At present, there are more and more people with three highs, and they are becoming younger and younger. In addition to routine hypertension and diabetes, the number of people with hyperlipidemia is also on the rise.
As for hyperlipidemia, many people have many questions. Therefore, Dr. Clove specially invited Dr. Tian from the Department of Cardiology of Guizhou Provincial People’s Hospital to answer everyone’s doubts.
On the Problem of Blood Lipid
- How much is hyperlipidemia when blood lipid is high?
Dr. Tian:Triglyceride, cholesterol and low density lipoprotein, no matter which one rises above the upper limit, are hyperlipidemia.
The specific values vary slightly according to different detection methods. The following upper limits are for reference: triglyceride 1.7 mmol/L; Cholesterol 5.1 mmol/L; Low density lipoprotein 3.1 mmol/L.
- Is hyperlipidemia related to heredity? My father has coronary heart disease. I only have a little higher low density cholesterol, and everything else is normal.
Dr. Tian: This is not necessarily caused by heredity, but low density cholesterol is one of the most important indicators in blood lipid. For some people with coronary heart disease, arteriosclerosis and hypertension, it is best to control this indicator within 1.8 mmol/L. If it is too high, it should be controlled within 50% of the original level.
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What if the simple triglyceride is high?
Dr. Tian:If the triglyceride is found to be high for the first time, the low-fat diet can be strictly maintained for reexamination after one month under the condition that the upper limit of normal value is not more than 2 times. In a month, ifIf it does not drop to normal value, it may consider taking betates for intervention.
If it is found for the first time that the triglyceride increase exceeds the upper limit of normal value by 2 times, it can be reexamined immediately the next day. If it is still higher than the upper limit by 2 times, drug intervention can be considered immediately.
If the triglyceride measured many times is higher, drug intervention should be considered regardless of whether it exceeds the upper limit of normal value by 2 times.
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My blood lipid is normal, why is the blood viscosity high?
Doctor Tian: High blood lipid will lead to an increase in blood viscosity, but high blood viscosity is not necessarily caused by high blood lipid. As many cars will cause traffic jams, but traffic jams are not necessarily caused by too many cars, and there may be factors such as weather and road conditions.
The increase of formed components in blood may lead to slower blood flow and higher blood viscosity, such as the increase of fine cells, etc. Therefore, it is recommended that you take a further examination.
- I am a patient with hypertension. I don’t smoke or drink, and I also take antihypertensive drugs regularly. Why is the blood lipid suddenly high?
Dr. Tian: Smoking, drinking and improper diet are the inducing and aggravating factors leading to hyperlipidemia, but without these factors, you may still suffer from hyperlipidemia. It is recommended that you actively face it and maintain diet control and exercise.
It is recommended that you should choose statins for lipid-lowering drugs, such as atorvastatin or rosuvastatin, under the guidance of a specialist. If you are taking statins now and your blood lipid is still not well controlled, it is recommended to add ezetimibe under the guidance of a specialist and have regular liver and kidney function tests.
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Hello, doctor, I have been suffering from hypertension for 8 years, and my cholesterol is also much higher now. I am a little fat, do you need to take medicine?
Dr. Tian: It is recommended to take statins, such as atorvastatin or rosuvastatin, under the guidance of a specialist.
You now suffer from hyperlipidemia and hypertension at the same time, which is a high incidence group of coronary heart disease. You must control low density lipoprotein to about 50% of the normal high limit.
Maintaining a low-salt and low-fat diet, moderate exercise, weight loss and other lifestyle adjustments are all conducive to reducing your risk of coronary heart disease.
Also, you need to have regular blood lipid tests. If you feel unwell, you need to see a specialist at any time.
On the Problem of Lipid-lowering Drugs
- I have high blood lipid and have been taking statins to reduce blood lipid. The doctor told me to eat less to lose weight, but if I eat less, I will be hungry. What can I do?
Dr. Tian: Diet control is not absolute. It depends on the amount of exercise. It is most important to keep your weight at a reasonable level. Men’s height minus 105 is your standard kilogram weight, while women’s height minus 110 is your standard kilogram weight. If you have difficulty controlling your diet, it is recommended to increase the amount of exercise.
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I got hyperlipidemia, eat now to eat lipid-lowering drugs, such as normal blood lipid can stop the drug? Do you still need to control your diet?
Dr. Tian: Some people with hyperlipidemia need to take drugs for life, such as people with high risk of coronary heart disease and people with hypertension and diabetes. It is suggested that after you go to the cardiology department or endocrinology department of the hospital, the doctor will decide whether you will continue to use drugs.
Diet control is of great benefit to prevent blood lipid elevation and reduce the risk of cardiovascular diseases. It is suggested to adhere to diet control for a long time.
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Simple triglyceride is on the high side. At present, diet control plus exercise and taking statins ask how to withdraw statins if blood lipid drops normally. Do you need lifelong medication?
Dr. Tian: If the simple triglyceride is too high, you can also take betate lipid-lowering drugs, such as fenofibrate, under the guidance of a specialist. It is recommended that you adjust the medication according to the doctor’s advice and decide whether you need long-term medication after attending a specialist.
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Mother’s hyperlipidemia and hypertension exceed 140 mmHg, and when her head feels uncomfortable, she takes simvastatin and stops eating. Is this not conducive to controlling blood lipid and how should she use drugs scientifically?
Dr. Tian: Without the guidance of the doctor, taking medicine casually and stopping eating is extremely unfavorable to the patient’s health. Not only is it not conducive to the control of diseases, but also is it not conducive to the control of adverse drug reactions.
It is suggested that patients should take antihypertensive drugs and lipid-lowering drugs according to the doctor’s advice after going to the cardiology department of the hospital, and regularly follow up and necessary liver and kidney function tests according to the doctor’s advice.
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My blood lipid examination is normal, but my blood pressure is high, there is arteriosclerosis, and my liver function examination transaminase is high after taking statins. Is it OK to eat ezeimebu tablets instead? Does it also affect liver function?
Dr. Tian: Ezetimib is a drug that restricts cholesterol absorption. Statins are drugs that restrict cholesterol synthesis, both of which may affect liver function. Moreover, statins have been proved to have anti-arteriosclerosis and plaque stabilizing effects. If you take a single drug alone, it is definitely statins that are more suitable without considering side effects.
Ezetimibe is more suitable for combined medication when cholesterol is elevated alone or statins are used alone to control cholesterol. However, if transaminase is elevated, it is recommended to see a specialist, and the doctor will decide the medication according to the degree of transaminase elevation.
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After adjusting for a period of time, the blood finger is normal. Can you stop taking medicine?
Dr. Tian: Sometimes normal blood lipid still requires long-term medication, such as coronary heart disease and atherosclerosis. It is recommended that if you want to stop medication, you must be guided by a specialist. Do not stop medication at will to avoid repeated diseases.
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My blood lipid is normal, but there is still hypertension. Can I stop the medicine to reduce blood lipid?
Dr. Tian: Some patients with hyperlipidemia, especially those complicated with hypertension, hyperglycemia, coronary heart disease, etc., may need to take lipid-lowering drugs for a long time. Therefore, it is recommended that you decide whether to stop taking drugs after seeing a specialist.
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At present, the liver function is normal, and they are afraid that rosuvastatin will have great side effects. The doctor said it is quick-acting and lipid-lowering. Can pravastatin sodium be replaced?
Dr. Tian: Rosuvastatin and pravastatin belong to the same kind of lipid-lowering drugs with similar side effects. Your liver function is ideal at present. It is not recommended that you change drugs.
Your current blood lipid control is relatively ideal. It is recommended to continue to take it at the original dose, closely observe the changes of liver function indexes, and do not recommend dressing change for the time being.
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May I ask if there are 10 mg statins per tablet and 20 mg statins per tablet? Are they different from what?
Dr. Tian: Just like you buy mineral water, there are differences between large bottles and small bottles. However, buying drugs is not a matter of any specification. Some people need 10 mg per day, some people need 20 mg per day, and some even need 40 mg or 80 mg per day. According to the severity of the disease, choose the most suitable dose for themselves.
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I diagnosed cerebral infarction six months ago and have been taking lipid-lowering drugs. Now my blood lipid has been stable for six months. Can I ask if lipid-lowering drugs can be reduced?
Dr. Tian: If your current blood lipid control is ideal and there is no obvious abnormality in liver function, it is recommended to continue taking it at the original dose, closely observe the changes in liver function indexes, and do not recommend dressing change for the time being.
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I put a stent in my heart and took rosuvastatin calcium tablets all over my body. Please ask if you can stop taking it!
Dr. Tian: You have no strength all over. If you suspect that it is caused by taking statins, It is recommended that you immediately go to the hospital to draw blood for muscle enzyme examination. Statins have a side effect of myogenic damage and even rhabdomyolysis. However, your symptoms do not exclude coronary heart disease. If accompanied by chest tightness, chest pain and aggravation of fatigue after exercise, you cannot take it lightly. If necessary, you need to conduct coronary angiography examination again.
Position Statement
- The answer only represents the personal opinion, not the position of the organization I work for. The answer is only aimed at the content provided by the question and should not be used as the only basis for diagnosis and medication. Please respect the comprehensive judgment of clinicians when seeking medical treatment.