High cholesterol refers to the total cholesterol in the plasma being higher than the normal range. Its occurrence is mainly related to heredity, gender, mental stress, poor diet and living habits. Elevated cholesterol may have no obvious symptoms, but patients with severely elevated cholesterol may experience clinical manifestations such as skin color changes, dizziness, and small swellings. Cholesterol has the functions of synthesizing bile acid, forming cell membranes, and synthesizing hormones. When it is severely elevated, it will block blood vessels, thereby inducing coronary heart disease, cerebral infarction, hypertension, myocardial infarction and other diseases, threatening the patient’s life and health.
Epidemiology
Infectiousnone
symptom
Typical manifestations
Usually, high cholesterol does not cause any special symptoms, but if cholesterol is severely high, some corresponding symptoms will appear, as follows:
1. Skin color changes
The condition is caused by excess cholesterol accumulating in the lower eyelids, resulting in yellow patches around the eyes and sagging skin.
2. Dizziness
High cholesterol may cause dizziness in patients. Because high cholesterol affects blood circulation, it causes cerebral ischemia, which leads to dizziness. It should be noted that this is also one of the symptoms of many cardiovascular diseases.
3. Small swelling
Patients may also develop some small swellings and sores, which are usually smooth and yellow in color, and are more likely to occur on the eyelids, elbows, thighs, heels, etc.
reason
OverviewThe occurrence of high cholesterol is related to many factors. The high saturated fatty acids and cholesterol in daily food are the main causes of high cholesterol in the human body. Long-term mental stress can also easily increase the cholesterol level in plasma. The cholesterol level in the human body generally increases with age. In addition, the abnormality in some patients may be related to genetics.
Cause of symptoms
1. Genetics
Genetic inheritance is one of the important causes of high cholesterol, mainly manifested as familial hypercholesterolemia. Even if such patients have good control over factors such as diet, the total cholesterol in the blood will still be elevated.
2. Age and gender
The cholesterol in the blood increases with age. After the age of 50, the cholesterol level of healthy men tends to stabilize; before menopause, the cholesterol level of women remains at a relatively low level, and after menopause, it rises to roughly the same level as men.
3. Mental stress
Long-term mental stress can easily increase the cholesterol level in plasma. It may be that mental stress has many negative effects on life and work, and many people will have bad behaviors such as overeating, smoking and drinking to relieve stress, which will cause the cholesterol level in plasma to increase.
4. Lifestyle and eating habits
The main factor is diet. Saturated fatty acids and high cholesterol in food are the main causes of high cholesterol in the human body. These foods mainly include beef, pork, whole milk, egg yolks, animal offal (such as pig liver, pig kidney, etc.), seafood (such as fish roe, crab roe, etc.) and ice cream. Excessive consumption will lead to high cholesterol. In addition to diet, bad health habits are also related to high cholesterol. For example, people who lack exercise are more likely to have high cholesterol.
Common diseases
Angina pectoris, myocardial infarction, cerebral infarction, obstructive jaundice, hypothyroidism, nephrotic syndrome, diabetes, etc.
Medical treatment
Outpatient Indications
1. Physical examination revealed significantly elevated cholesterol;
2. Accompanied by high blood pressure, or repeated dizziness and headache;
3. Accompanied by repeated episodes of brief precordial pain and discomfort;
4. Accompanied by edema;
5. Other severe, persistent or progressive symptoms and signs occur.
All of the above require prompt medical consultation.
DepartmentPatients with dyslipidemia can undergo relevant examinations and treatments in departments such as endocrinology and cardiovascular medicine.
Medical preparation
1. Make an appointment in advance and bring your ID card, medical insurance card, medical card, etc.
2. The doctor will draw blood for testing and recommends fasting.
3. If you have had medical treatment recently, please bring relevant medical records, examination reports, test results, etc.
4. If you have taken some medicine to relieve symptoms recently, you can carry the medicine box.
5. Family members can be arranged to accompany the patient to seek medical treatment.
6. Patients can prepare a list of questions they want to ask in advance.
Questions your doctor may ask you
1. When did you find out that you had abnormal blood lipids? How did you find out?
2. Do you monitor your blood lipids regularly? Under what circumstances do blood lipids usually increase? Under what circumstances do they decrease?
3. Do you have symptoms such as blurred vision or decreased vision?
4. Do you have symptoms such as abdominal pain, nausea and vomiting, dizziness, headache, and lack of mobility?
5. Do you have symptoms such as chest tightness, palpitations, and shortness of breath?
6. Do you have diabetes, hypertension, coronary heart disease or other diseases?
7. Do any family members have dyslipidemia?
8. What are your daily living habits like? Do you smoke or drink excessively? How long have you been smoking/drinking? How much do you smoke/drink each time? What are your eating habits like?
9. How have your sleep, diet, and urination been since you became unwell?
Questions patients can ask their doctors
1. What is the most likely cause of my dyslipidemia?
2. Are there any other possible reasons?
3. What tests do I need to do?
4. Do I need to be hospitalized?
5. What methods will be used to treat my disease? Can it be cured?
6. What are the risks of these treatments? Will they cause other adverse effects on my body?
7. If medication is possible, what are the usage, dosage, and precautions?
8. I have other physical discomforts. Will it affect my treatment this time?
9. What aspects of my daily life do I need to strengthen? What should I pay attention to?
10. Is there any good way to prevent it?
11. Do I need a follow-up examination? How often? What items are usually reviewed?
examine
Estimated inspectionFor patients who seek medical consultation, the doctor will first conduct a full physical examination to check for xanthomas, etc. At the same time, the patient will be asked to draw blood for tests to check the lipid content in the blood and assess whether the blood cholesterol is elevated.
Physical examinationIt is mainly through visual examination and other examinations to check whether the patient has symptoms such as xanthomas.
Laboratory tests
The four blood lipid tests are the preferred method for checking cholesterol. The test results can clearly show whether cholesterol is elevated. The reference values of the four blood lipid tests are as follows (cited from the 9th edition of Diagnostics published by People’s Medical Publishing House):
(1) Total cholesterol: appropriate level <5.20mmol/L; marginal level 5.20~6.20mmol/L; elevated level >6.20mmol/L.
(2) Triglycerides: Suitable level: 0.56~1.70mmol/L; marginal level: 1.70~2.30mmol/L; elevated level: >2.30mmol/L.
(3) Low-density lipoprotein: appropriate level ≤ 3.40 mmol/L; marginal level 3.40-4.10 mmol/L; elevated level > 4.10 mmol/L.
(4) High-density lipoprotein: reference value 1.03~2.07mmol/L; appropriate level >1.04mmol/L; reduction ≤1.0mmol/L.
diagnosis
Diagnostic principles
Usually, a clear diagnosis can be made based on the patient’s clinical manifestations and laboratory tests. For example, if the patient has various forms of xanthomas, hypercholesterolemia should be a warning sign; if the patient suddenly feels pain in the precordial area, most of the time it is paroxysmal colic or squeezing pain, and coronary heart disease should be a warning sign.
Differential Diagnosis
1. Hypercholesterolemia
Hypercholesterolemia refers to a disease in which the total cholesterol in the plasma is greater than the normal value and the lipid metabolism is abnormal. The cause of hypercholesterolemia is mainly related to genetics, poor diet and lifestyle habits, as well as age and gender factors. Usually there are no obvious symptoms, and patients may have various forms of xanthomas (an abnormal localized skin protrusion that can be yellow, orange or brown-red in color, mostly in the form of nodules, plaques or papules, and generally soft in texture). Hypercholesterolemia can usually be diagnosed through blood tests.
2. Coronary heart disease
Coronary heart disease is also known as coronary atherosclerotic heart disease. The main clinical symptom is sudden pain in the precordial area, which is usually paroxysmal angina or squeezing pain. It can usually be diagnosed through electrocardiogram, echocardiogram, blood routine test, biochemical test, coronary artery CT and coronary angiography. Coronary angiography is generally considered the gold standard for detecting coronary heart disease.
3. Nephrotic syndrome
Nephrotic syndrome is a group of clinical syndromes with heavy proteinuria, edema, hypoproteinemia and hyperlipidemia as the main manifestations. Some patients may also experience fatigue, nausea, loss of appetite and low back pain. Generally, the diagnosis can be confirmed based on the patient’s clinical manifestations and urine routine, blood biochemical tests, renal function tests, serum complement tests and B-ultrasound tests.
treat
Expected treatmentFor patients with high cholesterol, doctors will first ask them to pay attention to managing their diet in daily life, give them corresponding dietary advice, and ask them to strengthen their exercise. They will also give them some lipid-lowering drugs according to their actual conditions to try to control blood lipids within an appropriate range.
Treatment
1. Improve your lifestyle
(1) Control diet: When the patient’s cholesterol level is high, he or she should pay attention to controlling his or her diet. He or she should eat less or no greasy foods that are rich in high cholesterol, such as egg yolks, animal offal, fried foods, seafood, beef, pork, etc. The patient can eat more light foods, such as fresh fruits and vegetables, rice porridge, etc.
(2) Strengthen exercise: Patients should try to exercise on a daily basis, such as jogging, playing basketball, cycling, playing badminton, etc.
2. Drug treatment
Lipid-lowering drugs are generally used in combination. The drugs that can be used clinically for lipid-lowering include:
(1) Statins: These are the most widely used powerful cholesterol-lowering drugs in clinical practice, such as simvastatin, atorvastatin, rosuvastatin, etc. These drugs are contraindicated for people who are allergic to statins and women who are pregnant or breastfeeding.
(2) Ezetimibe: Patients should maintain a low-fat diet while taking this drug. This type of drug is not recommended for patients under 10 years old.
(3) Probucol: This product has the effects of regulating blood lipids and resisting lipid peroxidation, but it should be noted that it is not suitable for children.
Related drugsSimvastatin, atorvastatin, rosuvastatin, ezetimibe, probucol
daily
Nursing principles
1. Eat a healthy diet
Many people have high cholesterol mainly due to unhealthy diet, so patients should pay attention to controlling their diet in daily life, try to eat less cholesterol-rich foods, and eat less or no fried foods. At the same time, you can eat more fresh fruits and vegetables, which is beneficial to the patient’s recovery.
2. Strict medication
For patients who need to take medication for treatment, they must strictly follow the doctor’s instructions and pay attention to adverse reactions of the drugs, such as nausea, vomiting, dizziness, etc. If adverse reactions occur, inform the doctor in time.
3. Exercise more
For patients with high cholesterol, they must strengthen exercise in daily life, such as jogging, playing basketball, playing badminton, and cycling. Appropriate exercise is not only beneficial in lowering cholesterol but also can exercise the patient’s cardiopulmonary function.
4. Develop a good lifestyle
People with high cholesterol also need to improve their lifestyles, try not to stay up late, quit smoking, quit drinking, etc.
5. Regular review
Patients need to have regular checkups to understand their cholesterol status and can bring relevant medical records and information with them.
prevention
Precautions
1. Control your body weight and maintain an appropriate body mass index (BMI 18.5-23.9 kg/m 2 ).
2. Eat a reasonable diet, control total calories, and reduce fat, especially the intake of cholesterol and saturated fatty acids. Eat less fatty meat, squid, egg yolk, fish roe, butter, cocoa butter, liver, brain, kidney and other animal offal; appropriately increase protein and low-animal fat foods, such as fish, chicken, egg whites and soy products, and increase the proportion of carbohydrates in the diet.
3. Exercise appropriately and start physical activities gradually. Do not force yourself to do strenuous activities.
4. Live a regular life, maintain an optimistic and happy mood, combine work and rest, and ensure adequate sleep.
5. Quit smoking and limit alcohol consumption.
6. Actively control risk factors such as blood pressure, blood sugar, etc.