What to do if your blood lipids are high? Experts teach you how to lower blood lipids scientifically and protect cardiovascular health!

Mr. Wang, who lives in Changsha, is a meat lover who eats very few vegetables and fruits. His recent physical examination results worried him: his triglycerides and total cholesterol were high. He found that people around him had different opinions on this. Some said he should take lipid-lowering drugs, while others said he needed to complete a complete examination before making a decision.

Confused, Mr. Wang came to the cardiovascular department of Hunan Provincial Second People's Hospital (Provincial Brain Hospital) for treatment. Chief physician Chai Xiaoli gave him a professional answer, which also provided a reference for many people with similar troubles.

First of all, high blood lipids do not necessarily mean that you need to take medicine immediately . If it is just a mild increase in blood lipids like Mr. Wang, for example, total cholesterol is in the marginal elevated range (5.2-6.2mmol/L), low-density lipoprotein cholesterol is slightly elevated (3.4-4.1mmol/L), and there are no other cardiovascular disease risk factors such as hypertension, diabetes, smoking, etc., then you can wait to take medicine.

At this time, lifestyle intervention is the key . In terms of diet, Mr. Wang needs to reduce the intake of high-fat foods, especially fatty meat, sausage bacon, butter, cream and other foods, and limit the intake of pork, mutton, pig's trotters, pig liver, duck liver, goose liver, egg yolk and other foods, because these foods contain a lot of cholesterol and saturated fatty acids, which will increase the accumulation of fat in blood vessels after eating. Increase the intake of vegetables and fruits to ensure adequate supply of dietary fiber.

At the same time, you should exercise regularly, such as doing at least 150 minutes of moderate-intensity aerobic exercise per week , such as brisk walking and jogging, to help the body consume excess fat. Quit smoking and limit alcohol consumption, control your weight , and maintain your body mass index between 18.5 and 23.9 kg/m². Through these lifestyle changes, blood lipids are likely to gradually return to normal.

Of course, we also need to check whether the elevated blood lipids are caused by certain secondary factors , such as dyslipidemia caused by hypothyroidism. If the primary disease of hypothyroidism can be actively treated, as the thyroid function returns to normal, blood lipids may decrease on their own.

Second, if blood lipids are seriously elevated, such as low-density lipoprotein cholesterol ≥ 4.9mmol/L, then regardless of whether there are other cardiovascular risk factors, lipid-lowering drugs, especially statins, are usually needed for treatment. Because in this case, the risk of atherosclerosis in blood vessels increases significantly, and the incidence of cardiovascular disease also increases significantly.

Third, for patients who already have cardiovascular diseases such as coronary heart disease and stroke, or have high-risk factors for cardiovascular diseases such as hypertension and diabetes, and whose low-density lipoprotein cholesterol is ≥2.6mmol/L, they also need to take lipid-lowering drugs . The purpose is to reduce the risk of recurrence and death from cardiovascular diseases. It is generally based on statins and, if necessary, combined with other lipid-lowering drugs such as ezetimibe, to promote blood lipids to reach the ideal target value. (Low-density lipoprotein should be lower than 1.8mmol/l, total cholesterol should be lower than 4.3mmol/l, and triglycerides should be lower than 1.7mmol/l.)

Fourth, for patients with coronary heart disease who have already had stents placed, the target value for low-density lipoprotein should be less than 1.4mmol/l. If it is an acute myocardial infarction combined with diabetes, the low-density lipoprotein should be reduced to about 1mmol/l.

In short, whether to take medicine for high blood lipids cannot be generalized. It is necessary to comprehensively consider multiple factors such as the degree of elevated blood lipids, the presence of cardiovascular disease or high-risk factors, and whether there are secondary causes. In cases like Mr. Wang, Director Chai suggested that further examinations be completed first, and the risk of cardiovascular disease be comprehensively assessed before determining whether drug treatment is needed and formulating a personalized lipid-lowering plan.

For the general public, if you find abnormal blood lipids, do not blindly decide whether to take medication on your own. It is wise to consult a professional doctor in time. This way, you can effectively control blood lipids while avoiding unnecessary side effects of drugs and safeguard your health.

Hunan Medical Chat Special Author: Deng Yanping, Department of Cardiovascular Medicine, Hunan Second People's Hospital (Provincial Brain Hospital)

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(Edited by Wx)