High cholesterol is a "metabolic alteration that can cause a whole series of unpleasant complications, including heart attack, stroke and sudden death; for this reason it is necessary that everyone is able to recognize hypercholesterolemia" and its dangers. However, a question arises from this awareness:
'Does high cholesterol manifest itself with real symptoms or not?'
Before answering this question it is necessary to understand the importance of the right levels of cholesterol in the blood and why it is crucial to keep them within certain limits.
General information on cholesterol
Cholesterol is a steroid molecule normally present in all tissues (and foods) of animal origin, where it performs numerous and essential metabolic and structural functions. These include: precursor of steroid hormones (eg testosterone and estrogen), vitamin precursor (of vitamin D), composition of cell membranes and bile (digestive-emulsifying juice produced by the liver and stored-released by the gallbladder) etc. Cholesterol moves between the various districts of the body thanks to the lymphatic and blood stream but, being a lipid, it is unable to dissolve in the hydrophilic liquid; for this reason, cholesterol uses as a means of solution and propagation (in lymph and blood) certain large complex and soluble molecules called lipoproteins (LP). All lipoproteins have a specific function (some transport it to the peripheries - LDL or BAD - others carry it to the liver - HDL or GOOD) and for the health of the "organism it is essential that they are quantitatively and qualitatively (molecular composition) in perfect balance. When the "carriers" increase, decrease, undergo oxidation or do not have the right interactions with the receptors (internal defect of the LP or of the receptors with which they must interact at the liver and tissue level), a " metabolic alteration called dyslipidemia. There are different types of dyslipidemia, different for the type of lipid and LP involved (cholesterol and / or triglycerides), and for the respective etiopathological cause (primary forms - hereditary and / or linked to environmental factors - and secondary, due to other pathologies); in the case of primitive forms, it is very important to divide the hereditary ones on the basis of the genetic defect responsible for the mutation.
(hepatic production - mainly) and exogenous (food intake through animal-type foods - to a lesser extent). When cholesterol is high, the cardiovascular risk (ischemic heart disease and cerebral vascular syndrome) increases, more or less significantly based on the entity and any other risk factors. High cholesterol is assessed by measuring the lipoproteins (LP) of transport in the blood; the respective evaluation criteria are: total cholesterol (with TOT) and bad cholesterol (with LDL). Leaving aside the secondary forms, the primary forms of high cholesterol affect genetics and / or lifestyle; genetics can be type: familial hypercholesterolemia, polygenic hypercholesterolemia and hyperlipemia with multiple phenotypes (with high cholesterol and triglycerides). Secondary forms of high cholesterol triggered by an incorrect lifestyle have as predisposing agents: sedentary lifestyle, diet rich in saturated fatty acids, rich diet of hydrogenated fatty acids, diet rich in cholesterol, hyperinsulinemia and / or diabetes mellitus t ipo 2. These are very specific and difficult to understand but absolutely decisive topics in the understanding of what will follow in the following paragraphs.
clinical. The difference between a symptom and a clinical sign is simply constituted from the point of view: while the symptom corresponds to the perception of the patient (it is therefore subjective), the clinical sign is objectively recognized by the operating doctor. Those affecting the more severe forms of high cholesterol can be interpreted in either way as the case may be.
High cholesterol can lead to its deposition in certain districts. In addition to promoting the formation of atherosclerotic plaques in blood vessels, with an increase in cardiovascular risk (which is not a symptom but a complication), this accumulation can affect both the skin and the muscle tendons of the patient: we are talking about xanthomas. Xanthomas are clinical signs which, in many cases, are distinctly felt by the patient as well (although they do not cause painful sensations); moreover, the skin ones are also clearly visible. These characteristics would also place xanthomas among the symptoms of high cholesterol, and not only among the clinical signs.
Note: xanthomas occur mainly in genetic forms (familial hypercholesterolemia and combined familial hypercholesterolemia) since these diseases cause blood cholesterol levels so high that they also cause peripheral deposition; however, this does not mean that in the absence of xanthomas the cardiovascular risk is always to be considered moderate. Hypercholesterolemia, even if less severe than in the cases mentioned above, and therefore without xanthomas, is still an extremely important risk factor. There is a certain distinction that concerns the correlation of the different types of accumulation with the respective causes and possible complications of cholesterol high. Xanthomas are formed by englobing cholesterol by macrophages which mutate into large foam cells, which also indicates a significant level of inflammation (hence the correlation with the risk of ischemic heart disease and cerebral vascular syndrome). tendon xanthomas it is often necessary to resort to palpation, in particular of: Achilles or calcaneal tendon, patellar tendon and tendons of the extensor muscles of the fingers. hands; limbs and buttocks; on the joints. At this point, kind readers will ask themselves:
"When high cholesterol is primary, caused only by environmental factors or by" association with polygenic forms (generally less severe), are there equally visible and important clinical signs or symptoms? "
The answer is not well defined; the onset of xanthomas is correlated to abnormal cholesterol levels which, fortunately, are not so frequent. On the other hand, the formation of atherosclerotic plaques (in addition to being almost silent) can manifest itself, in the long term, even with decidedly cholesterol levels less important.This difference is essential as most of the subjects with high cholesterol do not perceive any symptoms and do not see any clinical signs, which is why sometimes they do not intervene to moderate their blood concentrations, thus undergoing a slow but inexorably increase in the risk of complications. By the time the latter manifest themselves with their characteristic symptoms, it is too late to prevent serious health consequences.
Strong sense of oppression, as if the chest were tightened by a vise; pain symptoms can radiate up to the neck, left arm, shoulder, jaw and the central part of the upper half of the abdomen. Generally this symptomatology is aggravated by physical activity, cold air, stress and all other situations in which the heart's energy demands increase considerably compared to the resting condition.
Chest pain (such as a weight or grip in the center of the chest), typically located behind the breastbone, which can radiate throughout the chest, neck, left arm, shoulder, jaw, and middle of the upper half of the abdomen and shoulder blades.It may be accompanied by cold sweats, nausea, vomiting, weakness and dizziness.
Sudden onset of dizziness, with loss of balance and coordination of movements; difficulty speaking or understanding what we are told; paralysis or numbness, weakness, tingling or paralysis on one side of the body; vision disturbances, blindness in one eye, blurred vision or double vision; violent headache.
. In practice, in the general population, cholesterol (col) can be defined as high when: the plasma TOT is greater than 199-239mg / dl and the plasma LDL is greater than 129-159mg / dl. Then, in addition to the high TOT and LDL cholesterol, the insufficiency of HDL or GOOD cholesterol (<40mg / dl in menopause and 3 menopause) significantly increase the cardiovascular risk. By making sure your blood parameters are within normal range, you can significantly reduce your overall cardiovascular risk.
