohydrates (polysaccharides; whole grain products).
    • High-fiber diet, preferably soluble fiber, contained in oat and barley products, legumes, pectin-rich fruits such as apples, pears and berries.
  • Selection of appropriate foods based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Sports Medicine

  • Endurance training (cardio training) and strength training (muscle training).
    • Frequency: at least 150 min/week of moderate (30 min on 5 days/week) or 75 min/week of vigorous aerobic exercise (15 min on 5 days/week), or a combination thereof
    • Effects: physical activity, especially endurance sports, can positively affect blood lipids (blood fats) (increase HDL (+ 10%) and decrease LDL cholesterol (-5%) and triglycerides (-20-50%)).
  • Preparation of a fitness or training plan with appropriate sports disciplines based on a medical check (health check or athlete check).
  • Detailed information on sports medicine you will receive from us.

Psychotherapy