Hyperlipidemia refers to increased levels of fats in the blood, including cholesterol and triglycerides
. Although hyperlipidemia does not cause symptoms, it can cause serious disease by causing stenosis and/or blockage in the vessels that feed the heart, brain, arms and legs. Heart attack, stroke, limb loss due to leg vascular occlusion, hypertension due to renal vascular occlusion, and kidney loss are diseases caused by hyperlipidemia. For this reason, hyperlideemia is a disease that must be treated. .
Coronary artery disease risk factors:
-Hypelipidemia
-Diabetes melliture type-1 and type-2
-Hypertension
-Smoking
/> -Family history: A history of heart attack before the age of 55 in first-degree male relatives and before the age of 65 in first-degree female
relatives
-Age
-Male gender
-Chronic renal failure< br />
Types of lipids: The term lipid includes cholesterol and triglycerides. There are many different types of lipids, called lipoproteins. Lipoprotein levels are measured by blood tests. Standard lipid
measurement; total cholesterol It includes low-density lipoprotein (LDL), high-density lipoprotein (HDL) and
triglyceride. Very low-density lipoprotein (VLDL) is estimated to be one-fifth of triglyceride.
High total cholesterol increases the risk of cardiovascular disease, however Treatment decision
is generally taken according to the LDL level. If the total cholesterol level is less than 200 mg/dl, it is considered normal, between 200-240 mg/dl, it is considered borderline high, and if it is higher than 240 mg/dl, it is considered high cholesterol level. Total cholesterol can be measured at any time of the day, fasting is not required. LDL cholesterol is also called bad cholesterol. High LDL cholesterol levels increase the risk of cardiovascular disease. The LDL cholesterol target is determined by the presence of other risk factors for heart disease and whether there is known heart disease. Lower LDL cholesterol levels are targeted in patients at high risk for heart disease.
LDL cholesterol: It is calculated by subtracting VLDL and HDL cholesterol from total cholesterol and dividing by five. However, this formula is not valid if the triglyceride level is above 400mg/dl.LDL is direct. It can also be measured as LDL. If LDL can be measured directly, there is no need to take it fasting.
HDL cholesterol is also called good cholesterol. High HDL levels, especially levels higher than 60 mg/dl
, are protective against cardiovascular diseases. HDL If the level is less than 40 mg/dl, it does not protect against cardiovascular diseases. There is no medication to increase it. Quitting smoking and exercise cause it to increase slightly. There is no need to be fasting when measuring HDL. Non-HDL cholesterol is calculated by subtracting HDL cholesterol from total cholesterol. Non-HDL cholesterol is superior to LDL in the evaluation of cardiovascular risk. It is a good predictor in the evaluation of cardiovascular risk, especially in patients with type-2 diabetes and women. Appropriate non-HDL cholesterol The target is determined by adding 30mg/dl to the LDL cholesterol target.
Triglycerides are the largest but lightest lipid type in the blood. High triglyceride
also increases the risk of cardiovascular disease. Especially at levels of 600-800 mg/dl. There is a risk of pancreatitis. If the blood level is less than 150 mg/dl, it is considered normal, between 150-450 mg/dl, it is considered slightly high, 450-886 mg/dl, it is considered moderately high, and if it is higher than 886 mg/dl, it is considered very high. It should be checked after 14 hours of fasting.
When should I have my cholesterol level checked?
Many expert groups have guidelines for cholesterol screening. Guidelines indicate that screenings include; They differ in terms of when
when, how often and when they end. But they were basically similar.
Lipid screening in men without other risk factors at the age of 35, in men with other risk factors It should be started between the ages of 20-35. Hypertension, diabetes, smoking, and a family history of heart disease at an early age are other risk factors. Lipid screening should be performed at the age of 45 in women with risk factors for coronary artery disease, and some argue that it can be done even at the age of 20.
Total cholesterol, HDL, LDL cholesterol and triglycerides should be checked during screening; it should be repeated every five years
and at shorter intervals in high-risk individuals.
Treatment
Risk assessment is performed in every patient with hyperlipidemia. LDL cholesterol level should be targeted in the treatment. Patients with a previous heart attack, balloon-stent history, by-pass history, peripheral
vascular disease, diabetic patients with organ damage, patients with severe chronic renal failure are very
are in the high risk group. Patients with total cholesterol level more than 310 mg/dl, blood pressure more than 180/110 mmHg, diabetics, and patients with moderate renal failure are in the high risk
group. The target for LDL cholesterol should be 70 mg/dl in the very high risk group, and below 100 mg/dl in the high risk group.
All patients with hyperlipidemia should follow a diet. Saturated and trans fatty acids reduce LDL
cholesterol. The effect of carbohydrates on LDL is neutral. Therefore, it can be used instead of saturated fatty acids. However, excessive carbohydrate use increases triglyceride levels and lowers HDL. Fiber-rich fruits, vegetables and legumes have direct cholesterol lowering effects. br /> effect. Trans fatty acids taken with the diet should be reduced to the minimum possible,
less than 1% of the total energy taken should be from trans fats. Energy taken from saturated fats should be less than 10% of the total energy
, in patients with hyperlipidemia It should be less than 7%. The energy taken from carbohydrates should be between 45-55% of the total
energy. Daily fiber intake should be 25-40 g, of which 7-13 g should be soluble fiber.
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Weight control and exercise reduce LDL cholesterol and increase HDL. All patients should do regular exercise for 30 minutes every day. While excessive alcohol use increases triglyceride levels, light use increases HDL.
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