Key takeaways
- Hyperlipidemia, or high cholesterol, refers to elevated levels of fats (lipids) in the blood. This can increase the risk of heart disease.
- Hyperlipidemia does not always cause symptoms. However, familial (inherited) hyperlipidemia may cause yellow, fatty growths to develop around the eyes or joints.
- Doctors may recommend statins to help reduce cholesterol. Some lifestyle changes, such as consuming a heart-healthy diet and getting enough regular physical activity, may also help.
Hyperlipidemia, a condition involving elevated levels of lipids in the blood, affects almost
In this article, we explain the symptoms and causes of hyperlipidemia and discuss how to prevent and treat it.
When a person has hyperlipidemia, the levels of cholesterol and triglycerides in their blood are high.
Cholesterol is a waxy fat molecule that the liver produces. People also get cholesterol from the food they eat. Cholesterol is essential for healthy cell membranes, brain function, hormone production, and vitamin storage.
There are two types of proteins, called lipoproteins, that transport cholesterol to the cells: low-density lipoprotein (LDL), which is sometimes called “bad” cholesterol, and high-density lipoprotein (HDL), which is sometimes called “good” cholesterol. LDL has damaging effects on health. HDL counteracts the effects of LDL.
HDL is beneficial to health because it carries excess cholesterol back to the liver, and the liver then eliminates that cholesterol through bile. LDL that stays in the bloodstream can negatively affect health because it allows excess cholesterol to build up in the blood.
Triglycerides are another type of fat in the blood. They are not a type of cholesterol but have a strong association with heart disease. For this reason, doctors also measure triglyceride levels in people who have hyperlipidemia.
A person can develop hyperlipidemia if they have one or more of the following:
- high LDL levels
- high total cholesterol
- high triglyceride levels
The following table highlights the
| Total cholesterol | about 150 mg/dL |
|---|---|
| HDL cholesterol | Men: at least 40 mg/dL Women: at least 50 mg/dL |
| LDL cholesterol | Otherwise healthy people: about 100 mg/dL People with heart disease, diabetes, or unmanaged risk factors: less than 70 mg/dL |
| Triglycerides | less than 150 mg/dL |
People with hyperlipidemia typically do not experience any symptoms. However, those with familial (inherited) hyperlipidemia may develop yellow, fatty growths around their eyes or joints.
A doctor usually detects hyperlipidemia during a routine blood test or after a cardiovascular event, such as a heart attack or stroke.
An excessive buildup of fat in the blood over time can cause atherosclerosis, a condition in which plaques develop on the walls of the arteries and blood vessels, making the openings more narrow. This can lead to unstable blood flow through the vessels and can greatly increase the risk of heart attack and stroke.
Lifestyle and dietary strategies are important for preventing and treating hyperlipidemia.
Beneficial habits include eating a heart-healthy diet, exercising regularly, not smoking, and maintaining a body weight within the recommended range.
Dietary habits
Eating a heart-healthy diet involves minimizing the intake of saturated fat, trans fats, and dietary cholesterol and consuming a variety of whole fruits and vegetables, plenty of fiber, lots of water, fish and seafood, and whole grain foods.
People should try to limit or eliminate fast foods, high carbohydrate foods, highly processed foods, and any foods that do not offer good nutritional value.
Fish, nuts, and legumes contain healthy fats that can benefit people who need to reduce their LDL cholesterol levels. When using oil, choose olive oil or another oil rich in monounsaturated fats.
Consuming sources of omega-3 fatty acids, such as flaxseed and fatty fish like salmon, can further
Weight management
People with overweight or obesity are at greater risk of developing hyperlipidemia and heart disease.
In many cases, losing weight can help lower a person’s LDL, total cholesterol, and triglyceride levels. It can also boost levels of HDL, which helps remove LDL from the blood.
Physical activity
A lack of physical activity is another risk factor for heart disease.
Regular exercise and physical activity can help a person lower their LDL levels, increase their HDL levels, and manage their weight.
The American Heart Association recommends that people aim for at least
Not smoking
Smoking triggers many problems that contribute to heart disease.
It promotes atherosclerosis, increases LDL levels, and encourages inflammation and the formation of blood clots.
Quitting smoking will result in higher HDL levels. This may be one reason why the risk of cardiovascular disease decreases after a person stops smoking.
People with hyperlipidemia can reduce their risk of experiencing cardiovascular problems later in life by strictly following the diet and treatment plan their doctors recommend.
Self-management of hyperlipidemia through a balanced diet and regular physical activity may help a person lower the levels of bad cholesterol and increase the levels of good cholesterol in their blood.
However, because genetic factors also contribute to cholesterol levels, healthy lifestyle habits might not always be enough to lower cholesterol levels. Some people might need to take medications.
Doctors typically prescribe statins, such as simvastatin, lovastatin, atorvastatin, and rosuvastatin, for reducing cholesterol. These medications decrease the amount of cholesterol the liver produces.
Statins can cause side effects, including muscle pain. The pain is usually harmless, but in rare cases, statins can cause muscle damage or breakdown.
Anyone who finds the muscle pain hard to tolerate should talk with their doctor before stopping the medication. It is essential to weigh the risk of a cardiovascular event against the risk of side effects before stopping treatment with statins.
If a person’s cholesterol levels do not reach their desired target after they have taken statins, they may need higher doses of statins or additional medications. Doctors may recommend non-statin medications such as ezetimibe or, less commonly, fibrates or bempedoic acid.
New guidelines suggest that
PCSK9 inhibitors can be expensive, so a doctor should consider this before prescribing them. However, treatment guidelines advocate for lowering the cost of these medications to allow specific populations to access them.
These populations include people with inherited hyperlipidemia who may not otherwise be able to take the medication they need and people who have had a heart attack and cannot reach their LDL goal with other drugs.
Doctors screen for hyperlipidemia using a lipid profile blood test.
It is usually a fasting test, which means that a person should not eat or drink anything for 9 to 12 hours beforehand. However, new guidelines are less strict about fasting. A person can check with their doctor about whether they need to fast before the test.
A recent guideline update advises that parents can choose for their children to have cholesterol screenings beginning as early as
Most children should undergo a
When a person inherits hyperlipidemia from their parents, doctors refer to it as primary hyperlipidemia. When the condition results from diet and other factors, doctors refer to it as secondary hyperlipidemia.
Other risk factors include:
- excessive alcohol consumption
- obesity
- some medications, such as hormones and steroids
- diabetes
- metabolic syndrome
- long-term kidney disease
- premature menopause
- hypothyroidism (an underactive thyroid gland)
- pregnancy
- a lack of physical activity
Familial hyperlipidemia stems from a genetic disorder. A parent passes down a mutated gene that leads to a missing or malfunctioning LDL receptor. This means the body cannot clear LDL from the bloodstream, and dangerous levels of LDL can build up in the blood.
The risk of familial hyperlipidemia is
Doctors categorize hyperlipidemia into four types, according to the fats it involves and its effects on the body.
Type 1
Type 1, or familial lipoprotein lipase deficiency,
Type 2 (a and b)
Type 2a, or familial hypercholesterolemia, and type 2b, or familial combined hyperlipidemia, both result in
Type 3
Type 3, or familial dysbetalipoproteinemia, affects lipoproteins. It occurs when levels of very low-density lipoprotein (VLDL) in the blood are elevated. A typical feature of type 3 is the occurrence of xanthomas, which are flat, yellow-gray plaques on the eyelids and around the eyes.
Type 3 increases the risk of early onset cardiovascular disease and peripheral artery disease.
Type 4
Type 4, or hypertriglyceridemia,
A person may not notice type 4 hyperlipidemia until early adulthood.
Hyperlipidemia is a condition involving high levels of LDL cholesterol and triglycerides in the blood. It is a major risk factor for heart disease.
People may refer to low-density lipoprotein (LDL) as bad cholesterol and high-density lipoprotein (HDL) as good cholesterol.
Factors that can contribute to high cholesterol include a high fat diet, excessive alcohol consumption, and an underactive thyroid. However, some types of hyperlipidemia have genetic causes.
Regular physical activity and a diet rich in healthy fats can improve the balance of cholesterol in the blood and help prevent related health issues.
