Most patients know that high cholesterol is considered a bad thing, and most know that cardiologists and primary care doctors can detect early signs of the disease, but there is much more to the subject. For patients who suspect they may be suffering from high cholesterol levels, a trip to the physician is highly recommended in order to prevent serious complications from the disease. This is especially true for those patients suffering from other diseases that are associated with high cholesterol, like diabetes, hypothyroidism, kidney disease, or liver disease. If a physician can detect high cholesterol levels before heart disease has begun to degrade the cardiovascular system, treatments are more effective and the risk to the patient is lower.
Although blood testing is one useful component to determine whether cholesterol has become a problem for any given patient, there are other clinical signs as well. Sometimes, patients may experience abdominal pain due to an enlarged liver or spleen, gallstones, or an inflamed pancreas. At other times, they may experience tendon pain, or even eruptive xanthomas, which are areas of fat buildup under the skin that look like sores. Patients may also have thickening and darkening of the skin in areas such as the back of the neck (this is known as acanthosis), muscle weakness, joint pain, or nerve damage. These signs, in combination with the results of a comprehensive blood test can point to lipid disorders as the cause for symptoms and heart disease risk.
If disease is confirmed or there are obvious signs of hyperlipidemia (fat levels that are too high), then there are several options for treatment, depending upon the situation of each individual. For one thing, some patients may be able to modify their diets to the extent that it has a measurable impact on their cholesterol levels. This may be done by limiting total cholesterol intake to no more than 200 mg daily, and limiting fat to no more than 30% of total calories. Plant sterols and stanols are also encouraged as things that should be added to the diet, since they reduce the amount of cholesterol that is absorbed by the body. There are several different types of medications that are used to help with high cholesterol.
First among these medications is the family of cholesterol absorption inhibitors. Drugs such as azetimibe inhibits the absorption of cholesterol and phytosterols; it is designed to lower LDL but it does not affect triglycerides. Although unsafe for pregnant or breastfeeding women, in patients where it can be used it reduces cholesterol levels by 10-15% on average. Often, azetimibe is given in combination with statins. Statins are among the most well-known cholesterol-lowering drugs. They work by inhibiting the conversion of HMG-CoA to mevalonic acid, which prevents the formation of cholesterol; the use of statins can lower LDL levels by a whopping 15-50%. Statins are the most popular drugs used for this purpose, and have undoubtedly saved countless lives; their administration has been shown to reduce coronary events, and they contribute to coronary artery stability, improve cell function, and even improve outcomes in patients with osteoporosis and chronic kidney disease. For most patients, side effects are minimal or nonexistent.
The outlook for patients with high cholesterol is much more positive than it ever has been before; treatment with medications like statins has been able to reduce the blood lipid levels of many patients to acceptable levels or at least reduce the chances of acute cardiovascular disease. Increased efforts to better educate the general public about the impact of a good diet and regular exercise has also given many patients the ability to control their cholesterol levels without the need for medication. Most patients should remember to seek the advice and care of a qualified primary care physician at least once per year for an annual exam, and to consult a qualified cardiologist if risk factors for heart disease or evidence of its progression are detected.