Impact of lifestyle change (LSC) and multidisciplinary work on the treatment of hypercholesterolemia: case report

Abstract

Introduction: Hypercholesterolemia is an important risk factor for coronary heart disease (CHD). Lifestyle change has a significant impact on the treatment of these patients. Objectives: To highlight the importance of lifestyle change in hypercholesterolemia in patients who do not qualify for pharmacological therapy. Methodology: This study is a case report of a patient followed as an outpatient for two years. Results: Patient S.A, 59, Campinas, SP, evaluated by a cardiologist in February 2022 due to palpitations. She uses alprazolam and paroxetine. She is sedentary and denies alcoholism or smoking. In the anamnesis, she reports stress due to workload. Holter and MAP were requested, the results of which showed only 2 supraventricular tachycardias with 3 and 4 beats. Exercise stress test showed no alterations. Laboratory tests showed: total cholesterol (TC) 266, HDL 60, LDL 146 (borderline), triglycerides (TG) 101 mg/dL. Due to the lipid profile, sedentary lifestyle, and high stress, a multidisciplinary approach was adopted using lifestyle change. The objectives were to increase functional capacity gains by increasing lean mass and reducing fat. With the help of a physical trainer, the patient started weight training for 120 minutes per week and joined the “10,000 steps per day challenge”. Nutritional monitoring was carried out every 45 days. In July 2022, she lost 1.7 kg and stopped taking alprazolam. In May 2024, he returned, with excellent adherence to the pillars of MEV and significant improvement in the lipid profile: TC 196, HDL 71, LDL 108 and TG 83. The only laboratory alteration found was dyslipidemia. The intervention without statins was chosen. This decision was based on the Framingham Score, the risk of a CHD event in 10 years was 6.4%, and in Prevent it was 3.8%. A reduction of 26.03% in LDL and 26.32% in TC was observed. The Lifestyle Medicine approach demonstrated similar potency to that which would be found with the use of most statins. Conclusion: The importance of Lifestyle Medicine in quality of life and health promotion is demonstrated, without the use of unnecessary prescriptions in patients without proven indication.