Hyperlipidaemia
What is hyperlipidaemia?
Hyperlipidaemia means high levels of lipids in the blood. It is one of the main risk factors for coronary heart disease and stroke. This is important as coronary heart disease is second only to cancer as a leading cause of death in Singapore.
Lipids are fatty substances in our bodies which play an important role in all living cells. These include cholesterol, triglycerides, phospholipids and fatty acids. However, when there is too much of cholesterol and/or triglycerides, we will be at risk of certain diseases. Cholesterol is a major factor in the development of coronary heart disease and stroke. A high level of triglycerides also increases our risk of developing coronary heart disease and is associated with diabetes mellitus.
What happens when you have high cholesterol levels?
Too much cholesterol in the blood causes a build-up of fatty deposits on the inside walls of the blood vessels (atherosclerotic plaques). This results in blockage of the blood vessels, causing the blood flow through these blood vessels to decrease. When this happens in the coronary arteries that supply blood to the heart muscles, the decrease in blood supply (and therefore oxygen and other nutrients) causes the heart muscles to be damaged or die. This condition is called coronary heart disease, which presents as a heart attack if severe. When this happens in the brain, the person will suffer a stroke.
The risk of heart attack and stroke increases when other factors such as smoking, hypertension, diabetes, obesity, sedentary lifestyle and family history are also present in a person.
Are you at risk?
The following factors affect your cholesterol level in the blood:
- Hereditary metabolic disorders
- Increased dietary intake of cholesterol and fat
- Certain illnesses
- Obesity
- Lack of physical activity, sedentary lifestyle
If you have any of these factors, you are at higher risk of having high blood cholesterol levels.
How can you tell whether you have high cholesterol levels?
A person with high cholesterol levels will not show any signs and symptoms. Hence it is important for you to get a blood test to check for your blood cholesterol levels especially if you have a family history or are over 40 years of age.
How can high cholesterol levels be prevented?
To reduce the risk of high blood cholesterol, adopt a healthier lifestyle, including regular exercise and dietary control. Choose to eat foods with less fat especially saturated fat and less cholesterol content, and foods higher in fibre content such as fruits, vegetables, and wholegrain products. Foods containing soluble fibre like oats, barley, beans and peas are good in reducing cholesterol.
How can high cholesterol levels be treated?
If your blood cholesterol level is high and making changes to your diet does not bring the level down, your doctor may decide to start you on some lipid lowering medication. These are divided into 4 main groups;
- Statins such as simvastatin and lovastatin act on the enzyme to stop cholesterol being manufactured in the liver
- Bile acid sequestrants like cholestyramine bind bile acids at the intestinal level
- Fibrates like gemfibrozil stimulate the breakdown of the lipoproteins
- Niacin like nicotinic acid decreases the formation of LDL-cholesterol in the liver
- These different medications are suitable for different people and have different side effects. Your doctor will prescribe one that is suitable for you.