Hyperlipidemia (Cholesterol and triglycerides)

Hyperlipidemia is the fact of having high levels of blood lipids, including cholesterol and triglycerides. This physical state does not cause symptoms. For many people, it has no harmful effect. But this is one of many risk factors that, added together, can eventually lead to a heart condition.Excess of lipids in blood contributes to harden and thicken the arteries of the heart. Therefore, the heart adapts more and more difficult to physical exertion. Hyperlipidemia also contributes to the formation of blood clots, which can completely block an artery and cause a heart (heart attack).Objective: To avoid or delay heart diseaseHeart problems are the leading cause of death on the planète1. In Canada, according to the latest statistics, heart disease rose to the second highest cause of death (28% of deaths), just behind cancer (29% of deaths) 3.Although smoking has decreased by half, the increase of overweight, obesity and also the waistline (about 5 cm to 6 cm over the past 20 années50) suggests an increased frequency of disturbances heart for years to come.Nevertheless, it should be noted that heart problems are less often fatal than before: the mortality rate fell by about 40% in recent decades.Where does excess cholesterol and triglycerides?The liver produces vast majority of cholesterol used by the body in various functions. The rest comes from the diet, especially animal foods. These are foods high in saturated fats (fatty meats, butter, fat dairy products) and trans fats (hydrogenated margarines, vegetable shortening, desserts, pastries) that increase levels of "bad" cholesterol, called LDL. By cons, we now know that for most people, dietary cholesterol alone has little effect on blood cholesterol levels. Thus, eggs, prawns and offal, for example, high cholesterol, do not have to be banned because they are low in saturated fat.Besides the food ingested, physical inactivity and smoking can also raise cholesterol levels. Additionally, genes have influence.As to triglycerides, they are most often alcohol and excessive ingested sugars (especially sugar "fast", such as cakes, sweets and jams trade), processed by the liver into triglycerides. So while the triglycerides are a type of lipid (fat so) blood, their presence in excess in the blood does not usually come from dietary fat but sugars.
The expert viewDr. Martin Juneau, cardiologistDirector of Prevention at the Montreal Heart Institute

Sugary foods they have as much impact as fatty on blood lipids?Fatty foods are those that have the most negative effect on blood lipids but sugary foods also influence and play an equally important role of fat on health in general. Over the past 25 years, much has been accused fatty be harmful to the heart but for about 4 or 5 years, very good research teams realize we probably focused too much on fatty and not enough on sugars. We thoroughly talked about cholesterol, saturated fat, trans fat. The reflex of the industry has been to remove the fat anywhere: nonfat yogurt, cholesterol free products, etc. But to improve the taste, was added sugar. Today, many experts believe that the obesity epidemic is due to the reaction of the industry. Nowadays, especially eat more but we eat more sugar. It was certainly neglected the consequences of that surplus sugar.Sugar influence blood lipids, including the metabolism of insulin. When you eat a sweet dessert, say a piece of cake or a sweet yogurt up your insulin to lower blood sugar. When insulin is high in the blood, it causes a multitude of reactions. For example, a few hours after eating this dessert, your liver begins to produce more triglycerides. It also produces slightly more than LDL cholesterol but the effect of sugar on this type of blood lipid is lighter. And more generally, raising insulin levels, sugar causes fat storage. Fats that lodge in the intestines increases the waist and secrete a variety of pro-inflammatory and oxidative substances. Inflammation is certainly linked to cardiovascular disease and probably cancer, too.

 How to detect hyperlipidemia?For lipid profile done from blood samples is measured:

    the amount of LDL cholesterol, or "bad cholesterol";
    the amount of triglycerides;
    the amount of HDL cholesterol, or "good" cholesterol;
    the total cholesterol (TC).As appropriate, other blood tests may be suggested by the doctor. For example, the measurement of apolipoprotein B or C-reactive protein, a marker of inflammation."Good" cholesterol, "bad" cholesterol, triglycerides!Like other blood lipid, cholesterol is not soluble in blood. To move and be routed to the cells, it needs to be transported by substances called lipoproteins.The main two types of lipoproteins:

    HDL (high density lipoprotein - High Density Lipoproteins). They are associated with the "good" cholesterol. They cause cholesterol to the liver and affect "cleaner" in the blood vessels;
    LDL (low density lipoprotein - Low Density Lipoproteins). They are associated with the "bad cholesterol". If they are too abundant in the blood, they can be deposited on the walls of arteries and penetrate. This can initiate a process of inflammation and cause accumulation of various substances which, in the long run will eventually form a plate which shrink more and more the diameter of the arteries. This is called atherosclerosis (see illustration at the top of the page). In addition to harm the flow of blood, this plate can then cause blood clots. In turn, these clots, trapped by the plate, will clog the artery in question (thrombosis) or else move and cause an obstruction later in the bloodstream (embolism);
    Triglycerides are another type of fat that is found in the blood and the form in which fat is stored. This is the second store of energy provided by the body, which will be sought once the primary source of energy "fast" has been exhausted (this is glycogen found in the liver and muscles) .

 Too high or normal: how to assess the cholesterol?Doctors now estimate cholesterol relatively. They speak more than normal rates but rates related to the patient's general condition and, above all, the presence of other risk factors for heart disease.Thus, the cholesterol that an individual must aim are estimated based on his personal rate risk of heart disease (angina or myocardial infarction) within the next 10 years. This depends on several factors: personal history of cardiovascular disease, age, smoking, diabetes, high blood pressure, current rate of total cholesterol and HDL, family history of cardiovascular disease, abdominal obesity and gender.For example, for identical levels of cholesterol:

    a male smoker aged 55 with hypertension will be considered at high risk. It should therefore aim to further reduce cholesterol levels;
    a 34-year non-smoker and without hypertension will be considered low risk: it will not need to reduce as much his cholesterol.To assess the risk for heart disease patients, Canadian and US doctors commonly use the test Framingham, which is named after the US city where it was élaboré4. In Europe, one of the most used is the SCORE test (for "Systematic Coronary Risk Evaluation"), developed by the European Society of Cardiologie5. There are several types of tests because they must be adapted to people who use them. Their predictive value is however questionable.

Heart disease risk staff in the coming 10 years
Initiate treatment if:
Aim the following result:Low (less than 10%)
LDL 5.0 mmol / L * (193 mg / dl)or more
LDL drop of over 50%Moderate (from 10% to 19%)
LDL 3.5 mmol / l (135 mg / dl)or more orTC / HDL> 5
LDL <2.0 mmol / l (77mg / dl)orLDL down 50%High (20% or more)orMost diabetics and people with heart or vascular disease
The treatment is consideredin all high-risk patients, although LDL <2.0 mmol / L (77 mg / dl)
LDL <2.0 mmol / l (77mg / dl)orLDL down 50%Source: Guidelines of the Canadian Cardiovascular Society on the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease, updates in 20092.* Measures in mmol / l are used almost everywhere in the world except the United States, where one uses instead of the measure in milligrams per deciliter (mg / dl).And triglycerides?Triglyceride levels vary quite easily from one day to another, depending on the diet. Experts have not yet determined a target to be reached in order to prevent heart disease. However, when the triglyceride level reaches or exceeds 1.7 mmol / l, is a risk factor of metabolic syndrome. It hypertriglyceridemia y when the ratio exceeds 2 mmol / l.