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Cholesterol - Lipids - Hyperlipidemia

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Cholesterol

NIH - Cholesterol “Cholesterol is a waxy, fat-like substance that occurs naturally in all parts of the body. Your body needs some cholesterol to work properly. But if you have too much in your blood, it can stick to the walls of your arteries. This is called plaque. Plaque can narrow your arteries or even block them. High levels of cholesterol in the blood can increase your risk of heart disease. Your cholesterol levels tend to rise as you get older. There are usually no signs or symptoms that you have high blood cholesterol, but it can be detected with a blood test. You are likely to have high cholesterol if members of your family have it, if you are overweight or if you eat a lot of fatty foods. You can lower your cholesterol by exercising more and eating more fruits and vegetables.“

NIH - What Is Cholesterol? "Blood is watery, and cholesterol is fatty. Just like oil and water, the two do not mix. To travel in the bloodstream, cholesterol is carried in small packages called lipoproteins (lip-o-PRO-teens). The small packages are made of fat (lipid) on the inside and proteins on the outside. Two kinds of lipoproteins carry cholesterol throughout your body. It is important to have healthy levels of both: -- Low-density lipoprotein (LDL) cholesterol is sometimes called bad cholesterol. High LDL cholesterol leads to a buildup of cholesterol in arteries. The higher the LDL level in your blood, the greater chance you have of getting heart disease. -- High-density lipoprotein (HDL) cholesterol is sometimes called good cholesterol. HDL carries cholesterol from other parts of your body back to your liver. The liver removes the cholesterol from your body. The higher your HDL cholesterol level, the lower your chance of getting heart disease."

NIH - High blood cholesterol and triglycerides (Medical Encyclopedia) “The medical term for high blood cholesterol and triglycerides is lipid disorder. Such a disorder occurs when you have too many fatty substances in your blood. These substances include cholesterol and triglycerides. A lipid disorder increases your risk for atherosclerosis and heart disease. Causes: High cholesterol and other lipid disorders can be inherited (passed down through families) or associated with: • Fatty diets • Disease such as diabetes, hypothyroidism, Cushing syndrome, and kidney failure • Certain medications, including birth control pills, estrogen, corticosteroids, certain diuretics, and beta-blockers • Lifestyle factors, including inactivity and regular, excessive alcohol use If you smoke and also have high cholesterol you have an even greater risk for heart disease. Lipid disorders are more common in men than women.”

NHS - Cholesterol “Cholesterol is carried in the blood by molecules called lipoproteins. There are several different lipoproteins, but the three main types are: • Low density lipoprotein (LDL). This is often known as bad cholesterol and is thought to increase arterial disease. It carries cholesterol from the liver to the cells and can cause a harmful build-up if there is too much for the cells to use. Normally, the blood contains about 70% of LDL, but the level will vary from person to person. • High density lipoprotein (HDL). This is often referred to as 'good cholesterol', and is thought to prevent arterial disease. It takes cholesterol away from the cells and back to the liver, where it is either broken down, or is passed from the body as a waste product. • Triglycerides are another type of fatty substance present in the blood. They are found in dairy products, meat and cooking oils. Triglycerides are also produced by the liver. Those who are overweight, have a diet that is high in fatty or sugary foods, or drink a large amount of alcohol, have an increased risk of having a high triglyceride level. The amount of cholesterol present in the blood can range from 3.6 to 7.8 mmol/litre. A level above 6mmol/litre is considered as high, and a risk factor for arterial disease. Government advice recommends a target cholesterol level of less than 5. However, in the UK, two in three adults have a total cholesterol level of 5 or above. In England, men, on average, have a level of 5.5, and women have a level of 5.6 … A high cholesterol level may only be revealed if you have symptoms of atherosclerosis. These can include: • angina, caused by narrowed coronary arteries in the heart, • leg pain on exercising, due to narrowing of the arteries that supply the lower limbs, • blood clots and ruptured blood vessels, which can result in a stroke or mini-stroke (transient ischaemic attack (TIA)), • ruptured plaques, which can lead to a blood clot forming in one of the arteries delivering blood to the heart (coronary thrombosis), and may lead to heart failure if a significant amount of heart muscle is damaged, and • thick yellow patches (xanthomas) around the eyes or elsewhere on the skin. These are cholesterol deposits and can often be seen in people with inherited, or familial cholesterol (where your family members have a history of high chloresterol).”

Highlighted Articles

Triglycerides Linked to Coronary Disease Risk (2008) “A new study showing that high levels of triglycerides were strong predictors of cardiac trouble strengthens the case for including measurement of the blood fats in prevention programs. "Triglycerides traditionally have been viewed as second-class citizens," said Dr. Michael Miller, director of preventive cardiology at the University of Maryland Medical Center and lead author of the report in the Feb. 12 issue of the Journal of the American College of Cardiology.. "LDL cholesterol has always taken center stage. We know that LDL is intimately involved in bringing cholesterol to scavenger cells, which deposit them to form plaques in the arteries. This study shows that triglycerides in and of themselves are also lipids to blame." “

Cholesterol Reducing Drugs (2008)“There are five main categories of cholesterol reducers: statins, bile acid resins, nicotinic acid, fibrates and ezetimibe. Most are available only by prescription, while nicotinic acid, a form of vitamin B3 (niacin), is available over-the-counter. However, niacin should only be taken under the care of a physician to monitor any side effects that could arise, such as severe upset stomach (nausea) and flushing. “

Visit InfoMedSearch's Home Page for all InfoMedLinks Cardiovascular Topics: Atherosclerosis, Atrial Fibrillation, Coronary Artery Disease, Cholesterol - Lipids, General Cardiovascular, Heart Failure, Hypertension, Myocardial Infarction (Heart Attack), Peripheral Artery Disease, and Stroke.

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Notes

The 2007 Treatment Guidelines section will contain the 2007 published guidelines. To view Guidelines from previous years, view year 2006 Treatment Guidelines and 2005 InfoMedlinks (Articles section) or our Monthly Online Newsletter (under the Guidelines section).

Cholesterol - Lipids - Hyperlipidemia

Daily Treatment Report

Cognitive Therapy-CBT-Psychotherapy

Device Therapy

Drug Side-Effects and Interactions

Side Effects of Cholesterol-Lowering Statin Drugs

Statins May Increase Intracerebral Hemorrhage Volume (The Canadian Journal of Neurological Sciences 2010)

Chronic Cholesterol Depletion using Statin Impairs the Function and Dynamics of Human Serotonin1A Receptors. (Biochemistry. 2010)

Muscle Injury from High Doses of Zocor

Statins May Lower Testosterone, Libido

High-Dose Simvastatin Associated With Increased Risk for Myopathy, FDA Warns

Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials (The Lancet 2010) “Statin therapy is associated with a slightly increased risk of development of diabetes, but the risk is low both in absolute terms and when compared with the reduction in coronary events. Clinical practice in patients with moderate or high cardiovascular risk or existing cardiovascular disease should not change.”

Can I Take Statins and Grapefruit Together? “Grapefruit contains the compound bergamottin, which interacts with certain enzyme systems in the body, such as cytochrome P-450 and P-glycoprotein. These enzyme systems are responsible for breaking down statins, as well as other drugs, into more usable chemicals and transporting them in the body. When grapefruit juice is consumed at or around the time you take your statin, the components in grapefruit prevent these enzyme systems from breaking down the drug, causing the drug to accumulate in high amounts in the body. This can be very dangerous and can cause a variety of health problems, such as liver damage or a rare condition called rhabdomyolysis (severe muscle and kidney damage). “

Drugs

Statins and statin combinations for high cholesterol

Exercise

General Information

Management of Hypercholesterolemia in Older Persons for the Prevention of Cardiovascular Disease (Cardiology in Review 2010)

Resolution of Statin-Induced Myalgias by Correcting Vitamin D Deficiency (Southern Medical Journal 2010)

Guidelines

Immunotherapy

 

Internet Sites

Treatment Information

Anticoagulation Resource

DrugBank (drug structure)

FDA - MedWatch (Drug Alerts)

NIH - Cholesterol Lowering Medicines

NIH - How to Lower Your Cholesterol Level

NIH - The Benefits of Cholesterol Lowering

Drug-Food-Supplement Information

Drug Information Online

Drug Interaction Checker

DrugDigest (drug interactions)

FDA - Drug Interactions: What You Should Know

NIH - Botanical Dietary Supplements: Background Information

NIH - Drug, Supplements, and Herbal Information

NIH - Herbal Supplements: Consider Safety, Too

NIH - Medicines

NIH - Vitamin and Mineral Supplement Fact Sheets

Nutrition

Flaxseed Lowers High Cholesterol In Men: Iowa State NWRC Study

Pistachios Increase Serum Antioxidants and Lower Serum Oxidized-LDL in Hypercholesterolemic Adults (J. Nutr. 2010)

Other

Other Treatments

Experimental

Radiotherapy

 

Supplements-Vitamins-CAM

When Niacin is a Drug “Niacin’s beneficial effect on blood cholesterol has been recognized for at least half a century. It does not reduce LDL (“bad”) cholesterol as much as statins do, but one advantage of niacin is that it raises HDL (“good“) cholesterol substantially; statins raise HDL only modestly. No one is sure exactly how niacin works, but it does change the proportion of LDL to HDL in a favorable direction. It also decreases triglycerides, fats in the blood that can increase the risk of heart disease. In clinical trials niacin has proved to reduce the risk of heart attacks, perhaps because it boosts HDL so much. Niacin may raise blood sugar slightly, but it is now considered safe for people with diabetes.”

Surgery

Transplantation

 

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