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Høyt kolesterol, hyperlipidemi

Høyt kolesterol, hyperlipidemi, er en av flere risikofaktorer for hjerte-/karsykdom. Behandling består av kostomlegging, regelmessig mosjon og eventuelt bruk av kolesterolsenkende medisiner.

Hyt kolesterol
Høyt kolesterol er ofte koblet til genetiske mekanismer og kosthold med høyt inntak av mettet fett.

Sist oppdatert:

30. mars 2025

Hva er hyperlipidemi?

Hyperlipidemi er en tilstand med høye verdier av fettstoffer i blodet. Begrepet brukes ved forhøyelse av fettstoffene kolesterol og triglyserider. Hyperkolesterolemi betyr forhøyet kolesterol i blodet. Kolesterol måles både som totalkolesterol, HDL-kolesterol og LDL-kolesterol.

Annonse

HDL-kolesterol, High-Density Lipoprotein, betegnes ofte "det gode kolesterolet" fordi høyt HDL-kolesterol er vist å beskytte mot hjerte- og karsykdom. LDL-kolesterol, low-density lipoprotein, er den skadelige delen av kolesterolet. Det betyr at lavt nivå av HDL- og høyt LDL-kolesterol er spesielt ugunstig for hjertet. Fettstoffer i blod måles i enheten millimol per liter (mmol/L). 

Animasjon om høyt kolesterol

Når er verdiene for høye?

Fettstoffer i blodet kan bare påvises ved hjelp av blodprøver. Høye verdier gir ingen symptomer eller plager, men øker risikoen for hjerte- og karsykdommer som hjerteinfarkt og angina, hjerneslag og trange blodårer i bena.

Når vi snakker om "for høye" verdier er det viktig å vurdere totalrisiko for hjerte-/karsykdom. Viktigst er det å skille mellom personer som har kjent hjerte-/karsykdom, personer med familiær hyperkolesterolemi (se under) og personer uten slike sykdommer. I all hovedsak er det LDL-kolesterol som benyttes som behandlingsmål.

Alle personer med kjent hjerte- og karsykdom som følge av åreforkalkning (aterosklerose) bør tilbys behandling med kolesterolsenkende medikamenter, de hyppigst brukte betegnes statiner. Med kjent hjerte-/karsykdom menes blant annet angina, gjennomgått hjerneslag eller hjerteinfarkt, trange halskar, hjerneslag og dårlig blodsirkulasjon. Målet er ifølge norske retningslinjer LDL-verdier lavere enn 1,8 mmol/L, mens det kan være gunstig at pasienter med særlig høy risiko for hjerte- og karsykdom når en LDL-kolesterolverdi under 1,4 mmol/L. Alle personer med Familiær hyperkolesterolemi (FH) anbefales også kolesterolsenkende medikamenter, med mål om LDL-kolesterolnivå < 2,5 mmol/L. Dersom FH oppdages senere kan det være aktuelt med lavere behandlingsmål. Dette gjelder uanvhengig om vedkommende har gjennomgått hjertesykdom eller ikke.

Andre personer som har økt risiko for hjerte-/karsykdom (f.eks. grunnet kjent hjertesykdom i familien, røyking eller høyt blodtrykk) anbefales også behandling. Det er ifølge norske retningslinjer ikke noe klart behandlingsmål, men reduksjon i LDL-kolesterol på 30-40% eller til under 3,0 mmol/l gir vanligvis god risikoreduksjon. Det gode kolesterolet HDL er anbefalt å være under 1,1-1,3, og triglyserider er anbefalt å være under 2 mmol/L.

Personer som ikke har hjerte- og karsykdom eller økt risiko, kan gjerne ha høyere verdier uten at behandling er nødvendig.  Fastlegen din kan hjelpe deg til å bedømme om dine verdier er for høye. 

Dette dokumentet er basert på det profesjonelle dokumentet Hyperlipidemi . Referanselisten for dette dokumentet vises nedenfor

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