Hypercholesterolemia

 Hypercholesterolemia Hypercholesterolemia is a condition of high cholesterol levels in the blood. Cholesterol, a wax-like, fatty substance is produced in the body as well as obtained from animal-derived foods (e.g., egg yolks, meat, poultry, fish, and dairy products). Cholesterol is an essential constituent of cell membranes, certain hormones, and also participates in fat digestion. But cholesterol in large amounts leads to disorders of the heart.

 Causes 

1) Heredity: 

Cholesterol can be inherited in large amounts as the genes may affect the LDL (bad) cholesterol metabolism. 

2) Foods High in Saturated Fats and Cholesterol: 

Saturated fats in large amount increases the levels of LDL (bad) cholesterol. 

3) Other Diseases: 

Diabetic patients may suffer from this disorder. 

4) Lifestyle Changes: Reduced physical activity increases the levels of fat and cholesterol.

Symptoms 

1) Angina resulting due to heart disorder,

2) Xanthomas (deposits of fat on elbows, buttocks, knees, and tendons), 

3) Xanthelasmas (deposits of cholesterol around the eyelids), and 

4) Corneal arcus (deposits of cholesterol around the corneas). 

Diagnosis 

Lipoprotein profile is a blood test which is performed to determine the levels of total cholesterol, LDL, HDL, and triglycerides in the blood. 

Treatment

The cholesterol level in plasma can be reduced by the following ways: 

1) Consumption of PUFA: Consuming Polyunsaturated Fatty Acids (PUFA) in the diet lowers the plasma cholesterol level as it facilitates the transport of cholesterol. Cotton seed oil, soya bean oil, sunflower oil, corn oil, fish oils, etc., are some examples of PUFA-rich oils; while ghee and coconut oil are PUFA-deficient.  

2) Dietary Cholesterol: Animal-derived foods (and not plant-derived) are the sources of cholesterol. Cholesterol obtained from such sources mildly affects the plasma cholesterol level. However, it is suggested to avoid cholesterol- rich diet. 

3) Plant Sterols: Some plant sterols and their stanols (e.g., sitostanol esters) lower the plasma cholesterol levels by inhibiting intestinal absorption of dietary cholesterol. 

4) Dietary Fibre: Vegetable fibres reduce plasma cholesterol levels by reducing its absorption through intestines. 

5) Avoiding High Carbohydrate Diet: Hypercholesterolemia can be controlled by avoiding carbohydrate-rich foods (especially sucrose). 

6) Impact of Lifestyles: Hypercholesterolemia is often observed in people with smoking, abdominal obesity, lack of exercise, stress, high blood pressure, consumption of soft water, etc. Thus, plasma cholesterol level can be controlled by making some adequate lifestyle changes. 

7) Therapeutic Agents: Cholesterol synthesis can be decreased by using drugs which inhibit HMG COA reductase (e.g., lovastatin). Statins currently in use are atorvastatin, simvastatin, and pravastatin. Some drugs like cholestyramine and colestipol bind with bile acids and thus reduce the intestinal reabsorption of cholesterol. It converts more cholesterol to bile acids and allows its excretion through faeces. Clofibrate decreases the plasma cholesterol and triacylglycerols levels by increasing lipoprotein lipase activity.