For patients: Should you panic about high cholesterol?

What does cholesterol look like?

Many people think of cholesterol as fat and believe that the fattier the food, the more cholesterol it contains. This point of view is only partly justified. Cholesterol is found in the blood and looks like a viscous substance. Cholesterol cannot be considered exclusively harmful, because it is consumed by the body in the process of producing hormones and forming cell membranes. To varying degrees, cholesterol is involved in the functioning of the immune, nervous and digestive systems, so a certain amount of cholesterol must be contained in the body at all times. Another thing is that keeping it within acceptable limits is not always easy.

Excess cholesterol

tends to deposit on the inner walls of arteries.
At first, this is an imperceptible process, but gradually, due to the cholesterol layer, the diameter of the artery narrows, and blood begins to pass through it worse. In places where the vessel narrows, a dense formation is formed from the cholesterol layer, which is commonly called a “ cholesterol plaque
.”
Cholesterol plaques not only almost completely block the flow of blood through the vessel, but also reduce its elasticity. The process of cholesterol formation is called “ atherosclerosis
”.

By themselves, single cholesterol plaques do not pose a serious health hazard, but if you do not take action, over time there will be too many of them. In addition, cholesterol plaque

- This is the initial stage of
thrombus
. Often blood clots form where atherosclerotic plaques were located. The danger of a blood clot is that it completely seals the vessels and can block the flow of blood to vital organs. If a blood clot occurs in a vessel supplying the heart, a person may have a myocardial infarction, and if blood flow stops in a vessel supplying the brain, the person may suffer a stroke.

Does high cholesterol cause death?

Cholesterol itself is not considered deadly. Complications caused by high cholesterol levels can lead to death. We have already named some of them. Atherosclerosis can trigger the development of coronary heart disease, and one of the complications can be myocardial infarction, stroke, acute thrombosis and other diseases. The list can be large and is determined by which arteries were affected.

Main causes of leukocytosis

There are many factors that can influence changes in blood composition. The following are various causes of leukocytosis in the blood in adults.

Often the disease is provoked by infections. One of the main functions of leukocytes is to maintain anti-infective immunity. Therefore, the appearance of foreign pathogens in the body leads to an increase in the number of white blood cells in the blood. Different types of pathogenic microorganisms provoke different types of leukocytosis.

With the bacterial type, the number of neutrophils and monocytes increases. Their action in fighting infections can be compared to an “oxygen explosion” that literally destroys hostile pathogens.

Viral infections provoke an increase in lymphocytes. This type of leukocyte produces specific antibodies to trigger the apoptosis mechanism in viral cells.

Helminthic infestations – the level of eosinophils changes. They contain a cationic protein that can act on helminths that have infected the body and negatively affect the metabolic processes within them.

The causes of leukocytosis can be systemic diseases:

• diffuse connective tissue diseases (for example, dermatomyositis or systemic lupus erythematosus);
• joint diseases (rheumatoid arthritis, etc.);
• systemic vasculitis (giant cell arteritis, nonspecific aortoarteritis).

The exact mechanism of leukocytosis in systemic diseases has not been established. Presumably, the production of leukocytes is provoked by cytokines and mediators that are formed during the process of rheumatic inflammation.

Allergies become the main cause of the development of eosinophilic leukocytosis.

Blood diseases - pathologies such as leukemia, polycythemia, lymphomas, cause the development of hyperleukocytosis. It develops against the background of oncological transformations occurring in bone marrow stem cells. As a rule, the result is severe acute leukocytosis.

Other causes of leukocytosis:

• endocrine type disorders;
• lesions that cause large-scale tissue destruction (for example, extensive burns);
• various types of toxic effects on the bone marrow;
• malignant neoplasms;
• primary immunodeficiency;
• diseases of the lungs and respiratory tract;
• diseases of dermatological type, etc.

Is all cholesterol the same?

Cholesterol is found in the blood, but does not dissolve in it. Cholesterol is carried throughout the body by lipoproteins. High density lipoprotein (HDL) molecules

move cholesterol from the arteries to the liver. Later, this cholesterol is excreted from the body and is not deposited on the walls of blood vessels. Such cholesterol is considered “good” because it not only does not increase, but reduces the risk of developing cardiovascular diseases.

Another type of cholesterol carried by low-density lipoprotein (LDL) molecules

from the liver throughout the body. In peripheral tissues, cholesterol gradually settles on the walls of blood vessels, resulting in the formation of atherosclerotic plaques. It is important for a person to monitor and prevent an increase in the level of low-density lipoproteins, or “bad” cholesterol.

Another form of lipids that provide the body with energy, but in large quantities can be harmful, are triglycerides. They are synthesized by the liver or enter the body with food, and then pass into the blood. A high content of triglycerides in the blood is also undesirable, since it can disrupt the functioning of the circulatory system.

Cholesterol. What is it and why does everyone need it?

Cholesterol (or, in other words, cholesterol) is an organic compound that is produced by our body and also enters it with food. And not from any product. If we talk about food, it should be of animal origin: eggs, fish, meat, milk and offal. And in the human body, the liver acts as the main “factory” for the production of cholesterol. The substance is also formed in the intestinal walls, skin, adrenal glands and some other organs. There are certain values ​​within which the cholesterol level in the blood is considered normal. Indicators for women and men differ not only by gender, but also by age. Nevertheless, cholesterol in a broad sense is a building material for cells. The organic compound is found in cell membranes; participates in the synthesis of vitamin D, sex hormones and metabolism. Thus, without cholesterol our body cannot function normally.

What increases cholesterol?

Increased cholesterol levels can be due to various factors. The first thing you should pay attention to is your diet

.
If a person has a slight increase in cholesterol levels, doctors usually recommend that they eat less foods high in saturated fat, but certain health problems can also contribute to high cholesterol levels. For example, chronic renal failure or decreased thyroid function. Some people may have high cholesterol levels “naturally” and be inherited. This genetic abnormality is called “ familial hypercholesterolemia
”.

When shaping your diet, you need to remember that cholesterol is found only in products of animal origin. This argument is often made in favor of a plant-based diet by vegetarians. However, this does not mean that if animal food is excluded, the rest of the diet can be uncontrolled. Food fried in vegetable oil and products containing palm oil can also have a negative effect on lipid metabolism.

Do healthy people need to monitor their cholesterol?

Often people begin to monitor certain indicators when problems appear and their health worsens, but prevention is always better than cure. The concept of “healthy person” is too general. You may not have liver or metabolic problems now, but that doesn't mean you won't have them in the future. People with identified lipid metabolism disorders should regularly undergo cholesterol tests, but others should not check the strength of their body.

If your diet often contains fatty foods, high-calorie foods, and in general you like to indulge in sweets, then sooner or later this will increase your cholesterol. Other cardiovascular risk factors may also have an impact. As a result, you risk getting atherosclerosis with all the attendant consequences.

Cholesterol norm

If, according to the test results, your cholesterol is normal, then there is no serious cause for concern. Provided you follow the rules of a healthy diet and a healthy lifestyle, the next examination can be done in a few years.

If the cholesterol level is elevated ( from 5 to 6.4 mmol/l or more

), then it’s worth monitoring it every six months to observe the dynamics. At the same time, you need to reconsider your diet, remove foods that increase cholesterol, and also give up bad habits: smoking and drinking alcohol. Your doctor should warn you about additional risks associated with the presence of concomitant diseases.

over 6.4 mmol/l is considered a high-risk level.

. This indicator indicates the need for specialized treatment, since there is a high probability of developing coronary heart disease and other cardiovascular complications. The treatment program should be drawn up by a doctor based on the tests performed, including identifying the level of LDL, HDL and triglycerides.

Cholesterol: lowering cannot be increasing

Do you know why Americans are considered aggressive and assertive? Their blood cholesterol levels are on average significantly lower than those of Europeans. Scientists are already clear: the zeal that we show on the fronts of the war against cholesterol is unnecessary and sometimes even harmful. It's time to reconsider the strategy and tactics of the cholesterol wars!

GUILTY, BUT NOT VERY GUILTY

A recent statement from doctors sounds sensational: there is no direct connection between high cholesterol levels and cardiovascular diseases!

Doubts about this have always existed, but in the late 90s unexpected research data appeared. It turned out that lowering cholesterol with the help of powerful drugs - statins, reduces the risk of cardiovascular diseases only at first, when its level drops by 10-20%. Then no matter what you do, the risk no longer decreases. Some scientists even suggest that the positive effect is achieved not at all by lowering cholesterol, but due to other effects that statins have.

There are already many such studies. It turns out to be a paradoxical situation: just yesterday we were called upon to suppress cholesterol by all possible means, almost to the level of a rabbit (the norm for rodents is 50 mg/dL, for humans – 200 mg/dL).

There is no point in reducing blood cholesterol levels by more than 20%.

Cholesterol is just one of the risk factors for atherosclerosis, although it is the most important. Observational data show: the higher the average cholesterol in a population, the higher the incidence of cardiovascular diseases. High cholesterol.

SEARCHING FOR THE ENEMY

If you lower cholesterol, this does not mean that you are thereby fighting atherosclerosis. A bear, for example, has a normal cholesterol level that is 2 times higher than a human, and atherosclerosis, however, is not the most common disease among clubfoot.

It is not the cholesterol in the blood that is dangerous, but the cholesterol that settles on the walls of blood vessels, forming plaques. Especially in combination with other lipid metabolism disorders: high levels of triglycerides in the blood or low levels of cholesterol carriers - high-density lipoproteins (HDL). Each of these disorders provokes atherosclerosis.

It makes no sense to fight cholesterol as such and get too carried away with this war. The body cannot exist without cholesterol - it is its building material. All cellular structures and tissues of the brain contain cholesterol; it is the precursor of all steroid hormones; without it, the central nervous system cannot function.

But you still need to try to maintain its level within the normal range. In most cases, this can be achieved with diet. Doctors agreed to consider 5.2 mmol/l (200 mg/dl) as the norm. For most, this figure is a dream: the average cholesterol level among Russians is 240 mg/dl.

The cholesterol level is 5.2 mmol/l (200 mg/dl).

WE CARRY OUT EXPLORATION

The only way to find out how high your cholesterol levels are is with a blood test. It is advisable for men to have it done for the first time at the age of 35-40, especially if there are additional risk factors - smoking, diabetes, hypertension (but excess weight is considered not such an important factor). Women are advised to have their cholesterol levels checked as they approach menopause.

Can you trust the analysis? Not long ago, experts assessed the accuracy of determining blood lipids in the laboratories of regular clinics. It turned out that 80% of them make large errors. Therefore, it is better to contact laboratories certified by the All-Russian Certification Center.

There is another way: ask what method is used to determine cholesterol levels in the laboratory - if it is enzymatic, then you can assume that the analysis will be quite accurate. But keep in mind that this method is expensive, and therefore you will have to pay for it. The biggest doubts should arise from free tests: they are performed using the most ancient, cheapest and most inaccurate method.

INCREASED CHOLESTEROL

So, you know your blood cholesterol level and now you must decide whether you need to change something in your life or not.

If your cholesterol level is 240-250 mg/dL (or 6 mmol/L), it's worth considering whether you're eating right. Especially if you have other risk factors for heart disease. However, there is no need to take emergency measures.

If the cholesterol level is 280-300 mg/dl (7-7.5 mmol/l), you need to take decisive action. But under no circumstances should you reach for medications – after all, in principle, you are still quite healthy. To stay that way, it is vital to change your lifestyle: move more, eat less and watch what you eat. You need to monitor your results monthly for the first 2-4 months to assess the effectiveness of your diet.

HOW TO LOWER CHOLESTEROL CHOLESTEROL DIET

• No sandwiches. Try to sharply reduce your butter consumption, ideally switch to vegetable oil. This one step can often bring your cholesterol levels to an acceptable level of 240 mg/dL in just 2-4 weeks.
• Soy instead of cheese. It would also be good to give up cream, sour cream, fatty cheeses and eggs, and at the same time quit smoking. Switching to soy products is very beneficial. This is a protein diet that helps fight excess weight and replaces cholesterol-containing concentrated dairy products.
• Lard lovers should remember that it is very rich in cholesterol. Its consumption must be compensated by eating vegetable oil and fatty fish. It is good to eat lard with garlic: it helps to utilize fats faster.
• Maintain a balance of fats - saturated (animal), monounsaturated and polyunsaturated - there should be a third of them in the diet. In other words, every “eaten piece” of animal fat must be compensated with vegetable fats. You can do this: mix olive, sunflower (or corn) and soybean oils in equal parts and add this balanced mixture to salads, cereals and pasta. DIET FOR HIGH CHOLESTEROL

Walnuts do not help lower cholesterol!

* If there is little HDL (high-density lipoprotein that carries cholesterol) in the blood, substances contained in red grapes will help increase their levels. This is the effect that data on the benefits of moderate consumption of red wine is based on - but juice is also quite suitable!

* If your HDL cholesterol is more than 300-320 mg/dL (8-10 mmol/L) cholesterol, it is better not to try to cope with the problem on your own. A doctor must understand the reasons for such a serious violation.

If dietary cholesterol is to blame, the only thing that will help is diet. But there are other, more serious violations. For example, genetic: the gene responsible for lipid metabolism has broken down. But such defects, as a rule, make themselves felt in childhood and are very rare.

ANTI-CHOLESTEROL MEDICATION ANTI-CHOLESTEROL MEDICATION

Another way to reduce cholesterol from the borderline value of 240-320 mg/dl is dietary supplements. More precisely, not a method, but a help: Dietary supplements are not medicines and will not do a miracle. In addition, you can only take those whose effectiveness has been confirmed by studies, preferably double, placebo-controlled ones. This is important because there are many dietary supplements on the market, and serious research has been carried out on only a few of them.

Conventionally, dietary supplements that control cholesterol levels can be divided into three groups:

• improve lipid metabolism (they contain garlic extract);
• preventing the absorption of dietary fat in the intestines (based on crustacean chitin);
• specialty foods (eg wheat germ oil and fish oil).

STATINS FOR CHOLESTEROL

The last weapon is drugs: statins and fibrates. They block internal cholesterol synthesis. They should be taken only on the advice of a doctor, when the diet does not give the desired result even with the most severe restrictions.

Once you start taking statins, you will have to take them for life. Withdrawal within a few days will bring cholesterol levels back to the original levels, if not higher. In addition, statins are known for their side effects: for example, they can provoke severe depression. And they are not a gift for the liver. The harm of statins

And recently, scientists found that statins can replace... ordinary apples!

In developed countries, statins are prescribed for secondary prevention of heart attacks or other vascular pathologies. For example, a person has had a heart attack or coronary artery bypass surgery, has high cholesterol, plus there is another risk factor - old age, male gender, diabetes or hypertension - then the prescription of statins is justified. In all other cases, it’s shooting sparrows from a cannon.

Author: Olga Smirnova Published: February 17, 2021

Risk group for atherosclerosis

Atherosclerosis

- an insidious disease that develops gradually. Cholesterol level is an indirect indicator of the risk of developing atherosclerosis, but some categories of people need to be tested for cholesterol at certain intervals. The following recommendations are given:

• men over 40 years old;
• women over 45 years old;
• people with diagnosed diabetes;
• overweight people;
• people with diseases of the thyroid gland, kidneys and high blood pressure;
• smokers;
• people who lead a sedentary lifestyle.

It is important to understand that at the first stage of development, atherosclerosis has no visible specific manifestations. A person may not even be aware of the developing disease and the problem with cholesterol. Therefore, doctors recommend regularly donating blood for biochemical analysis.

Diagnostics and tests

To establish why cholesterol has increased, a comprehensive examination of the body is necessary. To determine the level of lipophilic alcohol, after collecting anamnesis, auscultation and measuring blood pressure, the following laboratory diagnostic methods are prescribed:

• blood chemistry;
• lipid profile study;
• immunological analysis.

If you want to identify a genetic defect that may be causing high cholesterol, you may need to donate blood to test the patient's relatives.

When should you start monitoring your cholesterol?

It's never too early for prevention. It’s better to get used to monitoring your health from a young age, then it will present you with fewer unpleasant surprises. It is especially important to pay attention to your health after 40 years of age

, this is true for both men and women. In men, coronary heart disease may begin to develop earlier than in women. This is explained by hormonal levels. Women of childbearing age have more “good” cholesterol in their bodies, while in men the preponderance may lean toward “bad” cholesterol. After menopause, women's bad cholesterol levels may also begin to rise along with their triglyceride levels.

If previously it was believed that atherosclerosis mainly affects mature and elderly people, now the disease is diagnosed in younger patients, so it would be reasonable to start controlling cholesterol levels at 30-35 years of age. If the analysis shows that everything is normal, a re-check can be carried out after 3-4 years, but if the cholesterol level is elevated or there is a genetic predisposition to the development of heart and vascular diseases, then it is worth checking the cholesterol level more often.

Do children suffer from high cholesterol?

Cholesterol levels in children, as a rule, do not rise above normal, but they can also be at risk if hereditary hypercholesterolemia is found in their family. In this case, the child will be registered with a pediatric cardiologist from an early age. A cholesterol test should be done at the age of two years, and then repeated periodically.

Changes in cholesterol levels over the years in men

Men are naturally protected from atherosclerosis less than women. They do not have a high level of estrogen in the body, but they have a higher craving for bad habits that increase the risk of dangerous diseases.

Norms of total cholesterol in men:

• up to 5 years: from 2.95-5.25 mmol/l;
• 5-10 years: from 3.13 to 5.25 mmol/l;
• 10-15 years: from 3.08 to 5.23 mmol/l;
• 15-25 years: from 2.93 to 5.59 mmol/l;
• 25-35 years: from 3.44-6.58 mmol/l;
• 35-40 years: from 3.78-6.99 mmol/l;
• 40-50 years: from 3.91 to 7.15 mmol/l;
• 50-60 years: from 4.09 to 7.17 mmol/l;
• 60-70 years: from 4.12 to 7.15 mmol/l
• 70 years or more: from 3.73 to 7.86 mmol/l.

The closer the cholesterol level is to the lower limit of normal, the safer it is for blood vessels and the heart. Regular levels exceeding 5–6 mmol/l signal the need to prevent atherosclerosis. It is especially important to monitor indicators for men over 50 years of age. From this age their growth accelerates.

Symptoms of high cholesterol

It is possible to determine the exact level of cholesterol in the body only after an analysis, but there are symptoms that may indicate the presence of disturbances in the functioning of the body. This will not allow you to make a diagnosis, but it should be a reason to visit a lipidologist or cardiologist. Make an appointment for a preventive appointment if:

• physical activity or excessive anxiety provokes the appearance of aching pain in the chest;
• even minor physical activity causes a feeling of lack of oxygen;
• you begin to get tired faster, and fatigue is accompanied by a feeling of heaviness in the chest area;
• you often have a headache for no reason, there is noise in your ears, you feel oxygen starvation to the point of fainting.

If you notice the symptoms described, make an appointment with your doctor. It will be enough to visit a therapist so that he can conduct a preventive examination and, if necessary, refer you to other specialized specialists.

The diagnosis of atherosclerosis is difficult to make without biochemical and instrumental examination, so be prepared for the fact that you will have to undergo a series of tests. The examination usually begins with a blood test and an ECG.

. Then, depending on the results obtained, a treatment program is prescribed, if necessary. The patient’s blood is usually taken from a vein, but if a quick result is needed, it can be obtained using the express method by drawing blood from a finger. To obtain more accurate results, it is recommended to donate blood on an empty stomach.

Treatment

Along with treatment of the underlying disease, the following measures are taken to reduce cholesterol levels:

• normalization of physical activity (their degree depends on the level of oxygen flow);
• diet aimed at weight loss;
• balanced nutrition with control of substances entering the body;
• giving up bad habits and foods that contain cholesterol.

During drug therapy, the patient takes medications to cleanse the blood and correct the cellular structure (drugs that contain omega-3 PUFAs, HMG-CoA reductase inhibitors, lipid-lowering agents, fibrates, etc.).