High cholesterol
What is cholesterol?
Cholesterol is a substance similar to fat that is found in every part of the body. It is essential for the body to function correctly. Cholesterol travels through the blood in particles called lipoproteins.
Depending on the particle in which the cholesterol travels, we have:
High-density lipoprotein (HDL) or HDL cholesterol
This is known as good cholesterol. High-density lipoprotein absorbs cholesterol from the body and carries it to the liver, from where it is flushed away. A high level of HDL cholesterol has a protective effect against cardiovascular diseases.
Low-density lipoprotein (LDL) or LDL cholesterol
This is known as bad cholesterol and is the most harmful. Low-density lipoprotein carries cholesterol from the liver to the rest of the body. If the LDL cholesterol level is very high, it tends to adhere to the artery walls, hardening and narrowing them. The arteries can become blocked, thus impeding blood flow. This process is called arteriosclerosis and it can lead to cardiovascular diseases.
The recommended level of LDL cholesterol in the blood varies according to the patient’s cardiovascular risk and whether they have suffered from any cardiovascular disease.
Among the general population, total cholesterol levels are classified as follows:
- Normal: Normal: less than 200 mg/dl
- Moderates: between 200-249 mg/dl
- High: higher than 250 mg/dl
What are triglycerides?
They are a type of fat found in the blood. The body uses them to obtain energy. An appropriate level of triglycerides is necessary for the body to function correctly. However, a high level can cause arteriosclerosis and increase the risk of cardiovascular disease.
Among the general population triglyceride levels are classified as follows:
- Normal: less than 150 mg/dl
- Borderline high: between 150-199 mg/dl
- High: 200-499 mg/dl
- Very high: more than 500 mg/dl
Medicinal treatment is recommended for triglyceride levels of 500 mg/dl or above.
With what health problems
are they associated?
This occurs when the amount of LDL cholesterol in the blood exceeds what the body needs. This condition is the main cause of cardiovascular diseases.
1 out of every 5 people has total cholesterol over 250 mg/ml
This occurs when there is a high amount of triglycerides in the blood. Triglycerides are a type of fat that derives from the food we eat.
Hypertriglyceridaemia affects 27 % of the Spanish population
This occurs when the total blood cholesterol levels are moderate or high and when the triglyceride levels are high or very high.
Development of the disease
Cardiovascular disease is the leading cause of death worldwide and is associated with the development of arteriosclerosis.
A high level of LDL cholesterol in the blood can build up in the arteries.
As a result, the flow of blood that reaches the heart, brain, and the rest of the body may be obstructed, and the following complications could arise:
Main arteries
Coronary
Carry blood to the heart
Complications
Acute myocardial infarction or angina pectoris
Cerebral
Carry blood to the brain
Complications
Cerebral infarction or ischaemic stroke
Peripheral
Carry blood to the rest of the body
Complications
Pain in the calf, which starts when walking and disappears when at rest (intermittent claudication syndrome).
High cholesterol is one of the main cardiovascular risk factors
* The result of the cardiovascular risk calculation indicates the probability that a person will have a cardiovascular event in the next 10 years, based on their clinical characteristics.
High cholesterol is an asymptomatic health problem and many patients are unaware of the risk it involves
“Doing nothing” is not an option, high cholesterol does not resolve on its own
Complementary measures to
reduce cardiovascular risk
Patients with hypercholesterolaemia and/or hypertriglyceridaemia should follow a series of recommendations for a healthy lifestyle, aimed at reducing LDL cholesterol and triglyceride levels in the blood and thus reducing the cardiovascular risk.
Blood pressure control*
Maintaining blood pressure within the recommended levels reduces cardiovascular risk.
A healthy balanced diet*
Make fruit, vegetables, pulses and wholemeal cereals a priority. Avoid saturated and trans fats, and follow a low sodium diet.
Regular physical exercise*
At least 30 minutes a day almost every day of the week.
Avoiding tobacco and alcohol*
Reduce the risk of suffering a cardiovascular event.
Weight control*
Maintaining a healthy weight helps to prevent cardiovascular diseases.
* Benefits backed by science
Do you want to follow a healthy lifestyle?
We can explain how
Healthy lifestyle
Following a balanced diet and engaging in regular physical activity (more than 150 minutes/week) is essential for treating high cholesterol.
Complement with medications
If a healthy lifestyle is not enough to control high cholesterol, a medicinal treatment will be added to help reduce your cholesterol levels.
Complement with more than one type of medication
If one type of medication is not enough to control cholesterol, other lipid-lowering agents will have to be added to the treatment.
When is treatment
necessary?
There are two instances when it may be necessary to take medication to reduce cholesterol levels:
Primary prevention: when the cardiovascular risk is very high (more than 10 %) but the patient has not previously suffered from any cardiovascular disease.
Secondary prevention: when a patient has already suffered from a cardiovascular disease caused by arteriosclerosis.
What arelipid-lowering agents?
They are drugs that have the property of reducing blood cholesterol and/or triglyceride levels and thus preventing cardiovascular diseases such as stroke or heart attack.
The purpose of controlling blood cholesterol and/or triglyceride levels is to reduce cardiovascular risk.
The different treatments
There are different lipid-lowering treatments, of which the most commonly used are:
CHARACTERISTICS
They reduce the creation of cholesterol in the liver and reduce the level of LDL cholesterol in the blood.
Simvastatin/Atorvastatin/Pravastatin
- Acts on the: Liver
- Benefits
They reduce LDL cholesterol by 20-40%
- Adverse effects
- How and when to take it
With or without food, preferably at night
Common. May affect less than 1 in 10 people
Very Common. May affect more than 1 in 10 people
CHARACTERISTICS
They reduce triglyceride levels and, as a result, increase HDL cholesterol levels in the blood.
Gemfibrozil
- Acts on the: Liver
- Benefits
Reduces Triglycerides by 20-40%
Increases HDL cholesterol by 7-15%
- Adverse effects
- How and when to take it
With food
Common. May affect less than 1 in 10 people
Very Common. May affect more than 1 in 10 people
CHARACTERISTICS
Inhibits intestinal absorption of the cholesterol we consume in our diet and thus reduces the amount of cholesterol that reaches the liver.
Ezetimibe (on its own or in combination with statins)
- Acts on the: Intestine and Liver
- Benefits
Reduces LDL cholesterol by 12-14%
- Adverse effects
- How and when to take it
With or without food
Common. May affect less than 1 in 10 people
Very Common. May affect more than 1 in 10 people
+
When combined with Statins
These are the most commonly used lipid-lowering agents, but there are other medicines that can be prescribed. If you have any questions about your treatment you can always consult your doctor, practice nurse or pharmacist.
You can also find reliable information in the Medicines Information Centre of the Spanish Agency of Medicines and Medical Devices.
Is it compatible with breastfeeding?
The e-lactancia website will tell you if your treatment is compatible with breastfeeding.
Monitoring Plan
Clinical practice guidelines recommend a blood test for monitoring purposes at least once every 18 months