Hyperlipidaemia

Hyperlipidemia is an “umbrella” term indicating the elevation of one or more blood lipids, including but not limited to triglycerides, cholesterol, and the like.

Hyperlipidemia is the term for increased lipids within the blood and falls under dyslipidemia, a broader term that indicates high or low abnormalities within the lipid levels in the blood.

Lipids are essential molecules that include fats, oils, and others, such as certain hormones or waxes. For instance, lipids create the structure of the cell by being an essential part of the cell membrane; they also act as the basic building block of steroid hormones across the body. 

Cholesterol is another example of a lipid. This waxy fat molecule is mainly secreted by the liver and balanced with oral intake and is essential for digestion, hormone production, and Vitamin D production.

What causes hyperlipidemia?

Although lipids such as cholesterol are required for life, their levels can also become imbalanced and cause issues within the body. For cholesterol, a compensatory mechanism in the body regulates production within the liver with cholesterol intake from the person’s diet to prevent imbalances. 

Cholesterol is hydrophobic, meaning that it repels water and does not mix with it. Unfortunately, the main solvent of blood is water. Thus cholesterol has to be carried in the blood by binding to special transport proteins known as lipoproteins. 

These lipoproteins can be either high-density lipoprotein with cholesterol (HDL-C) or low-density lipoprotein with cholesterol (LDL-C). 

HDL-C and LDL-C have different functions within the body. HDL-C functions to move unutilized cholesterol back to the liver to be broken down and excreted from the body. 

LDL-C, on the other hand, transports cholesterol from the site of synthesis (i.e., liver to tissues and cells). LDL-C is also responsible for the buildup of atherosclerotic deposits in the arteries, which can create plaque and blockages known as atherosclerosis. HDL can help slow/reduce this buildup.

Symptoms

Hyperlipidemia itself typically presents no symptoms. However, in cases of extreme lipid values, tendon xanthomas can be a symptom. Furthermore, there can be xanthelasmas, which are yellow plaques that can occur near the inner part of the eyelid. 

There can also be tuberous xanthomas that are firm, painless nodules usually on pressure areas such as the buttocks. However, hyperlipidemia is typically suspected in patients with a family history of early onset atherosclerotic disease (men younger than 55, women younger than 60). 

Diagnosis

Most people who routinely have check-ups at their doctor’s office may undergo routine testing for early diagnosis and possible prevention of hyperlipidemia. Your doctor will request a blood test to check the balance of HDL-C and LDL-C and other lipid levels.

How can I lower my lipid levels?

Diet

Lifestyle alterations such as changing your diet to be ‘heart-healthy’ are an excellent way to lower lipid levels if you have concerns. Several dietary patterns are known to improve serum lipids, such as the Mediterranean Diet, Dietary Approaches to Stop Hypertension (DASH) diet, vegetarian and similar meat-restricted diets, low-carbohydrate diets as well as those that avoid trans fats.

If you find it hard to stick to one of these dietary patterns, specific dietary components can also help. You can try substituting any meat in recipes with tofu and similar soy-based products, substitute with lean meat or fish, replace refined grains with high-fiber whole grains, drink water or unsweetened tea instead of soft drinks or juices, and use nut butter instead of dairy.

By changing your diet to be more inclusive of ‘heart-healthy’ foods, you can improve the lipids in your blood and reduce the risk of cardiovascular disease. 

Medication

For some people, a change in diet or lifestyle alone isn’t enough to reduce lipids to healthy levels. 

For these people, medication is required to reduce the level of LDL-C in the blood, get the amount of cholesterol circulating in their bloodstream to a manageable level as well as prevent cardiovascular events. 

The most common medications given can include:

• Statins: a form of medication that reduces the amount of cholesterol in the blood by inhibiting a key part of the synthesis of cholesterol in the liver

Many statins are currently approved for use in the USA and are the main part of the treatment plan for people who have had a heart attack or other coronary event. 

Unfortunately, statins aren’t perfect, as they can be associated with muscle pain, headaches, and gastrointestinal and respiratory issues. If you develop any of these symptoms while on statins, you should see a doctor. 

• Non-statins: an umbrella term for a wide range of medications often given to patients who have not been able to tolerate statins or who have other health problems

The range of potential medications is wide, and they all work differently. Therefore, you should ask your doctor if you think statin treatments are not working for you.

Prevention

Hyperlipidemia can often be prevented by changes in lifestyle. One common cause of hyperlipidemia is obesity. This can be prevented by changing to a ‘heart-healthy’ diet or losing weight. 

Additionally, a sedentary lifestyle lowers the amount of HDL-C in the body, so increasing physical activity can increase HDL-C levels. Smoking is another risk factor for hyperlipidemia.

When you should see a doctor 

You should see a doctor if you are concerned about your cholesterol levels. This may be because you have symptoms of heart disease such as chest pain, or risk factors such as obesity, low level of physical activity, or are a current or former smoker. 

Your doctor will be able to give you a blood test and advise you on a suitable plan to lower your LDL-C levels if necessary. 

The lowdown

Hyperlipidemia is a disease that can be caused by a number of different factors. The dysregulation of lipid levels within the blood can cause plaque to form and heart disease. This may result in symptoms such as chest pain, shortness of breath, or sweating.

If you have concerns about your cholesterol, see your doctor for a blood test to determine lipid levels. You can also take precautions such as increasing your exercise levels, losing weight and stopping smoking.

A doctor may prescribe medications or a change in diet if they have concerns about your lipid levels.