ABC of Vascular Disease


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1. What is hyperlipidaemia?
"Hyper-" means "too much", "-lipid-" means "fat"; and "-aemia" means "blood"; so hyperlipidaemia is medical jargon for too much fat in the blood.

2. Are there different sorts of hyperlipidaemia?
Yes.  There are two major types of lipid in the blood which are called cholesterol and triglyceride.  Either or both of these can be raised causing different patterns of hyperlipidaemia.  Some of the cholesterol in the blood is from the diet and some is actually made by the body and you can have hypercholesterolaemia without eating too much cholesterol containing foods.  Triglyceride comes mainly from the digestion of fat in the diet.  Some patients have hyperlipidaemia due to faulty genes.  These patients often have complications of hyperlipidaemia at an early age and often have a family history of similar problems.

3. What problems does hyperlipidaemia cause?
The most common problem is accelerated arterial disease.  Patients with severe, untreated hyperlipidaemia are at higher risk of heart attacks at an early age.  Less severe forms will accelerate the development of occlusive arterial disease and will aggravate other risk factors such as smoking, and diabetes.

4. How is hyperlipidaemia diagnosed?
Hyperlipidaemia itself doesn't usually cause any symptoms so it can go unnoticed for many years.  It often runs in families so anyone with a family history of arterial disease, heart attack or stroke at an early age (e.g. 30's and 40's) are more likely to have the condition.  The diagnosis is confirmed by a blood test, and kits are now available from the chemist to do this test at home.  For a definitive test a sample of blood should be sent to a laboratory.  Even if you don't have a family history, it is worth having your cholesterol checked every 5 years or so.

5. How is hyperlipidaemia treated?
In mild cases a permanent change of diet may be all that is required to bring down the blood levels to an acceptable range.  In other cases a diet has only a limited effect and drug treatment may be required.  The drugs that are used work by modifying the way that the liver handles the lipids.  Drugs for hyperlipidaemia do rarely have side effects and a blood test to check that the liver is working correctly should be done before starting on these drugs.  Sometimes a single drug is effective, in other cases a combination of drugs is required.  Simple hyperlipidaemia is usually diagnosed and managed by the GP, more complex and severe forms usually require the help of a specialist.  Once treatment is started, the effect on the blood lipid should be checked at regular intervals to ensure the optimum dose is given.

6. Is there a cure for hyperlipidaemia?
Unfortunately not. Treatment is usually required for life.

7. How effective is the treatment?
Large clinical trials have shown that patients at risk of complications of arterial disease (e.g. those who have already had a heart attack) do better in the long term if they are treated after their first complication (secondary treatment).  Treatment of hyperlipidaemia does not guarantee complete immunity to arterial disease, instead it reduces the likelihood of having a serious complication form the arterial disease.

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S.R.Dodds 2001

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