For people with high blood pressure, doctors do some tests. This is to assess the patient's cardiovascular risk.
Because patients with hypertension often have other cardiovascular risk factors. If there are many risk factors, the cardiovascular risk is high, and the chance of cardiovascular disease in the future is large, so it is necessary to take preventive measures early.
One of the items examined is lipids.
Lipids are an important part of cardiovascular risk assessment.
What do lipids mainly look at?
Generally, there are four blood lipids: total cholesterol, triglycerides, HDL cholesterol, and LDL cholesterol.
The key is to look at cholesterol.
Triglycerides or not? Also look, however, for atherosclerosis, cholesterol has a higher status.
Many people see the "oil" and "fat" in triglycerides, do not pay attention to the "lipoprotein cholesterol" of cholesterol, always think that triglycerides are blood lipids, do not think that cholesterol is blood lipids. In fact, for atherosclerosis, cholesterol is the most important.
In the cholesterol, the total cholesterol and LDL cholesterol are not good, and the HDL cholesterol is not good. If you simply remember, it is "the high is higher, the lower is lower", so it is good.
Therefore, if total cholesterol, LDL cholesterol is high, or HDL cholesterol is low, these are all risk factors. Now add another one, called "non-HDL cholesterol", that is, the total cholesterol minus the part of HDL cholesterol, which is not good when it is high.
This is also easy to understand, high blood pressure itself damages blood vessels, if the blood lipids are high, cholesterol will drill through the damaged vascular lining, deposited inside, the formation of atherosclerotic plaque, the danger is great.
* In patients with high blood pressure, if the blood lipids are not normal, the HDL cholesterol is low, or the total cholesterol and LDL cholesterol are also high, it is at least cardiovascular.
* Even if total cholesterol and LDL cholesterol are not high, but not particularly low, but HDL cholesterol is low, or there are other risk factors, such as smoking, obesity, or a certain age (male ≧ 45 years old, female ≧ 55 years old), that is high risk.
Therefore, patients with hypertension should pay more attention to lowering blood lipids.
*In moderately ill patients, total cholesterol and LDL cholesterol should be controlled at least within the normal range.
* High-risk patients should at least reduce LDL cholesterol below 2.6 mmol/L.
* If there are many risk factors, or diabetes mellitus, it will drop lower, below 1.8mmol/L. In this way, the risk of cardiovascular disease can be reduced in the future.
Some people will ask, why does lowering blood lipids only reduce "LDL cholesterol" and not raise high "HDL cholesterol"? Isn't it bad to have a high density and a low density?
Here's why.
* Lower LDL cholesterol benefits clearly, there is medicine.
Elevated LDL cholesterol is the initiator of atherosclerosis, as well as lowering LDL cholesterol to reduce the risk of cardiovascular disease, and cholesterol-lowering injections such as statins, mebs, and PCSK9 can lower cholesterol and reduce cardiovascular events.
The study found that for every 1 mmol/L reduction in LDL cholesterol, the main cardiovascular event was reduced by 21%; coronary events such as unstable angina and myocardial infarction were reduced by 24%, blood revascularization such as stenting and bypass was reduced by 25%, stroke, that is, stroke was reduced by 16%,and deaths caused by cardiovascular disease were greatly reduced.
LDL-C: LDL cholesterol
The benefits of cholesterol reduction, medicine, efficacy and safety have been confirmed, so it is clinically applied.
* There is currently no specific drug for elevating HDL cholesterol, and it has not been confirmed whether it is beneficial after elevating.
Studies to elevate HDL cholesterol have been ongoing. However, studies have found that some drugs, such as niacin, although they can increase the "high density", but can not reduce the cardiovascular risk; there are also some drugs, after raising hdL lipoprotein cholesterol, cardiovascular events have increased, adverse reactions are also obvious, so it can not be used. There are also some drugs under investigation that have found to be effective, but further research is needed to confirm them. Therefore, there is no clinical drug that specifically raises HDL cholesterol, let alone the question of whether the effect is good after it is elevated.
In fact, when statins lower LDL cholesterol, they also have some effects on raising HDL cholesterol, but they are relatively weak.
Doctors in the patient to check blood lipids at the same time, but also check liver and kidney function, check muscle enzymes, blood glucose, etc., these are to prepare for the next step of medication, because lipid-lowering drugs may have liver damage, muscle damage adverse reactions, before taking the drug to determine the liver and kidney function, muscle enzymes and other normal.