Hyperlipidemia – causes, symptoms & therapy

Hyperlipidemia comes in two varieties – primary and secondary hyperlipidemia. The first form (primary hyperlipidemia) is an original, usually genetic disease, while the second form (secondary hyperlipidemia) is the result of another underlying disease.

The classification according to Fredickson, in which the specific values ​​(total cholesterol, LDL- and HDL-cholesterol, triglycerides) as well as the staining of the fasting serum and the result of the gel electrophoresis have been included, has proven itself for the differentiation of the primary hyperlipidemias.

Five types of primary hyperlipidemia can be diagnosed in this way: HLP type 1 to HLP type 5 for short. The more common secondary hyperlipidemias are in many cases related to diet and lifestyle. Hyperlipidemia is not a side issue: around 20 percent of adults in western industrialized nations have problems with their lipid metabolism. In the 40plus generation, the rate is even around 50 percent.

causes

The causes for the development of hyperlipidemia can be very different. The decisive factor is whether it is a disease of its own or whether the hyperlipidemia is merely a symptom of another disease. This leads to the distinction between primary and secondary hyperlipidemia. The former form is usually genetic, so it is not caused by other diseases.The other form of hyperlipidemia can result, for example, from diabetes – both in the case of type 1 diabetes and type 2 diabetes .

Liver or kidney diseases, bile congestion (cholestasis), hypothyroidism (hypothyroidism), inflammation of the pancreas (pancreatitis), some rare metabolic diseases and even alcoholism can be the cause of hyperlipidemia.

In addition, drugs and hormonal changes – for example after pregnancy – can cause an increase in lipids in the blood. And even diet can play a role in the development of hyperlipidemia – in the form of overeating or malnutrition.

Diseases

• hypothyroidism

• Inflammation of the pancreas (pancreatitis)

• metabolic disorders

• Cholestasis

When to the doctor?

The disease usually has an insidious course. The initial symptoms will be difficult for most people to recognize, making it difficult to see a doctor early. As soon as they are overweight, the person concerned should take countermeasures without consulting a doctor. If that doesn’t work, it helps to ask a doctor for advice. If you become overweight, you need to see a doctor.

A doctor must be consulted in the case of symptoms such as high blood pressure, heavy sweating and limited mobility. Chest discomfort, feelings of pressure, cardiovascular problems or heart rhythm problems must be examined and treated. If there is a racing heart , a general feeling of illness or exhaustion, a doctor’s visit is necessary. Further investigations should also be initiated if everyday obligations or professional tasks can no longer be fulfilled as usual.

If there are emotional problems, a doctor should also be consulted. Mood swings, persistent dissatisfaction, depressive phases or feeling unwell should be clarified in order to prevent mental illness. A doctor is needed in the event of circulatory disorders, irritability, inner restlessness or an increased occurrence of inflammatory diseases of all kinds. If breathing problems or sleep disturbances set in, medical care is needed to prevent acute health situations that can be life-threatening.

symptoms and course

Typical symptoms of hyperlipidemia:

• increased blood lipid levels

• high blood pressure

• obesity

In most cases, hyperlipidemia initially causes no symptoms or specific symptoms. In a few cases, so-called xanthomas are visible on the skin – especially in the area around the eyes, elbows and knees.

In addition, the patient usually does not observe any changes in his appearance or his state of mind. But that is precisely what is insidious: This disease can develop over a longer period of time without the patient noticing anything.

If certain risk factors such as high blood pressure, obesity, lack of exercise or smoking are added to the elevated blood fat levels, there is a great risk that hyperlipidemia can develop into a secondary disease – for example coronary heart disease . In the end, a stroke can even threaten. In many cases, the cause of such a course is an existing arteriosclerosis , which can be the result of increased blood lipid levels over a longer period of time.

Diagnose

Is there hyperlipidemia or not? The medical clarification of the question or the corresponding diagnosis includes various factors: First of all, the determination of the blood lipid levels already provides a certain amount of information. After that, the treating doctor will certainly ask the patient whether close relatives – i.e. parents or siblings – have already suffered a heart attack or stroke.

An ultrasound examination is also a good idea to see whether there is a deposit of the so-called bad LDL cholesterol in the patient’s blood vessels. The main artery in the neck is particularly suitable for determining this: the so-called intima-media complex can be determined here. Too much cholesterol in this tissue layer is then considered an indication of a significantly higher vascular risk and thus of hyperlipidemia.

complications

Hyperlipidemia causes patients to suffer from a variety of symptoms. However, the complications also depend on the type of disease, so that a general prediction cannot usually be given. However, the patients suffer from a significantly increased risk of a heart attack. In the worst case, this can lead to the death of the person concerned or cause certain disabilities. A fatty liver or significant obesity can also occur as a result of hyperlipidemia and thus significantly reduce the quality of life of those affected.

In many cases, the patients suffer from pain in the upper abdomen and thus also from a loss of appetite. The risk of certain circulatory diseases is also increased and promoted by this disease, so that those affected by hyperlipidemia may have a reduced life expectancy.

Treatment of the condition is usually not associated with complications and can relieve symptoms. With the help of medication and a healthy diet, the fat levels in the blood can be reduced again. Furthermore, however, the treatment of the underlying disease is also necessary in order to completely limit the hyperlipidemia.

treatment and therapy

If hyperlipidemia is associated with being overweight , it is essential to ensure a balanced diet and increased physical activity at the same time in order to achieve a normal weight as quickly as possible. With regard to nutrition, the ratio of fat and protein content (about 25 percent each) in relation to the carbohydrate content ( about 50 percent) is particularly important.

However, this change in diet or diet is not always sufficient to counteract hyperlipidemia efficiently. In these cases, statins are used. They have a stronger lowering effect than other groups of substances. The so-called CSE inhibitors are particularly suitable for drug treatment of hyperlipidemia: they primarily cause a significant reduction in cholesterol levels.

Patients who have suffered a heart attack or stroke are primarily predestined to take these CSE inhibitors. In addition, hyperlipidemia patients with increased fat storage in the aforementioned intima-media complex also benefit from taking it, regardless of whether this group of people has already suffered a heart attack or a stroke or not.

prevention

There is no real prophylaxis for genetically caused hyperlipidemia. The most important preventive measure is therefore the elimination of other risk factors. In addition to normalizing body weight, this includes, above all, controlling blood pressure. To prevent hyperlipidemia from occurring in the first place, from the age of 36 the blood lipid levels should be checked regularly – at least every two years.A routine health check by the family doctor is a good idea for this. In most cases, the costs are covered by the health insurance companies. In some cases – for example in the case of changed living conditions with weight gain – an earlier check-up even seems advisable. Thus, hyperlipidemia will soon have its fat years behind it.