Have you heard of Dyslipidemia before? Do you know what that is and why that is an emerging issue these days? There are so many people in the world who have it. According to a study, 20% of American adults and 20% of Korean adults have this problem. It is a really common disease but if you don’t control it well it can cause other troubles. It is important to manage it carefully.
What are HDL and LDL?
Have you heard of good cholesterol and bad cholesterol by any chance? Lipoproteins in the body exist in various forms in the process of metabolising. And two of those are high-density lipoprotein(HDL) and Low-density lipoprotein(LDL).
People sometimes say that HDL is a ‘good’ cholesterol. HDL moves cholesterol in the blood to the liver. And the cholesterol is decomposed and discharged from the body. That lowers the cholesterol level.
On the other hand, LDL is considered a ‘bad’ cholesterol. It is accumulated in the blood vessels and causes health issues. There is a risk of getting worse, causing arteriosclerosis and clogging by clots in the blood vessels. That’s why it is important to maintain this level in a healthy range.
How do I know if I’m at risk?
First, you should check your lipoprotein level. You should fast at least 8 hours before the blood test to get a precise test result. And your status will be different depending on the numbers of your results.
You don’t just treat dyslipidemia for treating itself. What we want to get from treating it is to prevent complications. That’s why we divide risk groups and diversify treatment plans.
We make a plan for the treatment based on the following risk factors of cardiovascular disease you might have since that disease is the common complication.
Here are the risk factors
Age (over 45 years old for men, over 55 years old for women)
Family history (check if your family members have or have had coronary artery disease when they were less than 55 years old for men and 65 years old for women)
Hypertension (see if your blood pressure is higher than 140/90mmHg or check if you are taking medicine for that currently.)
Smoker
HDL level is lower than suggested range (40mg/dL is suggested)
And, here are some brief treatment plans.
1) Ultra-high risk group : People who already have Coronary Artery Disease, Stroke, Ischemic attack, or Peripheral Vascular Disease. In this case, if they have an LDL level higher than 70, we consider medication treatment. The goal of the treatment is lowering the LDL level to less than 70.
2) High risk group : People with carotid artery stenosis, aneurysm in their abdomen, or diabetes. In this case, they are considered to get medication treatment when their LDL level is over 100.
3) Moderate risk group : People who have 2 or more than 2 of the risk factors I suggested but don’t have typical disease. In this case, we do not start the medication treatment just yet. Instead, we try to adjust their life habits for weeks or months. If it seems it doesn’t work and they have the LDL level over 130 still, then we consider the medication.
4) Low risk group : People who have one or less than one risk factor. If their LDL level is between 160 to 190, we try to adjust their life habits. If it doesn’t work, we consider the medication.
What are the symptoms?
Most of the time, there’s not typical symptoms, just like hypertension. The symptoms from lipid abnormalities are often shown after other complications from it. Specifically, blockage of the blood vessels due to the clots and lipid accumulation from dyslipidemia generates symptoms. For example, chest pain would occur from coronary artery disease. Also, numbness with blurred vision, discoordination of your body, and slurred speech would happen from transient ischemic attack or stroke.
How do I fix it?
Yes, it helps a lot if you take some medicine, but more importantly, you should remedy your life habits.
lifestyle remedy
Reduce saturated fat and trans fat intake. Saturated fat and trans fat increase cholesterol level. Red meat and dairy products contain a lot of saturated fat. Natural trans fats are found in artificially made products like snacks and fast food.
Eat healthy. I recommend food that contains fiber or unsaturated fat. For example, there are fruits, vegetables, oats, beans, nuts, and fish. Omega-3 will also help lowering your cholesterol level.
Exercise at least 120 min a week. If you do it for 30 min a day, 4 times a week is recommended.
Do not just starve. It might be bad for your health. You can find the right diet and exercise for you, so consult with your doctor and start.
Medication treatment
If you are at a high risk of dyslipidemia, or if the implementation of your lifestyle remedy plan didn’t work, you need to take medicine along with the other treatment plans. Medicine may vary with your condition.
You will get medicine according to your test result.
For example, if it is the LDL problem, they can give you Statin(HMG-CoA reductase inhibitor). That medicine has a side effect that might give you muscle pain or joint pain. Besides that medicine, they can prescribe you with Ezetimibe, PCSK9 inhibitor, or other drugs that are related to LDL metabolism. On the other hand, if it is the TG problem, you will control it with Fibrate or Omega-3 fatty acid.
If dyslipidemia is caused by another disease, that causing one has to be treated first.
Get the right medicine and keep taking it.
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References
AHA journals_guideline on the management of blood cholesterol