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Hypercholesterolemia


Overview :

Cholesterol circulates in the blood stream. It is an essential molecule for the human body. Cholesterol is a molecule from which hormones and steroids are made. It is also used to maintain nerve cells. Between 75 and 80% of the cholesterol that circulates in a person's bloodstream is made in that person's liver. The remainder is acquired from outside sources. Cholesterol is found in animal sources of food. It is not found in plants.

Normal blood cholesterol level is a number derived by laboratory analysis. A normal or desirable cholesterol level is defined as less than 200 mg of cholesterol per deciliter of blood (mg/dL). Blood cholesterol is considered to be borderline when it is in the range of 200 to 239 mg/dL. Elevated cholesterol level is 240 mg/dL or above. Elevated blood cholesterol is considered to be hypercholesterolemia.

Cholesterol has been divided into two major categories: low-density lipoprotein (LDL), the so-called "bad" cholesterol, and high-density lipoprotein (HDL), the so-called "good" cholesterol. Diet, exercise, smoking, alcohol, and certain illnesses can affect the levels of both types of cholesterol. Eating a high fat diet will increase one's level of LDL cholesterol. Exercising and reducing one's weight will both increase HDL cholesterol and lower LDL cholesterol.

The most common cause of elevated serum cholesterol is eating foods that are rich in saturated fats or contain high levels of cholesterol. Elevated cholesterol also can be caused by an underlying disease that raises blood cholesterol levels such as diabetes mellitus, kidney disease, liver disease, or hypothyroidism. It also can be caused by an inherited disorder in which cholesterol is not metabolized properly by the body. Obesity, which generally results from eating a diet high in fat, also can lead to elevated cholesterol levels in the blood. This is because obesity itself leads the body to produce excessive amounts of cholesterol.

Hypercholesterolemia increases the risk of heart disease. Elevated levels of circulating cholesterol cause deposits to form inside blood vessels. These deposits, called plaque, are composed of fats deposited from the bloodstream. When the deposits become sufficiently large, they block blood vessels and decrease the flow of blood. These deposits result in a disease process called atherosclerosis, which can cause blood clots to form that will ultimately stop blood flow. If this happens in the arteries supplying the heart, a heart attack will occur. If it happens in the brain, the result is a stroke where a portion of brain tissue dies. Atherosclerosis causes more deaths from heart disease than any other single condition. Heart disease has been the leading cause of death in the United States for the past half century.

There is a syndrome called familial hypercholesterolemia. Affected persons have consistently high levels of LDL. This leads to early clogging of the coronary arteries. In turn this leads to a heart attack. Among affected males, a first heart attack typically occurs in their 40s to 50s. Approximately 85% of men with this disorder have experienced a heart attack by the time they reach 60 years of age. The incidence of heart attacks among women with this disorder also is increased. However, it is delayed 10 years compared to men. The incidence of familial hypercholesterolemia is seven out of 1,000 people.




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