September 30, 2022

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Do I have to take lipid-lowering drugs for high blood lipids?

Do I have to take lipid-lowering drugs for high blood lipids?


Do I have to take lipid-lowering drugs for high blood lipids? Cardiovascular doctor refutes the rumors: not so! It depends on the situation.


Don’t think about taking medicine when you see high blood fat!

In the morning, a 50-year-old patient came to the outpatient clinic. A recent physical examination found high blood lipids. I heard people say that high blood lipids can cause cerebral infarction and myocardial infarction, so I was very scared; some people suggested that he take lipid-lowering drugs and prescribed several drugs. A lipid-lowering drug, but the instructions of the lipid-lowering drug have many side effects. I was afraid of the side effects of the drug. Later, I was introduced to me. I wanted to ask what kind of medicine to take to reduce blood lipids to normal?

Do I have to take lipid-lowering drugs for high blood lipids?
After reading it in detail, the advice given is not to take lipid-lowering drugs for the time being, live a healthy life first, control your diet, and recheck after 1-3 months. If blood lipids are still not normal by then, we will consider taking lipid-lowering drugs.

So can hyperlipidemia really cause cerebral infarction and myocardial infarction? Is it really necessary to take medicine for high blood fat? Why didn’t I advise patients to take medicine immediately?

 

1. The relationship between hyperlipidemia and cerebral infarction and myocardial infarction:


We often say that the three highs refer to hypertension, diabetes, and hyperlipidemia. The three highs include what we call hyperlipidemia. But blood lipids are not an item. Blood lipids include four items: total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides.

High-density lipoprotein cholesterol can prevent and control the aggravation of vascular plaque to a certain extent, so it is called good blood lipid; and low-density lipoprotein cholesterol can accelerate the aggravation of atherosclerosis, that is, accelerate the aggravation of intravascular plaque. We call it scurvy; elevated triglycerides will also indirectly lead to aggravation of atherosclerosis, thereby aggravating plaque.

What we call hyperlipidemia is roughly divided into three situations: hypercholesterolemia (mainly elevated low-density lipoprotein cholesterol), hypertriglyceridemia, and mixed hyperlipidemia (low-density lipoprotein cholesterol and Triglycerides are elevated).

When the bad blood lipids in the blood exceed the normal level, there will be too much lipid-like substances deposited on the inner wall of the blood vessels, which will accumulate into vascular plaques over time. The plaques continue to accumulate and grow to form vascular stenosis. It will cause angina or carotid artery stenosis and other problems. When these plaques rupture, thrombus will form, thrombus blocking the heart blood vessel is myocardial infarction, blocking the cerebral blood vessel is cerebral infarction!

 

 

2. Is it necessary to take medicine for hyperlipidemia?

not necessarily!

As we said above, hyperlipidemia mainly refers to elevated low-density lipoprotein and elevated triglycerides.

The main reason for elevated triglycerides is unhealthy diet, such as fried foods, fatty foods, foods with high cholesterol content, foods with high fat content, too much fine grains, too few fruits, vegetables, whole grains, etc. . This will lead to elevated triglycerides.

So when we find that triglycerides are elevated, we must first control our diet. Normal triglycerides are lower than 1.7, and higher than 2.1 belong to hypertriglyceridemia. The big brother who came today is triglyceride 3.4, which is indeed high blood fat. But as long as the triglycerides are not higher than 5.6, you can temporarily stop taking medicine, first control your diet, use more vegetables, fruits and whole grains, cooperate with exercise, do not drink alcohol, observe for 1-3 months, most of the triglycerides can be reduced To normal. That’s why I would advise this patient not to take lipid-lowering drugs in a hurry. Of course, if you find that triglycerides are higher than 5.6, then you should really take lipid-lowering drugs, such as fibrates, to reduce blood lipids to a safe level as soon as possible to avoid acute pancreatitis.

The main reason for the increase in low-density lipoprotein is caused by genetic genes, and it has a relatively small relationship with diet. Some people are very thin, do not eat fat, and eat very little oil, but low-density lipoprotein cholesterol is still high. reason. Because low-density lipoprotein has little to do with diet. Therefore, when the low-density lipoprotein cholesterol is found to be elevated, it may be necessary to take medication in most cases, just like most diabetes and high blood pressure. So they are called three highs!

 

3. Low-density lipoprotein cholesterol, pay special attention


Why should we pay special attention to low-density lipoprotein cholesterol?

Because of all blood lipids, low-density lipoprotein cholesterol is the worst blood lipid. The increase in low-density lipoprotein will stimulate the cells in the inner lining of the blood vessel wall to produce an inflammatory response, making the inner wall of the blood vessel more rough and more lipids. It is easier to deposit under the blood vessel wall, causing lipid accumulation, and eventually forming vascular plaque, causing cardiovascular and cerebrovascular diseases.

Ordinary people, that is, people without abnormal blood pressure or blood sugar, and without cardiovascular and cerebrovascular diseases, low-density lipoprotein cholesterol <3.4mmol/L is considered normal.

But for people with hyperlipidemia combined with hypertension or diabetes, obesity, smoking, family history, etc., the low-density target is <2.6mmol/L, which means that this part of people’s low-density should be <2.6mmol/L.

For people with cardiovascular and cerebrovascular diseases, the target of low-density lipoprotein is <1.8mmol/L, which means it must be less than 1.8mmol/L.

The basis for lowering low-density lipoprotein cholesterol is still a healthy life: healthy diet, low oil, low sugar and low salt, more vegetables, fruits, whole grains, quit smoking and alcohol, adhere to appropriate exercise, etc.; but most people may also need to cooperate with statins Lipid-lowering drugs can lower the low-density lipoprotein cholesterol to a normal level, thereby reducing the risk of cardiovascular and cerebrovascular diseases.

The 50-year-old brother in the outpatient clinic today was simply elevated triglycerides, and did not exceed 5.6mml/L, so I was not in a hurry to let him take medicine, but suggested life control and a review!

Don’t think about taking medicine when you see high blood fat!

 

(source:chinanet, reference only)


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