Symptoms
The blood fats are divided into “good” and “bad” fats. The HDL cholesterol is the “good” cholesterol. The most important representative of the “bad” fats is the LDL cholesterol.
Like all other “bad” fats, it increases the risk of atherosclerosis (hardening of the arteries). Unfortunately, arteriosclerosis remains asymptomatic for a very long time. Only when the arteries are highly calcified does it lead to secondary diseases.
Hyperlipidemia therefore often remains undetected for a long time. Among the diseases triggered by hyperlipidemia are all diseases caused by arteriosclerosis. At the heart, this is the coronary heart disease (CHD).
CHD affects the coronary arteries and leads to poor oxygen supply to the heart muscle, which manifests itself in attacks of angina pectoris. The heart attack is another consequence of coronary heart disease. Another possible consequence of arteriosclerosis is stroke (apoplexy).
On the legs, arteriosclerosis manifests itself as pAVK (Peripheral Arterial Occlusive Disease). The pAVK causes circulatory disorders of the legs and is manifested by pain when walking. Pronounced hyperlipidemia can lead to inflammation of the pancreas.
The excess fats can be deposited in the liver, resulting in fatty liver. Less frequent symptoms are deposits of cholesterol in tendons and skin, which is called xanthoma. Deposits on the eyelids are called xanthelasma, deposits in the eye are called “Arcus lipoides cornea”.
However, these deposits can also occur in patients with normal blood lipid levels and are not an absolute proof symptom of hyperlipidemia. The aim of therapy for hyperlipidemia is to reduce blood lipid values.The neutral fats should reach values below 150 mg/dl (1.7mmol/l), the LDL cholesterol should be below 70 mg/dl (1.8mmol/l) or below 115 mg/dl (3mmol/l) depending on the risk profile of the patient. The “good” HDL cholesterol should be above 40mg/dl for men and above 50mg/dl for women.
HDL is responsible for transporting cholesterol back to the liver and therefore reduces the risk of atherosclerosis. The first measure to lower blood lipid levels is a healthy diet and lifestyle. Patients should eat a balanced diet, avoid fast food that is rich in calories and fats, stop smoking and make sure they get enough exercise.
Just 30 minutes of exercise a day reduces the neutral fats and the “bad” LDL and increases the “good” HDL. An adapted diet for fatty liver can make this symptom of increased blood lipids disappear. The dietary fat ingested should be reduced to less than 30% of the total calories through appropriate nutritional therapy and changed from animal to vegetable fats.
Eating fish regularly has a positive effect on hyperlipidemia because of the good omega-3 fatty acids. Patients should consume complex carbohydrates (whole grain) and a lot of protein, eat lots of fruit and vegetables. In case of elevated cholesterol levels, attention should be paid to cholesterol intake with food, which should not exceed 300 mg per day.
For example, an egg yolk already contains about 270 mg of cholesterol. In the case of increased neutral fats in the blood, in addition to the general nutritional tips, it is recommended to avoid alcohol and to change to 5 smaller meals (instead of three) daily. A healthy diet reduces cholesterol levels by 20-60 mg/dl.
In addition, the response to medication is improved. In addition, triggering factors of hyperlipidemia should be eliminated: Diabetes mellitus should be well controlled and hypothyroidism should be treated. Overweight patients should lose weight.
Patients should also avoid alcohol. Other risk factors such as high blood pressure should be treated with medication if necessary. If an adequate reduction in blood lipid values cannot be achieved through a conscious diet, drugs can be used to treat hyperlipidemia.
The most effective cholesterol-lowering drugs on the market are statins. They inhibit the key enzyme in cholesterol synthesis, HMG-CoA reductase. As a result, less cholesterol is produced in the cells and the cells absorb more cholesterol from the bloodstream.
Statins reduce the risk of all atherosclerosis-related diseases (e.g. heart attack, stroke). However, the response to statins can be very different in different patients. However, statins interact with many other drugs (e.g. verapamil) and may cause muscle pain or muscle weakness as a side effect.
In rare cases, a life-threatening rhabdomyolysis (dissolution of muscle fibers) may occur. Other drugs used in the therapy of hyperlipidemia are the bile acid binder colestyramine, which can be combined with them if the statin effect is insufficient. Other drugs are ezetimib (inhibits cholesterol absorption) and fibrates (must not be combined with statins). A newer method that can be used in severe hyperlipidemia in addition to drug therapy is lipid apheresis, which is performed once a week. Here the excess blood lipids are filtered out of the blood.
