Lipoprotein disorders (patient information)

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Hyperlipidemia
Overview
What are the symptoms?
What are the causes?
Diagnosis
When to seek urgent medical care?
Treatment options
Where to find medical care for Hyperlipidemia?
Prevention
What to expect (Outlook/Prognosis)?
Possible complications
Hyperlipidemia On the Web
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Images of Hyperlipidemia
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FDA on Hyperlipidemia
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Hyperlipidemia in the news
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Directions to Hospitals Treating Hyperlipidemia
Risk calculators and risk factors for Hyperlipidemia

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate-Editor(s)-In-Chief: Varun Kumar, M.B.B.S., Hardik Patel, M.D.

Overview

The medical term for high blood cholesterol and triglycerides is hyperlipidemia or lipid disorder. Such a disorder occurs when you have too many fatty substances in your blood. These substances include cholesterol and triglycerides.

What are the symptoms of Hyperlipidemia?

Hyperlipidemia itself usually does not produce any symptoms and discovered during routine screening. Family history of premature coronary heart disease and severe hyperlipidemia may be present. Patient may have symptoms consistent with its complications.

What causes Hyperlipidemia?

A lipid disorder increases your risk for atherosclerosis, and thus for heart disease, stroke, high blood pressure (hypertension), and other problems.

There are many types of cholesterol. The ones talked about most are:

Total cholesterol - all the cholesterols combined High density lipoprotein (HDL) cholesterol - often called "good" cholesterol Low density lipoprotein (LDL) cholesterol - often called "bad" cholesterol There are several genetic disorders (passed down through families) that lead to abnormal levels of cholesterol and triglycerides. They include:

• Familial combined hyperlipidemia
• Familial dysbetalipoproteinemia
• Familial hypercholesterolemia
• Familial hypertriglyceridemia

Abnormal cholesterol and triglyceride levels may also be caused by:

• Being overweight or obese. See: Metabolic syndrome
• Certain medications, including birth control pills, estrogen, corticosteroids, certain diuretics, beta blockers, and certain antidepressants
• Diseases such as diabetes, hypothyroidism, Cushing syndrome, polycystic ovary syndrome, and kidney disease
• Excessive alcohol use
• Fatty diets that are high in saturated fats (found mainly in red meat, egg yolks, and high-fat dairy products) and trans fatty acids (found in commercial processed food products)
• Lack of exercise and sedentary lifestyle
• Smoking (which reduces HDL "good" cholesterol)

Diagnosis

Complete lipid profile, a blood test to check lipid levels, should be obtained for making the diagnosis of hyperlipidemia, ideally after 9 to 12-hour fast. It includes:

• Total cholesterol
• LDL cholesterol
• HDL cholesterol
• Triglycerides

Consider following reference values to see if your lipids fall in ideal levels.

Levels of total cholesterol (mg/dL)
< 200	Desirable
200 - 239	Borderline high
≥ 240	High
Levels of LDL cholesterol (mg/dL)
< 100	Optimal
100 - 129	Near optimal
130 - 159	Borderline high
160 - 189	High
≥ 190	Very high
Levels of HDL Cholesterol (mg/dL)
< 40	Low
≥ 60	High
Levels of serum triglycerides (mg/dL)
< 150	Normal
150 - 199	Borderline high
200 - 499	High
≥ 500	Very high

If your lipid profile results are abnormal, your doctor may also do:

• Blood sugar (glucose) test to look for diabetes
• Kidney function tests
• Thyroid function tests to look for an underactive thyroid gland

When to seek urgent medical care?

If you have high lipid levels or other risk factors for heart diseases, like smoking, diabetes or high blood pressure make appointments as recommended by your doctor.

Treatment options

Treatment depends on your age, health history, if you smoke, and other risk factors for heart disease, such as:

• Diabetes
• Poorly controlled high blood pressure
• Family history of heart disease

The recommended values for adults are different depending on the above risk factors, but in general:

• LDL: 70-130 mg/dL (lower numbers are better)
• HDL: more than 40-60 mg/dL (high numbers are better)
• Total cholesterol: less than 200 mg/dL (lower numbers are better)
• Triglycerides: 10-150 mg/dL (lower numbers are better)

There are steps that everyone can take to improve their cholesterol levels, and help prevent heart disease and heart attack. Here are the most important ones:

• Eat a heart-healthy diet with plenty of fiber-rich fruits and vegetables. Avoid saturated fats (found mostly in animal products) and trans-fatty acids (found in fast foods and commercially baked products). Instead, choose unsaturated fats
• Exercise regularly to help raise your HDL ("good" cholesterol)
• Get periodic health checkups and cholesterol screenings
• Lose weight if you are overweight
• Quit smoking

If lifestyle changes do not change your cholesterol levels enough, your doctor may recommend medication. There are several types of drugs available to help lower blood cholesterol levels, and they work in different ways. Some are better at lowering LDL cholesterol, some are good at lowering triglycerides, while others help raise HDL cholesterol.

The most commonly used and most effective drugs for treating high LDL cholesterol are called statins. You doctor will choose one of these: lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), fluvastatin (Lescol), torvastatin (Lipitor), rosuvastatin (Crestor).

Other drugs that may be used include bile acid sequestering resins, cholesterol absorption inhibitors, fibrates, and nicotinic acid (niacin).

Where to find medical care for Hyperlipidemia?

Directions to Hospitals Treating Hyperlipidemia

Prevention of Hyperlipidemia

The same heart-healthy lifestyle modifications that can lower your cholesterol can help prevent you from having the high cholesterol. To help prevent high cholesterol:

• Eat a heart-healthy diet with plenty of fiber-rich fruits, vegetables and whole grains. Avoid saturated fats (found mostly in animal products) and trans-fatty acids (found in fast foods and commercially baked products). Instead, choose unsaturated fats.
• Lose extra pounds and maintain a healthy weight.
• Exercise on most days of the week for at least 30 minutes to help raise your HDL ("good" cholesterol).
• Quit smoking.
• Drink alcohol in moderation, if at all.
• Get periodic health checkups and cholesterol screenings.

What to expect (Outlook/Prognosis)?

Hyperlipidemia can lead to hardening of the arteries, also called atherosclerosis. This occurs when fat, cholesterol, and other substances build up in the walls of arteries and form hard structures called plaques. Over time, these plaques can block the arteries and cause heart disease, stroke, and other symptoms or problems throughout the body. If you are diagnosed with high cholesterol, you will probably need to continue lifestyle changes and drug treatment throughout your life. Periodic monitoring of your lipid profile may be necessary. Reducing high cholesterol levels will slow the progression of atherosclerosis and prevent complications.

Possible complications

Possible complications of high cholesterol include:

• Atherosclerosis
• Coronary artery disease
• Peripheral arterial disease
• Abdominal aortic aneurysm
• Stroke
• Heart attack or death

Possible complications of high triglycerides include:

• Pancreatitis

Sources

http://www.nlm.nih.gov/medlineplus/ency/article/000403.htm