This is what family hypercholesterolaemia looks like. A disease that affects many Poles, i.e. 1 in 250 people. It is asymptomatic and, as a result, can cause atherosclerosis, premature heart attack or stroke.
– A person with familial hypercholesterolaemia has 50 percent. chances of having a heart attack before the age of 50. Many Poles suffer from the disease, because 1 in 250 people. It is very special because it is associated with a very high level of cholesterol from childhood. We can already find very high cholesterol levels in children – says Dr. med. Marcin Gruchała, head of the Cardiology Clinic of GUM.
Very early exposure of arteries to high cholesterol leads to premature development of atherosclerosis and to premature heart attacks and strokes. The disease does not have any specific symptoms, and many patients may not know they have it.
– Hypercholesterolaemia does not hurt. Hypercholesterolaemia has only serious consequences. Most often, the first symptom may be a heart attack or stroke. Therefore, it is very important to diagnose hypercholesterolaemia on the basis of primary prevention – adds Dr. med. Marcin Gruchała.
We ourselves should be interested in our own cholesterol level. The prevalence of premature heart attacks in the family, i.e. in the case of men under 55, and in the case of women under 60, in the case of women, may be alarming. This could indicate a family history of the disease.
The goal of treating patients with familial hypercholesterolaemia is to achieve LDL-cholesterol levels below 70 mg / dL. In most patients, this effect can be achieved thanks to pharmacotherapy based on strong statins or PCSK9 inhibitors. These drugs regulate cholesterol synthesis, thus significantly lowering cholesterol levels.
Statement: dr hab. med. Marcin Gruchała, head of the Cardiology Clinic of GUM.
Where does atherosclerosis come from?
Atherosclerosis is a disease process that develops over the years, mainly affecting large and medium-sized arteries. As a result, due to the long-term deposition of lipids in the vessel walls, the vascular flow may be limited. The result is a gradual, and sometimes sudden and life-threatening, restriction of oxygen and nutrient supply to specific organs, including the most important ones – the heart and brain.
It is known that atherosclerosis is an inflammatory process. It is a response to damage to the inner layer of the vessel wall. As a result, it leads to the formation of a fat band made of inflammatory cells under this layer. The progressive atherosclerotic process leads to the accumulation of lipids, collagen and calcium deposits in the inner membrane. This is how atherosclerotic plaque is formed, which can significantly reduce blood flow in the vessel, and its rupture – lead to complete closure of the artery and acute ischemia of the organ’s vascularization.
Atherosclerotic changes are present in childhood and progress over the years. This happens without any symptoms. Only after several dozen years, most often in the fifth decade of life in men, and after menopause in women, when these changes are already advanced, their first symptoms appear. They can be gradually increased or come on suddenly without warning.
What is a heart attack?
Myocardial infarction is the result of myocardial ischemia, which leads to myocardial necrosis. Symptoms of a heart attack are not always characteristic, but most often patients complain of severe pain in the area of the sternum.
The immediate cause of a heart attack is rupture or hemorrhage into the plaque, or the build-up of a blood clot on its surface. Scale builds up in the obstructed part of the artery and turns into a clot that constricts the artery and disrupts its capacity. The heart muscle does not get enough blood, becomes ischemic, hypoxic and dies. The size of the myocardial infarction depends on the size of the vessel lumen at the site where it obstructs further blood flow. The walls of the arteries may die partially or completely – then we are talking about a full-sided or incomplete infarction.
Stroke
A stroke is a symptom of sudden brain damage, usually in the form of paresis, loss of the ability to understand or express speech, visual and sensory disturbances caused by a sudden disturbance in blood circulation in the brain. Stroke is considered primarily a disease of the elderly, and the average age of onset is in the range of 65-70 years.