Hyperlipidemia

Basic Facts

  • Physicians use the term hyperlipidemia to describe several conditions in which high concentrations of lipids (fats) exist in the bloodstream. Hyperlipidemia includes:
    • Primary elevated cholesterol (commonly known as high cholesterol)
    • Metabolic syndrome
    • Primary elevated triglycerides
    • Primary low-HDL syndromes
      Other forms of hyperlipidemia include familial hypercholesterolemia and familial hypertriglyceridemia.
  • Hyperlipidemia in the blood can be caused by genetics, lifestyle, or a combination of both.
  • Atherosclerosis, which is the buildup of fatty streaks and cholesterol-laden plaque in the walls of the body’s arteries, can result from hyperlipidemia.
  • Lifestyle changes are the first choice for treating hyperlipidemia.
  • Lipid is the scientific term for fats in the blood. Like vitamins and minerals, certain fats are useful to the body as an energy source and to help build cells and hormones. Several types of fatty acids exist in the human body including:
    • Cholesterol
    • Triglycerides
    • Cholesterol-esters
    • Phospholipids
  • Abnormally high levels of these lipids in the blood can accelerate atherosclerosis. Physicians diagnose coronary heart disease (CHD) and peripheral artery disease (PAD) when the accumulation of plaque in a coronary or peripheral artery grows large enough to obstruct blood flow in the heart muscle or leg.
  • Like other fats, lipids do not dissolve in water, which is a prime component of both cells and blood. For cholesterol and fatty acids to be carried in the blood and used in cells, the body must use a special protein to carry the lipids through the blood and into the cells. These protein-bound fats are called lipoproteins. The lipoprotein classes include:
    • High density lipoproteins (HDL)
    • Low density lipoproteins (LDL)
    • Very low density lipoproteins (VLDL).

Causes & Risk Factors

Elevated levels of lipids in the blood can be caused in part by a diet high in fat and cholesterol, by lifestyle and environmental factors, and other conditions.

Medical conditions that contribute to hyperlipidemia include:

  • Diabetes mellitus
  • Hypothyroidism
  • Hypopituitarism
  • Nephrotic syndrome
  • Certain medications (anabolic steroids, beta blockers, diuretics, or oral contraceptives)
  • Chronic liver disease
  • Pregnancy
  • Chronic renal failure

Controllable, lifestyle-related risk factors associated with hyperlipidemia include:

  • High blood cholesterol
  • Low HDL cholesterol
  • Smoking
  • High blood pressure
  • Diabetes
  • Obesity
  • Excessive alcohol consumption
  • Physical inactivity

Risk factors that cannot be controlled by the individual, include:

  • Age (45 years or older for men; 55 years or older for women)
  • Family history of early heart disease

Some people suffer from lipid disorders that are a combination of genetic problems and lifestyle factors.

Diagnosis

There are no symptoms associated with hyperlipidemia. Therefore, the National Cholesterol Education Program recommends that people have blood tests to measure their lipid levels every 5 years beginning at age 20.

Treatment Options

Hyperlipidemia is treated with lifestyle modification, medications, or a combination of the two approaches.

Lifestyle Modification

When LDL levels are high enough to add to the risk for CHD, physicians usually recommend people first change their diet and exercise habits. Lifestyle changes might include:

  • Diet changes
    • Limiting saturated fats
    • Increasing intake of soluble fiber (found in oats, peas, beans, and certain fruits)
    • Increasing intake of plant stanols or sterols (found in nuts, vegetable oils, corn, and rice
    • Switch out fattier meats with cold-water fish (such as mackerel, sardines, and salmon)
    • Incorporate tofu as a meat substitute
    • Add or increase psyllium in the diet (psyllium is a source of soluble fiber)
  • Smokers should quit immediately after finding out they have hyperlipidemia.
  • Increased physical activity is appropriate when individuals are able to complete it safely. (As a general guideline, physicians recommend exercising aerobically for 20 to 30 minutes, 5 times each week.)
  • Weight management can positively affect blood LDL levels (The amount of weight a person should lose varies according to each person’s current target, and ideal weight.)
Medication

If lipid levels do not improve after 3 months of lifestyle changes (or in cases where a person has CHD or blood lipid levels that are thought to be genetically determined) physicians may consider adding medication on top of lifestyle changes. Medications used to treat hyperlipidema include:

  • Statins
  • Bile acid sequestrants
  • Fibrates
  • Niacin

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Medical Review Date: May 26, 2009 / Copyright © 2012 NorthPoint Domain, Inc. All rights reserved. This material cannot be reproduced in digital or printed form without the express consent of NorthPoint Domain, Inc. Unauthorized copying or distribution of NorthPoint Domain’s Content is an infringement of the copyright holder’s rights.

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