Patients often come with test sheets, and triglyceride is a little higher, so they are very anxious. What should I do if my blood lipids are high? Should I take medicine? Some people even took medicine. However, if cholesterol is high in , I don’t care about it because I don’t think cholesterol is blood lipids .
In fact, cholesterol is also blood lipids, and it is the most important part of blood lipids . Three of the four types of lipid disorders are obviously related to cholesterol abnormality: hypercholesterolemia , low-density lipoproteinemia , and mixed hyperlipidemia , which are both high in cholesterol and triglycerides; is hypertriglycerideemia , which is also related to cholesterol because it will be exchanged with cholesterol. Besides, cholesterol also contains "fat"! high-density lipoprotein cholesterol , low-density lipoprotein cholesterol, protein and lipids are bound!
So, let’s talk about four things in the treatment of lowering blood lipids .
The first thing to do is to lower blood lipids is to reduce low-density lipoprotein cholesterol. How high is the "low-density" required?
LDL cholesterol is an important culprit for atherosclerosis. Reducing LDL cholesterol has become an important basic treatment for preventing atherosclerotic cardiovascular disease. Practice has proved that if the "low-density" cholesterol is reduced, the progress of atherosclerosis will be curbed, delayed, and may even reverse. This has been recognized and there is a consensus, and all countries have relevant guidelines.
It should be noted that whether the blood cholesterol is high in is not only judged based on the normal value on the test sheet, but it should be judged in accordance with the patient's cardiovascular disease is serious and the risk level is high, and the rating is . The normal value on the test form is for normal people who do not have cardiovascular disease.
In this way, if the cardiovascular risk is not high, the cholesterol can be controlled within the normal range of ordinary people. As the cardiovascular risk increases, the "low density" standard must be lower than the normal standard . For example, there is hypertension or diabetes , atherosclerosis occurs, and there are other risk factors. The evaluation is high-risk , and the "low density" of must be controlled below 2.6 mmol/L ; there is already coronary heart disease , cerebrovascular disease, etc., that is is extremely high-risk , and should be controlled below 1.8mmol/L ; if there is repeated myocardial infarction, stent release, cerebral infarction, cerebral infarction, , or hypertension, diabetes, stent release, that is, is super high-risk , and should be reduced to below 1.4mmol/L .
The second thing is that everyone recognizes most. Should we treat triglycerides if they have high triglycerides?
Simply put, draws three lines to distinguish three situations and deal with .
The first type, triglyceride exceeds the normal value, but is lower than 2.3 (2.25) mmol/L, no medication is required.
The second type, triglyceride is particularly high, exceeding 5.7 (5.65) mmol/L, and usually requires medication . Because the blood lipids are too high, it will cause acute pancreatitis , which is a risk.
The third type, triglycerides are between 2.3mmol/L and 5.7 (5.65)mmol/L, so you need to know them according to the specific situation of the patient. The result of high triglycerides in
will also increase the high cholesterol, so it depends on the cholesterol level. Treatment is preferred.
- patients with coronary heart disease, the first thing to do is to lower cholesterol. The cholesterol has dropped, and the triglycerides are still high, so it needs to be reduced. Because high triglycerides at this time will increase the risk of cardiovascular residuals. However, when combined with statin drugs, pay special attention to adverse reactions.
- people with diabetes, high triglycerides are related to high blood sugar in , because sugar will "turn" into fat. Generally, if blood sugar is stabilized, triglycerides will also decrease.
- Triglycerides are closely related to their diet. It is important to control their mouths. Avoid high-sugar, high-fat and greasy diets, exercise and lose weight, which is beneficial to reduce triglycerides.
- If triglycerides are always close to the upper limit level and cannot reduce their lifestyle improvement, you can take medicine.
The third thing is, what should I do if my high-density lipoprotein cholesterol is low?
Everyone knows that cholesterol is "higher, lower ones, lower ones". When high-density lipoprotein cholesterol is low, some people are also worried. Isn't it good to say that it's low? what to do?
- The results of the current research on high-density lipoprotein and high-density lipoprotein cholesterol are not the same thing. What is really going to increase is high-density lipoprotein, which is the lipoprotein part inside.
- drugs that increase high density lipoprotein cholesterol have been studied, but because of obvious adverse reactions, they have not been used in clinical practice.
- returns to the first point, because it is not yet clear whether raises high-density lipoprotein cholesterol is good. There is no practical test to verify that increasing "high-density" is beneficial, and there is no drug that specifically raises high-density lipoprotein cholesterol. Therefore, is now reduced in high-density lipoprotein cholesterol, which is not the target of blood lipid treatment. , and there is no treatment if the high-density lipoprotein cholesterol is low. The cholesterol-lowering statins and triglyceride-lowering fenofibrate also have some effects on increasing high-density lipoprotein cholesterol.
Therefore, you don’t have to worry about the low high-density lipoprotein cholesterol.
The fourth thing. What are the treatments for high lipoprotein a?
There is a lipoprotein a in the complete set of blood lipids. After publicity, everyone knows that it is not good for lipoprotein a to be high, but what should I do if it is high?
also has 3 points:
- The increase in lipoprotein a is mainly related to genetic factors , and some diseases can affect lipoprotein a. Genetic factors are not easy to solve at present;
- Some drugs that lower lipoprotein a are still being developed and conducted clinical trials. There are no drugs on the market that specifically lower lipoprotein a. What can be done is plasma replacement, lipoprotein blood purification, and lipoprotein A can be dialyzed and filtered out.
- elevated lipoprotein a cause atherosclerosis, which is related to the increase of low-density lipoprotein cholesterol
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#Cardiovascular health Questions and Answers# #Healthy Heart Persistence# @Toutiao Health
Cardiovascular Internal Medicine Hou Xiaoping
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