High cholesterol levels are primarily associated as a risk factor for diseases such as heart attack, stroke, arteriosclerosis, and diabetes.
The focus is on the LDL-HDL ratio. However, cholesterol is an essential substance for humans.
It is an important component of cell membranes and the starting material for the synthesis of many hormones: cholesterol is used to produce bile acids, vitamins and hormones.
The body produces three quarters of all cholesterol in the course of cholesterol synthesis in the liver and in the intestinal mucosa itself.
The rest enters the body through food. Eating too many fatty foods, especially animal fat, causes too much cholesterol to be absorbed in developed countries.
Cholesterol is a fat in the blood. If the concentration in the blood is too high, cholesterol is deposited in the blood vessels.
HDL and LDL: good and bad cholesterol:
In the blood test, a distinction is made between HDL cholesterol and LDL cholesterol.
HDL (high-density lipoprotein) cholesterol is made up of half protein and half fat. It is formed in the intestinal mucosa and in the liver and is used to transport excess cholesterol back to the liver.
Through HDL cholesterol, it is returned to the liver, where it can be broken down and then excreted in the bile.
That is why HDL cholesterol is also called good cholesterol.
It makes up about 25 percent of the total cholesterol in the body.
Women have a hormonal advantage here: with them, estrogens ensure that they produce a particularly large amount of HDL cholesterol.
Although this does not always occur, it largely prevents vascular deposits. This advantage gradually disappears after menopause.
LDL cholesterol is high in fat:
LDL (low-density lipoprotein) cholesterol is the antagonist and is often referred to as the bad cholesterol.
LDL cholesterol is a protein produced in the liver with a high percentage of fat.
It transports cholesterol from the liver to the cells. If it circulates too much in the blood, the risk of formation of so-called plaques and calcification of the vessels increases.
If this calcification is very pronounced, it increases the risk of high blood pressure, heart attacks and strokes.
The values of HDL, LDL, VDL plus triglycerides, the third group of blood lipids, are added together. The values obtained are used to estimate the risk of cardiovascular diseases, diabetes mellitus or thyroid dysfunction.
If relevant diseases have already been diagnosed or there is excess weight that needs to be reduced, the therapy and course can be controlled by blood lipids.
A high blood cholesterol level is often detected too late because it does not cause any symptoms. Therefore, it is important to have your cholesterol level checked early and regularly.
The cholesterol ratio is determined from the blood serum. The blood sample must be taken on an empty stomach, so the patient must not have ingested anything in the last twelve hours.
Normal blood cholesterol values depend on age and sex. The concentration of lipids in the blood generally increases with age.
The cholesterol level is then higher in women than in men. It also increases significantly during pregnancy.
A total cholesterol value of less than 200 milligrams per deciliter (mg/dl) is considered a healthy normal value.
Millimoles per liter (mmol/l) is also used as a unit of measurement for cholesterol level. 200 mg/dl correspond to 5.17 mmol/l.
The LDL level in the blood should always be as low as possible. When performing the evaluation, the doctor will use the existing risk factors. These factors are:
high blood pressure
diagnosed cardiovascular diseases
low HDL cholesterol
Heart disease in the family
Age (men over 45, women over 55)
Depending on how many risk factors a person has, the following target limits for LDL cholesterol and total cholesterol apply, and should not be exceeded:
LDL cholesterol risk low risk (fewer than two risk factors)
below 160 mg/dl
moderate risk (two or more risk factors)
below 115 mg/dl
high risk (for example, very high blood pressure)
below 100 mg/dl
very high risk (diseases already diagnosed such as diabetes, arteriosclerosis, coronary heart disease, myocardial infarction, stroke)
below 70 mg/dl
If LDL cholesterol values are above the recommended values, you should reduce the value of LDL below the upper limit of normal value.
The proportion of HDL cholesterol in the blood should always be as high as possible, greater than 40 milligrams per deciliter in men and more than 50 milligrams per deciliter in women.
the LDL-HDL ratio:
The ratio of LDL to HDL cholesterol is important in assessing the risk of arteriosclerosis and other cardiovascular diseases.
This LDL-HDL ratio may be around 3.5 in a healthy person.
Lower values are applied for people who are pre-stressed and with certain risk factors and for patients with already manifest cardiovascular diseases, in these cases the quotient must be less than 2.5.
También se suele utilizar la proporción colesterol/ HDLcolesterol, que normalmente para que no exista riesgo, debe ser menor de 4,5
Causes of high cholesterol levels.
An unhealthy lifestyle with lots of high-fat foods and little exercise can raise blood cholesterol levels.
In addition, various diseases have an impact on the level of blood lipids. Kidney disease or hypothyroidism, as well as genetic causes; may be causes of an increase in value.
LDL values that are too high may indicate biliary obstruction or kidney failure. The value is also influenced by taking medication. These include steroid hormones or luteal hormones (progestins).
Causes of low cholesterol:
In general, low total cholesterol and low LDL are considered desirable. However, remarkably low values should be examined. These can occur, among other things, in:
Too low a level of good HDL cholesterol has an unfavorable effect on the LDL-HDL ratio and thus increases the risk of heart disease or stroke.
Lowering cholesterol reduces the risk of blood vessels.
The type of fat eaten is much more important to a healthy diet. To increase the HDL cholesterol level, you should avoid animal fat and instead consume vegetable fat with unsaturated fatty acids.
The so-called trans fats are also dangerous and should be avoided. They are found mainly in products with hydrogenated vegetable fats (margarine, frying fat, lard).
In addition, obesity should be reduced, and regular exercise can also help lower cholesterol.
Cholesterol-lowering drugs, statins and fibrates, can help lower cholesterol to less dangerous levels.
In cases of intolerance, ezetimibe removes cholesterol from the bile, omega3 fatty acids in large quantities are useful.
In extreme cases, monoclonal antibodies against PCSK9, evolocumab and alirocumab are used. They are a novel therapeutic tool that is very useful in cases of heterozygous familial hypercholesterolemia.
In some cases of homozygous familial hypercholesterolemia and in people with high cardiovascular risk, whose LDL-C levels cannot be controlled with maximum tolerated doses of the most effective statins, in addition to ezetimibe and lifestyle changes.
-PCSK-9: role in hypercholesterolemia and inhibitory specific monoclonal antibodiesÁlvaro J. Ruiz-Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia.
-Sharon Theimer-Family Hypercholesterolemia Is Different Than Typical High Cholesterol-July 12, 2017.
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Colesterol y riesgo cardovascular, ratio LDLcolesterol y HDLcolesteol,
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