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Hyperlipidemia (High Cholesterol)

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What is hyperlipidemia (high cholesterol)?

Hyperlipidemia is the term used to describe high lipid (fat) levels in your blood. Levels of low-density lipoprotein (LDL) cholesterol and/or triglycerides may be increased in people with hyperlipidemia. Both LDL cholesterol and triglycerides are lipids.

Hyperlipidemia may also be called high cholesterol.

What causes hyperlipidemia (high cholesterol)?

Cholesterol is vital for the normal functioning of our cells and our body uses cholesterol to manufacture cell membranes, hormones and vitamin D. We get cholesterol from our diet and our liver also makes cholesterol.

Triglyceride molecules are the most common way our body stores and transport fatty acids. Excess calories are converted into triglycerides and make up most of our body fat. Typically, our liver only stores small amounts of fatty acids; however, in people who are obese or eat excessively, triglycerides accumulate in the liver, leading to a clinical condition known as non-alcoholic fatty liver disease.

There are many different causes of hyperlipidemia, such as:

  • Obesity or increased body fat
  • Cushing syndrome
  • Diabetes
  • Genetic (eg, Familial hypercholesterolemia)
  • High blood pressure
  • Hypothyroidism
  • Lack of exercise
  • Medications (eg, anticonvulsants, antipsychotics, hormones, thiazide and loop diuretics)
  • Metabolic syndrome
  • Polycystic ovary syndrome
  • Smoking

What are the symptoms of hyperlipidemia (high cholesterol)?

Hyperlipidemia does not cause any symptoms, and for some people, the first time they are diagnosed with hyperlipidemia is after they develop other conditions, such as heart disease or circulation problems, or following a heart attack or stroke.

Hyperlipidemia is a factor in coronary heart disease (also called atherosclerosis). If damage occurs to the inner layers of the arteries, platelets stick to the site of the injury and may clump together to form blood clots. Cholesterol, calcium and other substances in the blood also build up at this site of injury and harden into plaques, narrowing the arteries and limiting blood flow to the heart muscle and other parts of the body. Narrowing of the arteries increases a person’s risk of having a heart attack or stroke and reducing blood flow to the limbs, particularly the legs.

How is hyperlipidemia (high cholesterol) diagnosed?

Because hyperlipidemia has no symptoms, the Centers for Disease Control (CDC) and prevention recommend high cholesterol should be screened for, starting from a young age.

The CDC recommends cholesterol screening tests should be done:

  • Before puberty (once between the ages of 9 and 11)
  • After puberty (once between the ages of 17 and 21)
  • Every 4 to 6 years after the age of 21

People with obesity, diabetes, or a family history of heart attacks or heart disease at a young age, should be screened for high cholesterol more often.

The most common types of hyperlipidemia diagnosed include:

  • High levels of LDL cholesterol (increases fat build-up in the arteries)
  • High levels of triglycerides (increases fat build-up in the arteries)

Low levels of HDL cholesterol may also be diagnosed but this condition is called dyslipidemia

How is hyperlipidemia (high cholesterol) treated?

Treatment depends on a person’s level of risk for heart disease or stroke.

Treatment aims to lower LDL, total cholesterol, and triglyceride levels. Current goals include:

  • Total cholesterol: Less than 200 mg/dL
  • LDL cholesterol: Less than 100 mg/dL or less than 70 mg/dL for people with diabetes or heart disease
  • Triglycerides: Less than 150 mg/dL

Treatment includes:

  • Lifestyle changes, such as eating a healthy diet, avoiding saturated fat, eating more vegetables
  • Increasing physical activity and exercise
  • Losing weight if you are overweight
  • Stopping smoking
  • Medications, such as statins (eg, atorvastatin, fluvastatin, lovastatin), niacin, bile acid resins, ezetimibe, fibrates, or PCSK9 Inhibitors (eg, alirocumab, evolocumab)