How to diagnose and treat hypercholesterolemia?

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Hypercholesterolemia has no physical symptoms until a cardiovascular event occurs as a consequence.


According to the Heart Foundation, hypercholesterolemia can be prevented by following these recommendations:


Maintaining a balanced diet is essential to prevent cholesterol levels from increasing. For this, it is necessary to avoid consuming saturated fats, as is achieved by following the Mediterranean diet.

The reason is that with it, people get their fat intake from monounsaturated and polyunsaturated fatty acids found in fish and olive oil. In addition, this diet guarantees the balanced consumption of legumes, fruits, vegetables, vegetables and cereals.


In addition to monitoring and taking care of the diet, people who want to prevent the appearance of hypercholesterolemia should include a sports plan in their routine. Running, swimming, cycling or walking are some sports that can start to be practised at moderate intensity and regularly (between three and five times a week).

This way, people will contribute to the increase in good HDL cholesterol and reduce LDL, or bad cholesterol, and triglyceride levels.


After performing the physical examination and establishing the level of cholesterol in the blood, the factors that influence its increase must be determined, such as diet, the administration of a drug, the presence of a disease, and the genetic and risk factors that favour it. In addition, the development of coronary diseases is associated with hypercholesterolemia. Secondary hypercholesterolemia can also be detected by urinalysis, measuring the serum concentration of thyrotropin, glucose, and alkaline phosphatase.


Generally, all people suffering from hypercholesterolemia should follow a dietary treatment to reduce the level of LDL cholesterol, increase their physical activity and eliminate risk factors that may favour the development of associated pathologies. Pharmacological treatment is reserved for patients with a very high risk of cardiovascular disease, severe forms of hypercholesterolemia, severe secondary dyslipidemia, or who have not responded to dietary treatment. Once the treatment has been established, regular checks of the cholesterol concentration in the blood must be carried out.

dietary treatment

Its main objective is to evaluate the patient’s eating habits and establish an individualised diet, which must be seriously involved by the patient, the doctors, and the affected person’s family. In this way, we try to achieve maximum compliance with the treatment. Once the foods with a high content of saturated fat and cholesterol the patient eats have been identified, other modifiable risk factors that may associate hypercholesterolemia with other pathologies are evaluated.

The diet must consider that calories from fat should not exceed 30 per cent of the total diet. Therefore, it is recommended that fats not exceed 30 per cent of the whole diet, that approximately 10 per cent of calories come from saturated fats, another 10 per cent from polyunsaturated fats and 10 per cent from monounsaturated fats. In any case, cholesterol should be less than 300 mg daily.

Three factors significantly influence the increase in cholesterol: saturated fatty acids or saturated fats, high cholesterol intake and imbalance between calorie intake and energy expenditure. The diet should be low in saturated fat and cholesterol and rich in fatty acids monounsaturated, vegetable fibre and carbohydrates. Generally, the diet reduces fat intake by 30 per cent, replacing the consumption of saturated fats with unsaturated fats. Likewise, other factors such as being overweight or having diabetes should be controlled. 


The substances most used to reduce cholesterol concentration in the blood are resins, nicotinic acid and statins. Likewise, derivatives of fabric acid, probucol, or hormone replacement therapy with estrogens can be used.


Currently, no vaccine can stop the concentration of cholesterol and, consequently, the formation of arteriosclerotic plaques. Numerous investigations try stimulating the production of specific natural antibodies against cholesterol, thus achieving anti-cholesterol immunisation. However, most specialists are sceptical.

cholesterol measurement

The total cholesterol level can be determined with a fasting blood test using the formula: LDL cholesterol = total cholesterol – HDL-cholesterol (high-density, ‘good cholesterol’) – triglycerides / 5. In the case of having suffered a recent trauma, a severe infection, a change in diet or weight loss, pregnancy or surgical intervention, it is necessary to carry out several lipid tests since their level may not correspond to the average concentrations in the patient and therefore they are little representative. Then it will be necessary to determine if it is primary or secondary hypercholesterolemia. It is also essential to consider the possible family history, which explains familial hypercholesterolemia.

This disease can be detected in newborns through a cord blood test, although this test is not entirely reliable as it has many false positives. Also, treatment in children should be postponed until the second year of life. Although there is no minimum recommended cholesterol level, the level above which the risk of coronary heart disease increases is known.

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