HYPERLIPIDEMIA, is the broad classification, referring to abnormally high values of lipids (mainly LDL – low density lipoprotein), cholesterol and triglycerides (fats) in the blood. High total cholesterol is referred to as hypercholesterolemia, which is a subset of hyperlipidemia.

The human body is designed to self-sustain and hence cholesterol, a vital substance for cell membranes, is made by the liver. However, the trouble starts when there is excess cholesterol present in the blood, either from uncontrolled genetic mutation or external, controllable factors such as diet and sedentary lifestyle habits. Although it is easier to blame genetics, only a minority of persons suffer from familial hypercholesterolemia (high cholesterol due to genetics), which shows up early in the childhood phase.

According to the CDC (Center for Disease Control), familial hypercholesterolemia increases the risk for heart disease 22 times more than a regular patient. A child as young as eight or 10 years could be diagnosed with hypercholesterolemia. So it is recommended by the American Heart Association that two blood-cholesterol tests be done, once at ages 9 to 11 and then at ages 17 to 21.

Generally for adults, from age 20 you can initiate checks on your blood-cholesterol levels and repeat every four to six years routinely, so as to keep tabs on your numbers. However, for men, it is recommended that close watch commences from age 35 and from age 40 for women, since there is an accumulative effect associated with a lesser active lifestyle.

Unlike the blood pressure and blood sugar where numbers can be changed drastically in a short time span, it must be noted that the cholesterol numbers go up at a slower pace and hence do not warrant frequent testing. Coronary risk can be calculated and projection of a coronary event within a 10-year span could be deduced if adjustments are not made. Sometimes the number can climb dangerously high so stealthily, since the majority of persons do not exhibit signs and symptoms. It is only in the associated genetic disorder that fatty deposits may be noted in the eyes and skin to indicate high cholesterol.

Statistics, which are more readily available from developed countries, indicate that 71 million Americans, or one in eight persons, have high cholesterol, the leading cause for morbidity and mortality. This is a precursor to heart attacks and strokes. Treatment for this type of genetic condition decreases your incidence of heart attack by 80 per cent overall in both genders, where men are at higher risk than women by age 50. It is the 50s and 60s age group that mostly experience heart attacks and strokes.

There are slight variances in guidelines between USA and Canada/ European countries. Getting acquainted with your most recent numbers puts you in the driver’s seat to make any required adjustments. Generally, total cholesterol should be below 180-200mg/dL for adults and up to 160mg/dl in children and total triglycerides should be below 150mg/dL in adults. Borderline ends at a maximum of an additional 40mg/dL for cholesterol (maximum is 240mg/dL) and upper limit of 50mg/dL more for triglycerides (200mg/dL). The severity of the condition depends on the levels of high or very high and dictates the corresponding strengths of medications a physician will prescribe. The recommended initial diagnosis must be done by a physician having taken a proper history and risk factors into consideration. It is not advisable to do a random rapid test without a12-hour fast (only water allowed), prior to the sample of blood taken.

Treatment may vary and includes statins (simvastatin, atorvastatin and rouvastatin are generics used locally or under the brands of Zocor, Lipitor and Crestor respectively), fibrates (gemfibrozil), and sometimes niacin. Diet and exercise are vital as a preventative or maintenance strategy, once the numbers are within range or borderline, for example 190mg/dl in adults. However, when the readings are in 200s or higher, medication intervention are mandatory to accelerate the drop in cholesterol.

Continuous use of the medication (statins) stabilise plagues in the blood vessels and reduce the associated inflammations, thereby preventing a plague from breaking off and blocking off blood supply in the arteries of a heart causing a heart attack or in the brain causing a stroke.

Like with all medications there are some associated side effects with some of the medications, but those are mostly mild and transient and in very rare cases are cause for concern. The benefits of preventing a heart attack, stroke, peripheral disease (where a plague can be lodged in the legs, arms, head or stomach) or the resultant amputation of a limb, far outweigh the risks of nausea, diarrhoea/ constipation and muscle soreness associated with the side effects. Adjustments such as lowering strengths, switching to a different statins or a short “break” in the treatment dictated by only your physician are some of the ways to monitor the situation. New studies are indicating a slight increase in type 2 diabetes, but only in a minority nine per cent of statin users. Some persons noticed memory loss or confusion whilst on statins. In many cases co-enzyme Q-10 has a potential therapeutic target for cardiac damage due to hyperlipidemia and also may relieve the associated muscle soreness.

Reducing your trans and saturated fats intake is a major goal for such patients. Fried foods, red meat, whole milk and pastries should be avoided at all costs. Limits also should be placed on sugar and salt contained foods. Read the labels where available so that you can make better choices. To preserve your heart health your diet must include fruits and vegetables, nuts and whole grains, poultry, fish and vegetable oils. Smoking and salt intake are two key, immediate lifestyle adjustments, since they also contribute to the hardening of arteries.

For further pharmacological guidance and physician referral, contact the pharmacist of Medicine Express PHARMACY located at 223 Camp Street, between Lamaha and New Market Streets. If you have any queries, comments or further information on the above topic kindly forward them to medicine.express@gmail.com or send them to 223 Camp Street, N/burg. Tel #225-5142.