HYPERCHOLESTEROLEMIA

Hypercholesterolemia is a non-communicable illness characterized by raised low density lipoprotein cholesterol levels of 190 mg/dL or greater.

HYPERCHOLESTEROLEMIA​

Hypercholesterolemia is a non-communicable illness characterized by raised low density lipoprotein cholesterol levels of 190 mg/dL or greater.

  • Increased fat and cholesterol levels in the blood promote calcification in arties and artery constriction, which are the primary causes of cardiovascular diseases (CVDs).
HYPERCHOLESTEROLEMIA nutrition

Prevalence

According to the World Health Organization, hypercholesterolemia is responsible for 56% of ischemic heart disease and 18% of cerebrovascular disease globally. The National Health and Nutrition Examination Survey reported that persons aged 20 to 39 and 40 to 64 had elevated levels of low density lipoprotein cholesterol (LDL), however only 10.6 percent (20 to 39) and 47.7 percent (40 to 64) of these adults were receiving treatment for hyperlipidemia (NHANES). The leading cause of death worldwide is cardiovascular disease, and abnormal lipids level is one of the major risk factors.

In the United States, roughly 33% of individuals have less than 200 mg/dl TC and low LDL above 130 mg/dl. Only 16% of persons have more than 40 mg/dl of HDL.

 A study directed in Pakistan reported that dyslipidemia was more common in men (97.18%) than in women (87.15%). The prevalence of hypercholesterolemia was determined to be 39.3%, Baluchistan having the lowest (22.7%) and Punjab having the highest (41.6%) and Baluchistan having the lowest (22.7%).  

The prevalence of food allergies has increased from around 3% of the population in 1960 to around 7% in 2018, worldwide.

Causes

It is a complex disease caused by both hereditary and environmental factors.

There are two forms of the disease:

  1. One is caused by an unhealthy lifestyle such as lack of exercise, poor diet, smoking, alcohol and obesity and the other by the cumulative modest effects of several genes (polygenic hypercholesterolemia).
  2. The other form is a Mendelian condition known as familial hypercholesterolemia, which is due to the impaired single gene deficiency.

The other causes of hypercholesterolemia includes:

  • Thyroid dysfunction
  • Diabetes mellitus
  • Mutation in lipoprotein lipase
  • Renal diseases
  • Alcoholism
  • Jaundice  
  • Medications such as diuretics, B-receptor blockers and cyclosporine

Patient’s Observation

The patient learns they have hypercholesterolemia through routine blood tests because the disorder’s signs and symptoms may not be obvious. Generally speaking, the patient may have pain in the chest, the abdomen, athermanous plagues in blood vessels, spleen hypertrophy and liver disorder.

Sign and Symptoms

The most common food allergy signs and symptoms include:

  • Itching
  • Hives/eczema
  • Trouble in breathing
  • Abdominal pain, diarrhea, nausea or vomiting
  • Dizziness or fainting
  • Inflammation and swelling of the lips, face, tongue and throat or other parts of the body

Nasal congestion

Complications

Complications includes:

  • Myocardial infection
  • Ishemic heart disease
  • Stroke
  • Peripheral artery disease

Medications

Taking cholesterol-lowering medications such as statins

    • Nicotinic acid
    • Ezetimibe
    • Bile acid sequestrants
    • Niacin
    • Fibrates
    • Bempedoic acid
    • PCSK9 inhibitors

Dietary Guidelines

  • A healthy lifestyle that includes eating well, maintaining a healthy body weight, regular exercise and limiting alcohol and smoking may assist to prevent hypercholesterolemia.
  • Avoid foods that are high in saturated fats (such as dairy dessert, fatty meal and cheese).
  • Select foods that are low in sodium (salt), tran fat, saturated fat and added sugars (include seafood, low or fat free dairy, lean meats, seafood and yogurt; whole grains; and vegetables and fruits).
  • Consume foods that are naturally high in fiber, like oat, beans, and unsaturated fats (olive oil, nuts, avocado and vegetable oils). These foods may increase levels of HDL (“good”) cholesterol while decreasing levels of LDL (“bad”), cholesterol and triglycerides.

References

  1. World Health Organization. Global status report on noncommunicable diseases 2014.http://www.who.int/nmh/publications/ ncd-statusreport-2014/en/.
  2. Fairoozy RH. Genetic functional studies of low density lipoprotein-cholesterol (LDL-C) associated variants and the genetic spectrum of familial hypercholesterolemia in different ethnic groups(Doctoral dissertation, UCL (University College London).2018:1-417.
  3. Beheshti SO, Madsen CM, Varbo A, Nordestgaard BG. Worldwide prevalence of familial hypercholesterolemia: meta-analyses of 11 million subjects. Journal of the American College of Cardiology. 2020 May 26;75(20):2553-2566.
  4. Ashraf S, Arfeen A, Amjad S, Ahmed Z. Effect of walnut (Juglans Regia) consumption on hyperlipidemic adults. Food Science and Technology. 2020 Oct 19:1678-1457.
  5. Sarfraz M, Sajid S, Ashraf MA. Prevalence and pattern of dyslipidemia in hyperglycemic patients and its associated factors among Pakistani population. Saudi journal of biological sciences. 2016 Nov 1;23(6):761-766.
  6. Basit A, Sabir S, Riaz M, Fawwad A. NDSP 05: Prevalence and pattern of dyslipidemia in urban and rural areas of Pakistan; a sub analysis from second National Diabetes Survey of Pakistan (NDSP) 2016–2017. Journal of Diabetes & Metabolic Disorders. 2020 Dec;19(2):1215-1225.
  7. Huriyati E, Luglio HF, Ratrikaningtyas PD, Tsani AF, Sadewa AH, Juffrie M. Dyslipidemia, insulin resistance and dietary fat intake in obese and normal weight adolescents: the role of uncoupling protein 2-866G/A gene polymorphism. International journal of molecular epidemiology and genetics 2016; 7(1): 67-73.
  8. Naser IH, Abd Alkareem Z, Mosa AU. Hyperlipidemia: pathophysiology, causes, complications, and treatment. A review. Kerbala journal of pharmaceutical sciences 2021; 1(19). 393-402.
  9. Kang YJ, Wang HW, Cheon SY, Lee HJ, Hwang KM, Yoon HS. Associations of obesity and dyslipidemia with intake of sodium, fat, and sugar among Koreans: a qualitative systematic review. Clinical nutrition research 2016; 5(4): 290-304.
  10. Kumar D, Parcha V, Maithani A, Dhulia I. Effect and evaluation of antihyperlipidemic activity guided isolated fraction from total methanol extract of Bauhinia variegata (linn.) in Triton WR–1339 induced hyperlipidemic rats. Asian Pacific Journal of Tropical Disease. 2012 Jan 1;2: 909-913.
  11. Ibrahim MA, Asuka E, Jialal I. Hypercholesterolemia. InStatPearls [Internet] 2022 Jun 19. StatPearls Publishing.
  12. Kelly RB. Diet and exercise in the management of hyperlipidemia. American family physician 2010; 81(9):1075-1102.