Cholesterol is a substance circulating in the blood which required primarily for the metabolisation of fat. If you have too much of it, this is known as high cholesterol, or hypercholesterinaemia in medical terms. This clinical picture facilitates the development of arterial calcification (arteriosclerosis). The consequences are cardiovascular diseases such as heart attack or stroke. In this case not only cholesterol but also the other blood lipid levels, such as those of the triglycerides (hypertriglyceridaemia), are raised.

The substance cholesterol is involved in metabolic processes in the body, primarily in the metabolisation of fat. The body covers its need for cholesterol by producing it in the liver and taking it from food. Foodstuffs which contain a particularly high level of cholesterol are eggs and animal products with a high percentage of fat (butter, cheese, sausages). If excessive cholesterol circulates in the body, it accumulates in the vascular walls and facilitates the occurrence of arteriosclerosis as a result. However, not every cholesterol is bad. Cholesterol appears in the body in three forms: HDL cholesterol (high density lipoprotein), LDL cholesterol (low density lipoprotein) and the VLDL cholesterol (very low density lipoprotein). The three forms differ in the percentage of fat. LDL cholesterol and VLDL cholesterol have a higher percentage of fat and facilitate the build-up of cholesterol in the vascular walls. On the other hand, HDL cholesterol has a lower percentage of fat and even protects the body from arteriosclerosis.

There are a variety of causes for high cholesterol. It is possible to differentiate between genetic-based familial hypercholesterolaemia and acquired forms of the disease.  In the case of familial hypercholesterolaemia, defective genes cause a disturbance in the metabolism of fat. Those affected already have an increased level of cholesterol in their blood when they are young. Acquired forms are far more common; however, they usually occur at an older age. Excessive weight, diabetes, lack of movement as well as a fatty and cholesterol-rich diet are risk factor in this case. Unknown factors also play a part in the development of acquired hypercholesterinaemia. This is why a fatty or cholesterol-rich diet does not cause everyone to have a high level of cholesterol in their blood. It seems to also require a certain predisposition.

Raised cholesterol itself does not cause any symptoms. Symptoms only appear through the consequences of the arteriosclerosis. They include general circulatory disorders angina pectoris, heart attack or stroke.

Hypercholesterinaemia is diagnosed by measuring the cholesterol level and the triglycerides in the blood. The treatment focuses on preventing the consequential damage. Besides adjusting one's lifestyle and eating habits, cholesterol-lowering medication is an important treatment option. Statine and fibrate are known representative cholesterol-lowering agents. Foodstuffs containing cholesterol (egg, animal fat) should be consumed only in moderation. Unsaturated fatty acids have a particularly good effect on the cholesterol metabolism. These, along with the fatty acids known as Omega-6 or Omega-3, are found in large amounts in fish, nuts and plant oils.

If there are already arterial constrictions and blockages as a result of vascular damage, these can be treated surgically. More information on the different options is available in the endartectomy, coronary artery surgery and balloon dilation sections.

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