Hypercholesterolemia
Hypercholesterolemia refers to the state of elevated cholesterol levels in the blood. The desirable serum cholesterol levels are 140 to 200 mg/dl, and thus anything above this level signifies hypercholesterolemia and is harmful to the human body. The condition can be either primary or secondary. Primary hypercholesterolemia is due to genetic causes, for instance, familial hypercholesterolemia and familial combined hyperlipidemia. As for secondary hypercholesterolemia, the causes are obesity, diabetes and nephrotic syndrome (Braamskamp, Wijburg,&Wiegman, 2012). Such a condition has disastrous effects on the individual, which include but not limited to atherosclerosis, coronary artery disease, and cardiovascular (heart) diseases. With such possibilities, it is beyond doubt that there is a need for an understanding of this condition. Central to the in-depth understanding of hypercholesterolemia are the risk factors, potential consequences, preventive measures and treatment strategies.
Risk Factors
The risk factors of hypercholesterolemia broadly fall into two classes namely, modifiable and non-modifiable. With the modifiable risk factors, an individual has all the power to control them. Such factors include but not limited to diet, physical inactivity (lifestyle), and weight gain (overweight). Concerning dietary practices, an individual that takes food rich in saturated fats is more likely to suffer this fate. Also, excessive intake of alcohol also has an effect on the cholesterol levels due to its impairment of the normal fat metabolism. On the other hand, failure to exercise regularly can also cause an increase in cholesterol levels in the serum levels due to the failure of the body to break down fats. An individual is also likely to suffer this fate if he/she gains weight. An increase in weight is characteristic of excessive saturated fats within the body whose implication is increased serum cholesterol level(Braamskamp, Wijburg,&Wiegman, 2012). Clearly, all these factors are within a person’s locus of control, and therefore their prevention is possible.
On the contrary, the non-modifiable risk factors relate to all factors that are not within an individual’s locus of control. They include age, family history, and gender. Firstly, people who are at an advanced age (45 years and above for men and women aged 55 years and above) are at risk of developing an increased cholesterol level in the blood. Also, women are at more risk of developing this condition during post-menopause due to the hormonal imbalance characterized by decreased estrogen level. The family history is also another risk factor for individuals that have a positive history of this condition in their family tree. For example, the familial hypercholesterolemia is a common type of this condition that children present with upon their birth(Braamskamp, Wijburg,&Wiegman, 2012).
Possible Consequences
As earlier noted, the implication of hypercholesterolemia on the person is severe. Such is the case given the health complications that owe their source from this condition. An example in point is the coronary artery disease, which develops following the deposition of saturated fats along the walls of the blood vessels (arteries). Such a deposition impairs the flow of blood resulting in ischemia to the heart(Braamskamp, Wijburg,&Wiegman, 2012).
Another likely consequence of hypercholesterolemia is a heart attack. A complication of this kind is inevitable given that the deposition of the fats along the arteries’ walls will impair the supply of blood to the heart. As such, the individual develops myocardial ischemia that is evident through manifestations like angina (chest pains) and shortness of breath in the affected person(Agabiti Rosei, &Salvetti, 2016).
Finally, a stroke may also develop as a possible complication of elevated serum cholesterol levels. That is the case because individuals with high levels of cholesterol circulating in the blood may develop plaques in the blood vessels, to which the blood cells may attach forming blood clots. A displacement of the blood clots may result in blockage of arteries that supply blood to the brain, causing a stroke(Agabiti Rosei, &Salvetti, 2016).
Prevention Strategies
The prevention strategies adopted mainly relates to the modifiable risk factors. That is the case given that modifiable risk factors are within one’s locus of control. A widely acceptable prevention strategy is the change of one’s lifestyle to include healthy habits like daily exercises. The use of exercises is essential since it facilitates the breakdown of the saturated fats that are responsible for the elevated cholesterol levels in the blood(Braamskamp, Wijburg,&Wiegman, 2012). As such, one is free of this complication.
Secondly, dietary modification is also central to the prevention of hypercholesterolemia. Lowering the intake of foods rich in saturated fats has shown in various studies to be beneficial to individuals adhering to such a practice. Moreover, cutting down on alcohol consumption can also facilitate fat metabolism which is subject to impairment in the event of excessive alcohol intake(Braamskamp, Wijburg,&Wiegman, 2012).
Furthermore, monitoring of own weight is also another preventive strategy that can notify one of the needs of taking measures to cut down the weight before it causes hypercholesterolemia. Such a technique is beneficial since it prevents one from becoming obese or overweight, which is a risk factor for developing hypercholesterolemia(Braamskamp, Wijburg,&Wiegman, 2012).
Treatment Strategies
Currently, the pharmacological therapy is the second line of treatment in the management of hypercholesterolemia since its consideration for use is after failed non-pharmacological interventions (lifestyle changes like exercises and dietary modification). Moreover, the drugs are second to lifestyle change practices given the possibility to result in adverse effects to persons using them(Braamskamp, Wijburg,&Wiegman, 2012).
Under the pharmacotherapy, the first choice drugs are the statins that include but not limited to Atorvastatin and Rosuvastatin. The preference of this class of drug is due to their significant role in lowering the low-density lipids like cholesterol and their high levels of safety. The statins inhibit cholesterol synthesis by inhibiting the HMG-CoA, an enzyme necessary for cholesterol formation(Braamskamp, Wijburg,&Wiegman, 2012).
Other notable classes of drugs that are essential in treating this condition are fibric acids derivates (Gemfibrozil), bile acid binding resins like Colestipol, nicotinic acid and cholesterol absorption inhibitors (ezetimibe) (Braamskamp, Wijburg,&Wiegman, 2012).
References
Agabiti Rosei, E., &Salvetti, M. (2016). Management of Hypercholesterolemia, Appropriateness of Therapeutic Approaches and New Drugs in Patients with High Cardiovascular Risk. High Blood Pressure & Cardiovascular Prevention, 23(3), 217-230. doi:10.1007/s40292-016-0155-2
Braamskamp, M. M., Wijburg, F. A., & Wiegman, A. (2012). Drug therapy of hypercholesterolaemia in children and adolescents. Drugs, 72(6), 759-772. doi:10.2165/11632810-000000000-00000
Pathophysiological Factors That Influence Incidence and Manifestation of Diseases
Pathophysiology refers to the pathway that describes the trajectory of disease development from exposure to a causative agent (Hannon,2011). Different illnesses have individual trajectories of illness progression. Such is the case given the difference in pathophysiological factors initiating them. As such, this means that the acute diseases have distinct pathophysiological factors, which influence their incidence and manifestations. Similarly, episodic and chronic illnesses have their pathophysiologic factors.
The standard classes of pathophysiological factors are mainly namely, social, psychological, behavioral, environmental and biological factors. An understanding of these disease-specific pathophysiology factors is of the essence since they will enable one to manage the condition effectively. For instance, as a means to prevent a disease with modifiable factors like obesity, a health care professional can advise one to avert those factors (intake of foods rich in saturated fats) and thereby prevent that condition. Evidently, with such an advantage, it is apparent the importance of establishing the pathophysiological factors of diseases.
Acute
Acute diseases refer to conditions with the short and rapid onsets and are self-limiting on their own. Their manifestations are relatively harsh but are self-limiting(Hannon,2011). Befitting examples of such conditions include but limited to infectious diseases such as malaria, typhoid, and cholera. The pathophysiological factors responsible for influencing the incidence and manifestation of acute diseases are mainly environmental factors and behavioral factors to some extent.
Considering malaria as an example of the acute illness, an environmental factor that is responsible for its existence is the female anopheles mosquito. The female anopheles mosquitoes initiate the pathophysiology by biting the human host. Another environmental factor is a surrounding that supports mosquitoes’ breeding. For example, bushy as well as swampy surroundings are central to supporting the mosquitoes’ breeding (Cottrell et. al., 2012).
On the contrary, an example of a behavioral factor that is necessary for the occurrence of malaria is the failure of human beings to sleep under treated mosquito nets and drain swampy areas.
Episodic
Diseases that have periods of remission and exacerbations are said to be episodic conditions(Hannon,2011). An example of such conditions is Rheumatoid arthritis, an autoimmune type arthritis that has episodes of joint inflammation and remission. The rheumatoid arthritis incidence and manifestations may be due to pathophysiological influences like biological and psychological factors.
A typical example of the biological factors that are contributing to the existence of this condition is rheumatoid factors that develop in the body of an individual. The rheumatoid factors are responsible for the immune reaction exhibited in the joints of an affected person as they sensitize the immune system to act against cells in the joints.
On the contrary, psychological factors, which are instrumental for the existence of rheumatoid arthritis (episodic conditions), are anxiety and stress. According to Matcham and colleagues,(2016) stress and anxiety are responsible for periods of exacerbation of this condition in individuals after periods of remission.
Chronic
Chronic diseases are illnesses with slow onset and gradual progression. They may be continuous or episodic and occur over an extended period (Hannon,2011). A case in point of a chronic condition is the coronary artery disease. The pathophysiological factors for chronic conditions are mainly biological, behavioral and psychosocial.
For example, in the case of coronary artery disease, a sedentary lifestyle characterized by poor feeding habits as well as the lack of exercises is an example of the behavioral factors. As for psychosocial factors, a person from a low social, economic status exhibits a faster worsening of his/her condition due to stress. Biological factors are manifest in the instance of genetics in which individuals with a family history of the condition are victims of getting this disease (Roberts, & Stewart, 2012). Evidently, from such cases, it is clear that chronic diseases are dependent on pathophysiological factors for their existence.
Conclusion
In closure, indeed the pathophysiological factors play significant roles for the existence of diseases. That is the case given their effect on the incidence and manifestation of diseases. As such, health care professionals must show understanding of these factors if they are to treat these conditions effectively. Failure to do so, however, will only impair the effectiveness of their services.
References
Cottrell, G., Kouwaye, B., Pierrat, C., Port, A. l., Bouraïma, A., Fonton, N., & … Garcia, A. (2012). Modeling the Influence of Local Environmental Factors on Malaria Transmission in Benin and Its Implications for Cohort Study. Plos ONE, 7(1), 1-8. doi:10.1371/journal.pone.0028812
Hannon, R. (2011). Porth Pathophysiology: Concepts of Altered Health States.
Matcham, F., Ali, S., Irving, K., Hotopf, M., & Chalder, T. (2016). Are depression and anxiety associated with disease activity in rheumatoid arthritis? A prospective study. BMC Musculoskeletal Disorders, 171-9. doi:10.1186/s12891-016-1011-1
Roberts, R., & Stewart, A. F. (2012). Genes and Coronary Artery Disease: Where Are We?. Journal Of The American College Of Cardiology (JACC), 60(18), 1715-1721. doi:10.1016/j.jacc.2011.12.062
