What is Hypercholesterolemia?

Hypercholesterolemia occurs when there is an elevated level of total cholesterol in the bloodstream. It is the result of high levels of low-density lipoprotein (LDL) as compared to high-density lipoprotein (HDL) cholesterol. These are the two major cholesterol groups.
LDL, the ‘bad’ cholesterol, leaves behind fatty deposits or plaques in the blood vessels. Accumulation of these plaques congests blood vessels and blocks blood supply to the organs. HDL, the ‘good’ cholesterol, cleans up excess cholesterol from the body, thus minimizing the amount of congestion and blockage.

Hypercholesterolemia hardens and narrows blood vessels in various parts of the body, leading to fatal diseases such as chest pains, heart attack and stroke. Blocked blood vessels in the limbs can cause pain, ulcers, infections and gangrene.

Causes. The primary cause of hypercholesterolemia is an unhealthy lifestyle. Lack of exercise and a diet that is high in saturated fat and cholesterol increase the amount of LDL in the bloodstream. Such a lifestyle may lead to obesity, which in itself causes the overproduction of cholesterol. Those who drink alcohol and/or smoke cigarettes excessively further increase their risk of this condition.

Certain diseases, such as kidney disorder, liver disease and diabetes, prevent the body from processing cholesterol efficiently, hence raising total cholesterol levels. Additionally, those with a family history of heart disease tend to have higher probability of developing hypercholesterolemia. Although rare, hypercholesterolemia can result from a hereditary condition known as lipid disorder. In this case, a genetic defect in the liver cells causes the production of excessive LDL cholesterol from birth.

Symptoms. Hypercholesterolemia is a slow and silent killer. There are no visible physical symptoms until it develops into other diseases such as heart attack and stroke.

Diagnosis. Hypercholesterolemia is diagnosed through a blood test. The patient is required to fast from all food and drink, except water, for 12 hours before a blood specimen is drawn. The blood test will measure LDL, HDL and total cholesterol levels. These levels are measured in milligrams (mg) per deciliter (dL) of blood. A desirable total cholesterol level is less than 200 mg/dL, while a borderline level is between 200 to 239 mg/dL. Hypercholesterolemia is diagnosed when the total cholesterol level exceeds 240 mg/dL.

Treatment. The treatment for hypercholesterolemia focuses on decreasing the LDL cholesterol level. There are two ways to do this:
1. Lifestyle Change

A healthy diet and regular exercise are essential. A diet rich in fiber and low in saturated fat and cholesterol reduces the LDL cholesterol level in the body. Simultaneously, a good exercise program is highly recommended to raise the HDL cholesterol level.

Weight should be managed constantly. Shed extra pounds to maintain the desirable weight. Remember, being overweight or obese, in itself, increases the incidence of hypercholesterolemia. Additionally, those who smoke should stop, as smoking reduces the HDL cholesterol level. Other benefits of quitting include lower blood pressure and reduced risk of lung cancer and heart disease.
2. Medications

If diet and exercise are insufficient, doctors may recommend medications as well. Statins are a common class of drugs prescribed for hypercholesterolemia and include Pravastatin, Fluvastatin, Simvastatin, Atorvastatin and Lovastatin. Gemfibrozil, Cholestyramine and Niacin are other medications that help lower blood cholesterol levels. Depending on the gravity of the condition, doctors may prescribe one or more of these medications.

Hypercholesterolemia does not discriminate. Anyone who leads an unhealthy lifestyle and/or has a family history of heart disease is especially prone to this condition. Therefore, it is prudent to have cholesterol levels checked regularly to catch the condition in its early stages.