Hyperlipidemia

Overview

What is hyperlipidemia?

Hyperlipidemia is a medical term referring to an elevated level of fats (or lipids) in the blood. The most commonly treated type of hyperlipidemia is high cholesterol. Having high levels of lipids in the blood can increase the risk of heart attack and stroke. This is because excess amounts of lipids can build up on the walls of the arteries, forming plaques, which obstruct the flow of blood. Hyperlipidemia can be managed with lifestyle changes but often requires medication as well. 

What type of foods contribute to hyperlipidemia?

A diet high in saturated fats, sugar and refined carbohydrates can lead to high cholesterol over time. However, not all foods with high cholesterol are bad for you. For example, eggs and fish are high fat foods that are considered highly nutritious and do not have a negative impact on your cholesterol levels or general health. On the other hand, processed foods, desserts and fast foods can raise cholesterol levels in the blood, increasing your chances of developing hyperlipidemia. 

Is cholesterol bad for you?

This is a common misconception that most people have. Contrary to this belief, cholesterol is not always bad. In fact, it is naturally made by the body and gives flexibility to cell membranes. Cholesterol is also essential in the synthesis of certain hormones and vitamin D. Low-density lipoprotein, or LDL for short, is what’s considered the “bad” cholesterol. On the other hand, high-density lipoprotein, or HDL, is the “good” cholesterol. Making unhealthy lifestyle choices, such as eating processed foods, drinking excessively and smoking, can contribute to an elevation of LDL (“bad” cholesterol).

LDL vs HDL. 

LDL, or low-density lipoprotein is “bad” because it causes fatty buildup in the arteries and contributes to heart disease. HDL, or high-density lipoprotein is “good” because it takes the cholesterol away from the arteries to the liver, where it can be broken down even further and then removed from the body. Therefore, it is ideal to have a high level of “good” cholesterol (HDL), and a low level of “bad” cholesterol (LDL).

Causes

What causes hyperlipidemia?

The cause of hyperlipidemia depends on the type of hyperlipidemia a person has. It can be divided into two big categories: primary hyperlipidemia and secondary hyperlipidemia. Primary hyperlipidemia is genetic and can be inherited at birth. Secondary hyperlipidemia is also known as acquired hyperlipidemia, which means it is a result of unhealthy lifestyle choices, such as poor diet, excessive drinking, and lack of exercise. Some medications, such as beta blockers, birth control pills and growth hormone can cause lipid levels to increase.

Symptoms

What are the symptoms of hyperlipidemia?

Hyperlipidemia in itself will rarely cause symptoms.  Unless you are tested for hyperlipidemia, you may not know you have this condition until you develop cerebrovascular disease, coronary artery disease, or symptoms of a stroke or heart attack.  Therefore, if you have risk factors for hyperlipidemia, yearly screening is essential.  Even if you do not have risk factors, most adults should be screened for hyperlipidemia every five years.

Diagnosis

How is hyperlipidemia diagnosed?

Because hyperlipidemia has no symptoms, your doctor will need to order a specific blood test called a lipid panel in order to check your cholesterol level. This test will then show your doctor your total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride levels (another type of lipid). The ratio of HDL to LDL is important in determining if you may need treatment for hyperlipidemia or high cholesterol.  Generally, if your total cholesterol level is over 200mg/dl, your doctor may advise you on ways to lower this, including lifestyle modifications and medication if necessary.

Treatment

How is hyperlipidemia treated?

Lipid-lowering medications are readily available by prescription and are in widespread use. The most well-known lipid-lowering medications are statins.  Statins may be prescribed to treat moderate or severe hyperlipidemia.  For patients with certain risk factors, such as a family history of heart attacks or strokes, statins may be prescribed if lipid levels are mildly elevated or even if levels are normal.

Mild hyperlipidemia can be treated with lifestyle changes alone, if your doctor believes this is appropriate.  Important lifestyle modifications may include:

  • Regular exercise
  • Healthy eating (e.g. increasing intake of fish and vegetables, and decreasing intake of fast foods, sugar and red meat)
  • General weight loss
  • Smoking cessation

Sources

Osborn, C. O. (2020, February 27). What You Should Know About Hyperlipidemia. Healthline.

https://www.healthline.com/health/hyperlipidemia#prevention

Hill MF, Bordoni B. Hyperlipidemia. [Updated 2021 Feb 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559182/

Information

Medically reviewed by:

Jodi B. Nagelberg, MD, MHA

Dr. Jodi Nagelberg is an endocrinologist, with board certification in Internal Medicine. She also holds a masters in Health Administration and Policy. She joins TeleMed2U as Endocrinology Director and supports our mission to increase access to healthcare for patients everywhere.

Postgraduate: University of Southern California Sol Price School of Public Policy Los Angeles, CA  Masters, Health Administration and Policy, 2011

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