Hyperlipoproteinemia refers to excessive lipoproteins in the blood. Lipoproteins are parcels of protein and fat that transport blood fats, such as cholesterol and triglycerides.

Humans require some proteins and fats in the bloodstream to function. However, too much cholesterol on the artery walls can increase the risk of problems, such as heart disease and stroke. Hyperlipoproteinemia is a common disorder, possibly affecting over half of the United States’s adult population.

This article breaks down the different types of hyperlipoproteinemia, what causes them, and how to manage them.

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Hyperlipoproteinemia means that an individual has high levels of lipoproteins and blood fats called lipids. These include:

High levels of blood fats, such as triglycerides and cholesterol, can contribute to plaque buildup on the walls of the arteries — a condition known as atherosclerosis. In turn, this may increase the risk of blood vessel blockages that can result in a heart attack or stroke.

As high lipoprotein levels have such close links to high cholesterol and triglycerides, the term “hyperlipoproteinemia” is often interchangeable with “hyperlipidemia.” Having high levels of lipids in the blood is a common disorder, possibly affecting over half of the adult U.S. population.

Hyperlipidemia can develop due to a primary or secondary cause.

Primary hyperlipoproteinemia

Primary causes are genetic, which means a parent typically passes them to a child through their genes. There are several genetic disorders that can affect how the body breaks down lipoproteins.

Secondary hyperlipoproteinemia

This refers to the increase of blood lipids and lipoproteins by another health condition. Secondary hyperlipoproteinemia might occur due to the following conditions or causes:

  • a diet containing too many foods with high saturated fats
  • medications — including a heart medication called amiodarone and glucocorticoids, a group of anti-inflammatory medications
  • hypothyroidism, or an underactive thyroid gland
  • untreated diabetes

Factors, such as obesity, can act as secondary factors that trigger lipid buildup in those who have underlying primary hyperlipoproteinemia.

Five different types of genetic or inherited hyperlipoproteinemia can affect levels of different blood fats in different ways, according to the Fredrickson classifications that first defined them. These include:

  • Type I: Children can inherit this from their parents, and it usually presents when people are young. Type I disrupts how the body breaks down fats, leading to a severe buildup of triglycerides.
  • Type IIa: Also known as familial hypercholesterolemia, this type occurs due to a gene alteration and causes high levels of LDL cholesterol.
  • Type IIb: A variation in a specific gene causes both high cholesterol and high triglycerides.
  • Type III: An increase in intermediate-density lipoproteins (IDL) sets type III apart. This type is genetic and affects how the body breaks down lipids, causing them to build up.
  • Type IV: This type usually leads to increased VLDL and triglycerides but normal cholesterol.
  • Type V: This type is severe and refers to an increase in the triglycerides contained in VLDL. It often has links to diabetes and does not occur due to reduced lipoprotein metabolism like type I.

Many people with hyperlipoproteinemia do not develop any symptoms and initially find out about high lipids when doctors are investigating a heart problem. However, different types may cause different symptoms. This allows doctors to identify a type and form a treatment plan.

For example, type III hyperlipoproteinemia can cause:

  • yellow, crusty, fatty deposits on the skin called xanthomas, particularly on the palms of the hands
  • enlargement of the spleen or liver
  • inflammation of the pancreas, or pancreatitis
  • cramping in the legs

Family histories of related conditions can also help doctors identify a type. For example, types III, IV, and V have links to diabetes.

Diagnosing hyperlipidemia involves testing the blood for its total cholesterol, triglycerides, and lipoprotein content. The test that measures this is a fasting lipid profile. For between 9 and 12 hours before the test, the individual will only be able to drink water.

Doctors may carry out other tests to rule out causes of secondary hyperlipidemia including:

Doctors treat hyperlipoproteinemia effects, such as high cholesterol and high triglycerides, when they assess that there is a high risk of CVD. Treatments might include lipid-lowering medications called statins, such as:

  • lovastatin
  • pravastatin
  • simvastatin
  • atorvastatin
  • rosuvastatin

These have reduced CVD risk by 20–30% in clinical trials.

According to the American Heart Association (AHA) hyperlipidemia treatment guidelines, lifestyle adjustments can also help an individual manage lipid levels, including:

  • eating a healthy, low saturated fat diet
  • engaging in regular physical activity
  • avoiding or quitting tobacco use
  • maintaining a moderate body mass index (BMI)

Hyperlipoproteinemia increases blood lipids and a person’s risk for cardiovascular disease and stroke. It can occur due to other health problems or genetics. There are several different types that vary depending on which lipoprotein or lipid they raise.

Doctors can diagnose the type and rule out other conditions using blood and urine tests. This informs treatment, which usually involves taking statins and making healthy lifestyle changes.