Hypercholesterolemia
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| Names | |
|---|---|
| IUPAC name
Cholest-5-en-3β-ol | |
| Systematic IUPAC name
(1R,3aS,3bS,7S,9aR,9bS,11aR)-9a,11a-Dimethyl-1-[(2R)-6-methylheptan-2-yl]-2,3,3a,3b,4,6,7,8,9,9a,9b,10,11,11a-tetradecahydro-1H-cyclopenta[a]phenanthren-7-ol | |
| Other names
Cholesterin, Cholesteryl alcohol | |
| Identifiers | |
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3D model (JSmol) |
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| ChEBI | |
| ChEMBL | |
| ChemSpider | |
| KEGG | |
PubChem CID |
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| UNII | |
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| Properties | |
| C27H46O | |
| Molar mass | 386.65 g/mol |
| Appearance | white crystalline powder |
| Density | 1.052 g/cm3 |
| Melting point | 148 to 150 °C (298 to 302 °F; 421 to 423 K) |
| Boiling point | 360 °C (680 °F; 633 K) (decomposes) |
| 0.095 mg/L (30 °C) | |
| Solubility | soluble in acetone, benzene, chloroform, ethanol, ether, hexane, isopropyl myristate, methanol |
| −284.2·10−6 cm3/mol | |
| Hazards | |
| Flash point | 209.3 ±12.4 °C |
Except where otherwise noted, data are given for materials in their standard state (at 25 °C [77 °F], 100 kPa). | |
 verify (what is  ?) | |
| Infobox references | |
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Hypercholesterolemia is a disorder involving an excess of low-density lipoprotein (LDL) in a person's blood. Low-density lipoprotein (LDL) is the means by which the bloodstream transports cholesterol into the human body.
Cholesterol is an essential component of cell membranes. Too much cholesterol can lead to cardiovascular issues, including stroke and artery disease. Atherosclerosis is an inflammatory disease of artery walls in which white blood cells invade the vessel wall and become engorged with cholesterol and other lipids. These areas can slowly close off a blood vessel or can suddenly rupture and trigger formation of a blood clot.
Types
Cholesterol is a lipid (fat), which cannot dissolve in water. The bloodstream is water-based and transports only soluble substances, and cholesterol is transported in a soluble structure called a lipoprotein. Lipoproteins may be classified by density. Doctors often measure the amounts of each different type to find out if someone has hypercholesterolemia.
High density lipoprotein (HDL) transports cholesterol from the body to the liver. There it can be recycled or converted to bile acid and excreted, reducing the amount of cholesterol in the body. For this reason HDL is sometimes called "good cholesterol". People with higher levels of HDL are less likely to have atherosclerosis.
Low density lipoprotein (LDL) transports cholesterol from the liver into the body, increasing the amount of cholesterol there. For this reason LDL is sometimes called "bad cholesterol". People with higher levels of LDL are more likely to have atherosclerosis.
Intermediate and Very low density lipoprotein (IDL & VLDL) and Chylomicrons transport triglycerides around the body. Triglycerides also play a role in atherosclerosis.
Treatment
The most common type of medicine to treat hypercholesterolemia are statin drugs. They are called statins because their names all end in -statin (such as rosuvastatin). They are also called HMG-CoA Reductase Inhibitors. This is because they work by inhibiting the enzyme HMG-CoA Reductase. Inhibiting an enzyme means to make it work less well.
The HMG-CoA Reductase enzyme causes the body to make more cholesterol. If it is inhibited, the body makes less cholesterol. So statin drugs lower the amount of LDL (bad) cholesterol in the blood which stops atherosclerosis from getting worse. Statin drugs can even help make atherosclerosis better. However, statins are not as good at increasing the HDL (good) cholesterol. Low HDL is hard to treat with medicines, but goes up with more exercise.
Side effects of statins
The two main adverse effects (problems) caused by treatment with statin drugs are liver problems and rhabdomyolysis.
Rhabdomyolysis is a disease where muscle cells are damaged and die. Statins can cause damage to muscle cells. This can cause weakness and muscle pain. The worse problem though is that when muscle cells die, they release cell proteins into the blood. The kidney removes the muscle protein from the blood. If the kidney takes up too much protein, it can be hurt. If it is bad enough it can cause kidney failure. So if people take statins and get muscle pain or weakness, stop the medicine and see a doctor.
Statins can also cause liver problems. They can cause mild irritation of the liver. They can rarely cause very bad liver damage. Because of this, when someone starts taking a statin, doctors check liver blood tests after six weeks. Doctors also warn patients to watch for the signs of liver damage: pain in the abdomen (on the right side), nausea, vomiting, and jaundice.
However, rhabdomyolysis and liver problems are both rare side effects[source?]. In someone with hypercholesterolemia, the benefit from statins is more than the risk. This means that someone is more likely to prevent problems than cause problems by taking them. There are many big scientific studies of this problem.
Other treatments
There are other kinds of medicines to treat hypercholesterolemia, but statins are usually preferred.
Fibrates are medicines that lower cholesterol levels. They may also help people with Type II Diabetes. This is a good effect because diabetes and hypercholesterolemia cause some of the same problems. If both diabetes and hypercholesterolemia happen in the same person the problems from these diseases can be much worse. Fibrates can have rhabdomyolysis like the statins and also can cause upset stomach. Use of fibrates and statins at the same time makes rhabdomyolysis happen much more often.
Niacin is a vitamin that lowers cholesterol levels. It is also called Vitamin B3 or nicotinic acid. Severe niacin deficiency in the diet can cause a disease called pellagra. This is rare in the developed world today. However, less bad deficiency of niacin can cause high blood pressure, weight gain, and hypercholesterolemia. So sometimes niacin is used to treat hypercholesterolemia.
Niacin is one of the medicines that may make HDL (good) cholesterol go up. The biggest problem with taking enough niacin to help cholesterol is that it causes severe flushing (hot, red, sometimes itchy skin). This side effect is so bad, sometimes people stop taking the medicine.
Bile Acid Resins are medicines that make people not absorb as much bile when they digest food. This causes them to take up less cholesterol also, which lowers blood levels of cholesterol.
References
- 1 2 "Cholesterol, 57-88-5". PubChem, National Library of Medicine, US National Institutes of Health. 9 November 2019. Retrieved 14 November 2019.
- 1 2 "Safety (MSDS) data for cholesterol". Archived from the original on 12 July 2007. Retrieved 20 October 2007.
- ↑ "Hypercholesterolemia". Retrieved 2026-08-25.
- ↑ "Atherosclerosis". Retrieved 2026-08-25.
- ↑ "Classifying Lipoproteins: Types and Methodologies". New Medical Life Sciences. Retrieved 2026-08-25.
- ↑ "The Role of Triglycerides in Atherosclerosis: Recent Pathophysiologic Insights and Therapeutic Implications". National Library of Medicine. Retrieved 2026-08-25.