Hypercholesterolemia
In an age where curative and rehabilitative medicine is becoming more costly for the health customer and the health care provider alike, it is important to focus more on preventive medicine. Preventive medicine has become better known as primary health care (PHC). One of the main strategies for PHC is health education to the public as a means of prevention. Health education can be done through administering health talks, health teachings, the internet and web-based applications, mass media, and social media.
In these health messages, the health customer receives vital information on the risk factors, the signs and symptoms, diagnostic tests, and treatment modalities. Such information can be very helpful in averting preventable diseases. For instance studies by the public health have revealed that Americans have learned that through lifestyle changes they can avoid cancer and CVDs (Tsouli, Kiortsis, Argyropoulou, Mikhailidis, & Elisaf, 2005). Lifestyle changes such as quitting smoking, exercising regularly, eating healthy and having regular physical checkups and screening tests have been learned through health education.
Brochures are simply small pieces of books or magazines with information; this paper will design a brochure that will be used to educate the community members about a body state known as hypercholesterolemia.
What is Hypercholesterolemia?
Hypercholesterolemia is a body condition whereby the blood levels of cholesterol are high above normal. Cholesterol is a substance that is similar to fat and is wax-like. Cholesterol gets into the body after consumption of animal proteins such as dairy produce, meat, poultry, and fish. Cholesterol is not entirely harmful to the body; the human body needs it for functions such as manufacturing hormones, building cell membranes and making compounds with lipids that are useful in the digestion of ingested food (Tsouli, Kiortsis, Argyropoulou, Mikhailidis, & Elisaf, 2005). The problem comes in when someone has too much cholesterol in the body; it significantly increases the risk of him getting a cardiovascular disease as the heart attack.
Individuals with hypercholesterolemia have a high danger of developing a cardiovascular disease known as coronary heart disease (CAD). CAD develops as a result of too much cholesterol within the blood of the individual collecting and accumulating in the blood vessel walls of the coronary artery. The coronary artery is the one that supplies blood to the heart muscle to enable it to pump blood to the rest of the body (Durrington, 2003). Continued accumulation due to continued excessive consumption of fatty foods will lead to the formation of plaques. Plaques are cholesterol clumps in the coronary arteries. The plaques further cause hardenings of the arteries that supply the heart muscle.
What’s more, the coronary arteries are like a pipe, and so they have lumen; they are hollow. The deposition of plaque in the pipe leads to narrowing of the hollow space within them. The more the accumulation, the more the clumps and plaques restrict the blood from flowing to the heart muscle (Nordestgaard et al., 2013). We all know that blood carries oxygen and nutrients to tissues and carries away carbon IV oxide and other waste substances for excretion and elimination. Therefore, with restriction of the blood vessel, the heart muscle is starved of oxygen and nutrients. Moreover, the heart muscle cells cannot rid themselves of the waste substances they have produced; accumulation of waste substances can be toxic to the heart cells.
The restriction of blood from reaching the heart muscle cell causes the cells to die; such cell death is called ischemia by the nurse and the doctor. The build-up of cholesterol in the coronary blood vessels can lead to a certain type of chest pain that is commonly referred to as angina. Angina can give rise to an individual developing heart attack (Tsouli, Kiortsis, Argyropoulou, Mikhailidis, & Elisaf, 2005).
Inherited types of hypercholesterolemia
There is substantive evidence that certain kinds of hypercholesterolemia that people acquire as a result of inheritance can cause other problems in the body apart from heart diseases. When the blood has too much cholesterol in circulation, and the cholesterol accumulates in the tendons (tissues that connect muscle to bone) the result will be a positive growth called tendon xanthomas (de Ferranti et al., 2016). These extensions in most cases affect the tendons in the Achilles tendon and the tendons in the fingers and the hands of the individual. If one develops yellow cholesterol deposits under the skin of the eyelids, it is called xanthelasmata.
Incidence and prevalence (How many people have hypercholesterolemia?)
Over thirty-four million people living in America have blood levels of cholesterol that are elevated above normal. A blood level of cholesterol above 240mg/dL is considered to be elevated. The forms of hypercholesterolemia that are inherited from relatives and family member occur less frequently, so the cases of people with the inherited type are rare (Tsouli, Kiortsis, Argyropoulou, Mikhailidis, & Elisaf, 2005). However, among the inherited types one is very common, it is called familial hypercholesterolemia. Familial hypercholesterolemia is likely to affect one person in every five hundred individuals in the other countries in the world. The familial hypercholesterolemia can be found to be more prevalent among particular populations such as the French Canadians, Afrikaners in South Africa, Lebanese and the Finns (Durrington, 2003).
Causes and Risk Factors
Elevated levels of blood cholesterol can arise from multiple environmental and genetic factors working together. Other factors affect the amount of cholesterol that is found in the body of an individual; lifestyle choices such as exercise, tobacco smoking, excessive alcohol consumption, and diet are some of the factors that can contribute to one having a high level of cholesterol in the blood (de Ferranti et al., 2016). Moreover, the age of the individual, gender, and other concurrent health problems such as diabetes mellitus and obesity may contribute to a person having an elevated level of blood cholesterol.
The most common cause for the familial hypercholesterolemia is a gene known as LLDR gene. This gene can be inherited from one family member to another (Nordestgaard et al., 2013). Therefore, if an individual has a family member who has a high level of cholesterol in their blood, then he or she is at an increased risk of having elevated levels of cholesterol in the blood too. Studies have however pointed to the fact that inheritance alone cannot cause the condition rather inheritance is aided by the other environmental factors and a behavioral factor of the individual (Durrington, 2003).
Diagnosis and testing
Trial and diagnosis to identify if a person has high blood levels of cholesterol are primarily done through blood tests. The doctor or the nurse draws a small amount of blood from the individual’s body and takes it to the laboratory for testing. The blood is analyzed in the laboratory by a laboratory technician to check the level of cholesterol in the blood (Hovingh, Davidson, Kastelein, & O’Connor, 2013).
The nurse may also perform physical examinations on the individual; the tests may reveal fatty growths in the skin and cholesterol depositions in the cornea. The nurse may further ask questions about the client’s family and record it as the family history. This history is relevant in establishing whether the hypercholesterolemia has any form of family linkage.
Management
The primary goal of management is to ensure the patient does not get cardiovascular diseases such as coronary artery disease. It is very possible that people who have only inherited one copy of the LLDR gene from their parents can live well on health diet and medications.
- Lifestyle modifications – the health care provider will most likely suggest that the client changes what they eat. The physician will as for this dietary change several months before they prescribe any medication for the customer. The client will be required to eat approximately 30% less fat (Santos & Pereira, 2015). Avoidance of high-fat foods such as beef, chicken, pork and full-fat dairy products. Other modifications include regularly exercising, avoiding smoking tobacco, avoiding excessive alcohol consumption.
- Medication – If the changes in lifestyle do not help the client reduce the amount of cholesterol in their blood then the physician will prescribe some drugs. Many drugs help lower the level of cholesterol in the blood of the client. They all work in different ways to achieve their goal. The statin drugs are used because they are often very active for instance Lovastatin and Pravastatin (Santos & Pereira, 2015).
III. Individuals who have a severe form of hypercholesterolemia may require a type of treatment called apheresis. In this kind of treatment, blood and plasma from the person is removed from their body, and then it is filtered to remove the Low-Density Lipoprotein cholesterols (Hovingh, Davidson, Kastelein, & O’Connor, 2013)
Complications that may arise
If the client does not get medical care, the hypercholesterolemia may complicate to early heart attacks, strokes, heart diseases of peripheral vascular disease (Hovingh, Davidson, Kastelein, & O’Connor, 2013). It is vital to seek immediate medical assistance as soon as one experiences chest pain as it may be an indicator of a heart attack.
Conclusion
In summary, this paper has described the contents of a brochure that will be used to teach the community about hypercholesterolemia. The condition simply refers to elevated levels of cholesterol in the blood. The condition is the result of multiple factors such as environment, genetics, and diet (Hovingh, Davidson, Kastelein, & O’Connor, 2013). Consumption of a high fatty diet will increase the likelihood of one getting the state. Client habits such as sedentary lifestyles, smoking tobacco, excessive alcohol consumption are some of the contributing factors that would cause the disease.
Hypercholesterolemia puts the individual at risk of getting coronary artery disease which could then lead to heart attacks if not monitored. The condition can be diagnosed primarily through blood assay analysis, what’s more, head to toe physical examinations; history taking can be used to make a more definitive diagnosis. Early diagnosis leads to early detection hence there is a need for people with familial linkage to go for routine screening tests and check-ups. Treatment is focused on avoiding development of cardiovascular diseases. A disease like a stroke, peripheral vascular disease, heart attacks could be the result of poorly managed hypercholesterolemia (Santos & Pereira, 2015).
Finally, the first mode of treatment will be dietary change, exercise, and other lifestyle adaptations. Then medications like statins will follow, and as a last option for severe cases, the doctor will perform apheresis. The clients’ blood will be filtered to remove excess LDL cholesterol.
References
de Ferranti, S., Rodday, A., Mendelson, M., Wong, J., Leslie, L., & Sheldrick, R. (2016). Prevalence of Familial Hypercholesterolemia in the 1999 to 2012 United States National Health and Nutrition Examination Surveys (NHANES)CLINICAL PERSPECTIVE. Circulation, 133(11), 1067-1072. http://dx.doi.org/10.1161/circulationaha.115.018791
Durrington, P. (2003). Dyslipidaemia. The Lancet, 362(9385), 717-731. http://dx.doi.org/10.1016/s0140-6736(03)14234-1
Hovingh, G., Davidson, M., Kastelein, J., & O’Connor, A. (2013). Diagnosis and treatment of familial hypercholesterolaemia. European Heart Journal, 34(13), 962-971. http://dx.doi.org/10.1093/eurheartj/eht015
Nordestgaard, B., Chapman, M., Humphries, S., Ginsberg, H., Masana, L., & Descamps, O. et al. (2013). Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population: guidance for clinicians to prevent coronary heart disease: Consensus Statement of the European Atherosclerosis Society. European Heart Journal, 34(45), 3478-3490. http://dx.doi.org/10.1093/eurheartj/eht273
Santos, P. & Pereira, A. (2015). Type of LDLR mutation and the pharmacogenetics of familial hypercholesterolemia treatment. Pharmacogenomics, 16(15), 1743-1750. http://dx.doi.org/10.2217/pgs.15.113
Tsouli, S., Kiortsis, D., Argyropoulou, M., Mikhailidis, D., & Elisaf, M. (2005). Pathogenesis, detection and treatment of Achilles tendon xanthomas. European Journal Of Clinical Investigation, 35(4), 236-244. http://dx.doi.org/10.1111/j.1365-2362.2005.01484.x
