treatment of elevated blood lipids

Cardiovascular diseases are still the most common cause of death in Germany, accounting for around 40% of all deaths. Nevertheless, in recent decades there has been a significant decline in the number of deaths caused by Heart attack or Stroke came.

Cardiovascular diseases are still the most common cause of death in Germany, accounting for around 40% of all deaths. Nevertheless, there has been a significant decline in deaths from Heart attack or stroke. Life expectancy for men rose from 1980 to 2002 years between 69,9 and 75,6, and for women from 76,6 to 81,3 years.

The largest contribution to the increase in life expectancy is the change in cardiovascular diseases. Life expectancy has increased by 2,6 years for men and 2,2 years for women. One of the main reasons for the increase in life expectancy is the treatment of elevated blood lipids.

The first priority of therapeutic measures are non-pharmacological measures such as increasing physical activity and a calorie-adjusted, high-fiber and low-fat diet. Nutrition, which should be rich in vegetables and fruits. Saturated fatty acids should be avoided. International guidelines recommend the intake of so-called phytosterols in the diet, as they reduce LDLcholesterol can be reduced.

Treatment of elevated blood lipids with medication: Statins remain the first choice

Statins are still the drugs of choice for drug lipid therapy. They inhibit the enzyme HMG-CoA reductase, which synthesizes cholesterol in the liver. Statins therefore reduce cholesterol formation. In addition, treatment with statins inhibits inflammation in the vessels, which leads to a stabilization of arteriosclerotic plaque formation. The various statins differ primarily in their effectiveness in lowering LDL cholesterol (bad cholesterol). A reduction of around 30% in LDL cholesterol can be achieved with 10 mg of artervastatin, 30 mg of simvastatin and 40 mg of lovastatin.

The most common side effects of the treatment are muscle pain and an increase in liver values; liver inflammation can also occur. Rhabdomyolysis, which leads to severe muscle diseases, is particularly feared. This disease usually occurs when other medications are used at the same time and the metabolism of the statins is disturbed.

Lowering LDL cholesterol by about 40 mg can reduce the risk of having a stroke or heart attack by about 20%. This means that, for example, lowering LDL cholesterol by 80 mg would lead to a reduced risk of 40%.

Another medication is nicotinic acid. With doses of around 1 to 2 grams per day, triglycerides and cholesterol can be reduced by around 30%. Nicotinic acid is the most effective medication for increasing HDL cholesterol (good cholesterol). Nicotinic acid is also the only medication that can lead to a reduction in lipoprotein A. In Germany, nicotinic acid is used relatively rarely because it is not very well tolerated. A common side effect is a flush (reddening of the skin, feeling of heat and itching).

In exceptional cases, cholesterol elevations that prove to be refractory to therapy can also be treated with a so-called LDL apharesis (plasma exchange).

There are currently other drugs being developed that are intended to lead to a sufficient reduction in LDL. Antibody therapies in particular promise significant progress in the drug therapy of elevated cholesterol levels.