Hyperlipiedmia refers to heightened levels of 'bad' cholesterol, or LDL, in the blood.
Most people will have no symptoms, but having hyperlipidemia increases the risk of developing heart disease.
It affects 1 in 3 Americans.
Genetic predisposition, cigarette smoking, obesity, poor diet, and a sedentary lifestyle can all lead to hyperlipidemia.
There are two types of cholesterol, low-density lipoproteins (LDL) and high density lipoproteins (HDL). LDL is considered unhealthy, while HDL is "good" cholesterol.
Cholesterol and lipoproteins, are not the same thing, although they work together. The lipoproteins carry the cholesterol to the cells.
Usually there are no symptoms with hyperlipidemia, but it can be detected by a simple blood test.
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Here are some key points about hyperlipidemia. More detail is in the main article.
- Hyperlipidemia is a major risk factor for heart disease, the leading cause of death in the U.S.
- It is also called high cholesterol or hypercholesterolemia,.
- Low-density lipoprotein (LDL) is known as bad cholesterol, while high-density lipoprotein (HDL) is considered good.
- Hypothyroidism, a high-fat diet, and being overweight contribute to high cholesterol.
- Regular physical activity can raise levels of HDL and lower LDL.
What is hyperlipidemia?
Hyperlipidemia means there is too much cholesterol in the blood.
Cholesterol is a waxy, fat protein that is made by the liver.
It is essential for healthy cell membranes, brain functioning, hormone production, and vitamin storage.
Cholesterol becomes a problem when too much bad cholesterol, or low-density lipoprotein (LDL), is produced or ingested through unhealthy foods.
Lipoproteins transport cholesterol through the blood to the cells.
HDL is good because it carries extra cholesterol back to the liver where it can be eliminated. LDL is bad, because it enables excess cholesterol to build up in the blood.
Triglycerides are a type of fat in the blood. These are different from cholesterol, but because of their strong association with heart disease, triglycerides are also measured.
A person with hyperlipidemia may have high levels of both LDL and triglycerides.
The causes of hyperlipidemia can be due to:
- Genetic factors: This is primary hyperlipidemia
- Poor diet and other factors: This is secondary hyperlipidemia
When the body cannot use or remove excess fat, it accumulates in the blood. Over time, this damages the arteries and internal organs and contributes to the development of heart disease.
Other causes include:
- excessive alcohol consumption
- use of medications such as hormones or steroids
- kidney disease
- underactive thyroid gland, or hypothyroidism
Familial hyperlipidemia stems from a genetic disorder.
A mutated gene is passed down from a parent and causes a missing or malfunctioning LDL receptor. The LDL accumulates to dangerous amounts in the blood.
Some ethnic groups, such as French Canadians, Christian Lebanese, South African Afrikaners, and Ashkenazi Jews have a higher risk of hereditary hyperlipidemia.
Signs and symptoms
A person with hyperlipidemia usually has no signs or symptoms. In familial hyperlipidemia, there may be yellowish fatty growths around the eyes or the joints.
Excessive fat in the blood accumulates over time, forming plaques on the walls of the arteries and blood vessels.
This will narrow the openings, producing turbulent blood flow through the vessels. The heart has to work harder to pump the blood through the constricted areas.
Screening for hyperlipidemia is done with a blood test called a lipid profile. It is important to have nothing to eat or drink for 9 to 12 hours before the test.
Screening may start at the age of 20 years for men at high risk, and later for lower risk men and women. If the result is normal, it should be repeated at least every 5 years.
Normal levels for a lipid profile are:
- Total cholesterol: less than 200
- LDL: less than 100
- HDL: greater than 40 for men, greater than 50 for women (higher is even better)
- Triglycerides: less than 140
If the person has high cholesterol levels, monitoring and treatment will be likely.
Treatment and prevention
Lifestyle options are the best way to prevent and treat hyperlipidemia.
This involves a "heart healthy" diet, regular exercise habits, no smoking, and maintaining a healthy weight.
Additionally, medications known as statins may be indicated.
An unhealthful diet can be a cause of hyperlipidemia.
Rather than following a low-fat diet, the individual should minimize their intake of saturated fat, trans fats, and cholesterol
The diet should include a variety of whole fruits and vegetables, plenty of fiber, and whole grains.
Fast foods, high carbohydrate foods, and any foods that do not offer good nutritional value should be restricted or eliminated.
Regular servings of fish, nuts, and legumes are recommended. When oil is used, it should be olive or another monounsaturated oil.
Being overweight is a risk factor for hyperlipidemia and heart disease.
Losing weight can help reduce LDL, total cholesterol, and triglyceride levels. It can also boost HDL, which helps to remove the bad cholesterol out of the blood.
A lack of physical activity is a risk factor for heart disease.
Regular exercise and activity helps lower LDL, raise HDL, and encourage weight loss.
At least 30 minutes of physical activity is recommended, at least 5 days a week. Brisk walking is an excellent and easy choice.
Smoking triggers many problems that contribute to heart disease.
It promotes plaque buildup on the walls of the arteries, increases LDL levels, and it encourages blood clot formation and inflammation.
Quitting smoking will result in higher HDL. This may be one reason why cardiovascular disease risk falls after quitting.
To determine if and when medications are needed, a physician will look at:
- the patient's lipid profile
- their risk factors
Statins are prescribed to manage the symptoms of hyperlipidemia
There are also new medications called PCSK9 inhibitors that are being looked at for people with cardiovascular disease that need additional lowering of their LDL.
Occasionally, statins are not tolerated due to side effects of muscle pain, and people stop taking them.
However, it is worth balancing the risk of a cardiovascular event against the risk of side effects before stopping the medication and talking with your doctor about the side effects.
Hyperlipidemia is a common health problem that can lead to serious cardiovascular or heart disease, but it can be prevented and treated through the appropriate use of medication and maintenance of a heart healthy lifestyle.