November 8, 2022 Author : Madalena Pinto Rocha Changes in blood lipids (fat) levels are called dyslipidemias . High cholesterol levels in the blood (cholesterolemia) are one of the most important dyslipidemias and are among the main risk factors for cardiovascular diseases, such as heart attack and stroke. Cardiovascular risk is the probability of developing a cardiovascular event or disease; In addition to dyslipidemia, other cardiovascular risk factors are tobacco consumption, alcohol abuse, overweight and obesity, high blood pressure, diabetes, physical inactivity, among others. Cholesterol and triglycerides, what are these compounds? Cholesterol is a natural compound present in the body and has essential functions. The important thing is that its blood levels are adequate . Cholesterol is produced in the liver and also comes from food; It takes part of the composition of cell membranes and some hormones and vitamins. In the blood, cholesterol is linked to proteins forming lipoproteins, which makes it possible to distinguish 2 types: Bad cholesterol , or low-density lipoproteins ( LDL ) cholesterol, which is related to an increased cardiovascular risk; Good cholesterol , or high-density lipoproteins ( HDL ) cholesterol, which can have a protective cardiovascular effect. Triglycerides are another type of lipid that exists in the blood. Triglycerides are produced in the liver; High triglyceride levels may be associated with increased cardiovascular risk and with a risk of acute pancreatitis. Who should know if they have high cholesterol? A determination of blood cholesterol and triglyceride levels should be carried out by people who do not undergo regular medical monitoring of their health and fall into one or more of the following categories : Are over 40 years old; Do not have a healthy diet; Have a family history of dyslipidemia; Have other cardiovascular risk factors; Are of Indian, Pakistani, Bengali, Sri Lankan, Chinese or North African descent. How is high cholesterol or triglycerides diagnosed? Cholesterol and triglyceride levels are determined in a blood test . For the results of the analysis to have the desired rigor, a 12-hour fast is required. What are the recommended levels? Surveillance and control of blood cholesterol levels is not based only on the value of the tests. The concept of cardiovascular risk is taken into account, which must be assessed individually. This means that the recommended cholesterol level for each person depends on the global cardiovascular risk , calculated by the doctor after a detailed clinical evaluation. In certain situations, formulas are applied to estimate for each person the probability of fatal and non-fatal cardiovascular events occurring over the next 10 years. The recent international guidelines are very demanding, defending that the lower the cholesterol level, the better. For example, some recommended values based on cardiovascular risk are: Low risk: LDL < 116 mg/dL; Moderate risk: LDL < 100 mg/dL; High risk: LDL < 70 mg/dL; Very high risk: LDL < 55 mg/dL. Therefore, the target cholesterol level to achieve is significantly more demanding for example in a person with diabetes (high or very high risk) than in someone who does not smoke and does not have any disease (low risk). What should you do to lower cholesterol? The approach to reducing blood cholesterol must focus on several areas , namely: Smoking cessation (essential!); Optimize lifestyle namely: Make a Mediterranean diet, low in fats; Practicing physical exercise (> 150 minutes/week, moderate intensity); Reduce alcohol intake. Maintain a healthy body weight (body mass index not greater than 25 kg/m 2 ), avoiding being overweight (body mass index > 25 kg/m 2 ) or obesity (body mass index > 30 kg/m 2 ); Controlling blood pressure; Control diabetes; Control stress; Maintain good mental health. Source: Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M, et al. 2021 ESC guidelines on cardiovascular disease prevention in clinical practice . Eur Heart J 2021;42:3227-337. Meet the general and family medicine clinical team of the Hospital da Luz network and book your consultation. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
