Hyperlipidemia, or high
cholesterol, refers to high levels of fat proteins in the blood.
The condition can
affect one fat protein or several. Most people will have no symptoms, but
having hyperlipidemia increases the risk of developing heart disease.
It affects 1 in 3 Americans.
Genetic predisposition,
cigarette smoking, obesity,
poor diet, and an inactive lifestyle can all lead to hyperlipidemia.
There are two types of cholesterol,
low-density lipoproteins (LDL) and high-density lipoproteins (HDL). LDL is
considered unhealthy, while HDL is "good" cholesterol.
Cholesterol and lipoproteins
are not the same, although they work together. Lipoproteins carry cholesterol
to the cells.
Usually, there are no symptoms
with hyperlipidemia, but it can be detected by a simple blood test.
Fast facts on
hyperlipidemia
Here are some key
points about hyperlipidemia. More detail is in the main article.
·
Hyperlipidemia
is a major risk factor for heart disease, the leading cause of death in the
U.S.
·
Low-density
lipoprotein (LDL) is known as bad cholesterol, while high-density lipoprotein
(HDL) is considered good.
·
Hypothyroidism,
a high-fat diet, and being overweight contribute to high cholesterol.
·
Regular
physical activity can raise levels of HDL and lower LDL.
What is hyperlipidemia?
Hyperlipidemia refers to heightened levels of 'bad'
cholesterol, or LDL, in the blood.
Hyperlipidemia means there is
too much cholesterol in the blood.
Cholesterol is a waxy fat
protein made by the liver.
It is essential for healthy
cell membranes, brain functioning, hormone production, and vitaminstorage.
Cholesterol becomes a problem
when too much bad cholesterol, or low-density lipoprotein (LDL), is produced or
ingested through unhealthy foods.
Lipoproteins transport
cholesterol through the blood to the cells.
HDL is good because it
carries extra cholesterol back to the liver where it can be eliminated. LDL is
bad because it enables excess cholesterol to build up in the blood.
Triglycerides are a type of
fat in the blood. These are different from cholesterol, but because of their
strong association with heart disease, triglycerides are also measured.
A person with hyperlipidemia
may have high levels of both LDL and triglycerides.
Symptoms
A person with hyperlipidemia
usually has no signs or symptoms. In familial, or inherited, hyperlipidemia,
there may be yellowish fatty growths around the eyes or the joints.
Hyperlipidemia is usually
detected during a routine blood test, or following a cardiovascular event, such
as a heart attack or stroke.
Excessive fat in the blood
accumulates over time, forming plaques on the walls of the arteries and blood
vessels.
This narrows the openings,
producing unstable blood flow through the vessels. The heart has to work harder
to pump the blood through the constricted areas.
Treatment
Self-management is one way to
reduce levels of lipoproteins in the blood.
However, in some cases,
self-managing hyperlipidemia may not be effective. In these cases, other
treatment options may be required.
Medications
To determine if and when
medications are needed, a physician will look at:
·
the
patient's lipid profile
·
their
risk factors
Statins are prescribed to manage the symptoms of
hyperlipidemia
The most commonly prescribed
high-cholesterol medicines are statins, such as simvastatin, lovastatin, atorvastatin,
and rosuvastatin.
There are also new medications
called PCSK9 inhibitors being studied for people with cardiovascular disease
that need additional lowering of their LDL.
Occasionally, statins are not
tolerated, due to the side effects of muscle pain, and people stop taking them.
However, it is worth
balancing the risk of a cardiovascular event against the risk of side effects
before stopping the medication and talking with your doctor about the side
effects.
Hyperlipidemia is a common
health problem that can lead to serious cardiovascular or heart disease, but it
can be prevented and treated through the appropriate use of medication and
maintenance of a heart-healthy lifestyle.
Diagnosis
Hyperlipidemia is screened
using a blood test called a lipid profile.
It is important to have
nothing to eat or drink for 9 to 12 hours before the test.
Screening may start at the age
of 20 years for men at high risk, and later for lower-risk men and women. If
the result is normal, it should be repeated at least every 5 years.
A normal lipid profile
consists of the following levels:
·
Total
cholesterol: less than 200
·
LDL:
less than 100
·
HDL:
greater than 40 for men, greater than 50 for women (higher is even better)
·
Triglycerides:
less than 140
If the person has high
cholesterol levels, monitoring and treatment are likely to be necessary.
Causes
The causes of hyperlipidemia
can be due to:
·
Genetic
factors: This is known as primary hyperlipidemia.
·
Poor
diet and other factors: This is known as secondary hyperlipidemia.
When the body cannot use or
remove excess fat, it builds up in the blood. Over time, this damages the
arteries and internal organs and contributes to the development of heart
disease.
Other causes include:
·
excessive
alcohol consumption
·
obesity
·
use
of medications such as hormones or steroids
·
diabetes
·
kidney
disease
·
an
underactive thyroid gland, or hypothyroidism
·
pregnancy
Familial hyperlipidemia stems
from a genetic disorder.
A mutated gene is passed down
from a parent and causes a missing or malfunctioning LDL receptor. The LDL
builds to dangerous amounts in the blood.
Some ethnic groups, such as
French Canadians, Christian Lebanese, South African Afrikaners, and Ashkenazi
Jews have a higher risk of hereditary hyperlipidemia.
Types
There are several main types
of hyperlipidemia that have different effects on the body. They are categorized
by the different types of fat affected and how they impact the body.
Type I: This normally occurs in childhood and
is severe. It can cause abdominal pain, repeated infections of the pancreas,
and enlargement of the liver and spleen.
Sometimes, this is referred to
as familial LPL deficiency, and it is an inherited condition that disrupts the
normal breakdown of fats.
Type II(a + b): Type
IIa is also known as familial hypercholesterolemia, and type IIb is commonly
referred to as familial combined hyperlipidemia.
Both result in high levels of LDL and
can lead to deposits of fat in the skin and around the eyes. They can also increase the risk of
heart problems.
Type III: Also
known as familial dysbetalipoproteinemia, this type affects lipoproteins.
Levels of LDL in the blood are often too low, but HDL levels remain normal. A
typical feature of type III is the occurrence of xanthomas, or flat,
yellow-gray plaques on the eyelids and around the eyes.
Type IV: This increases the levels of triglycerides in
the blood rather than cholesterol and can also lead to obesity, high blood
glucose, and high insulin levels.
It is normally not noticeable
until early adulthood.
The effects of all types can
be moderated with dietary measures.
Prevention
Lifestyle options are the best
way to prevent and treat hyperlipidemia.
This involves a
"heart-healthy" diet, regular exercise, avoiding or quitting tobacco
use, and maintaining a healthy weight.
Diet
A high-fat, unbalanced diet can be a cause of
hyperlipidemia.
Rather than following a
low-fat diet, the individual should minimize their intake of saturated fat,
trans fats, and cholesterol.
The diet should include a
variety of whole fruits and vegetables, plenty of fiber, and whole grains.
Fast foods, high carbohydrate foods, and any foods that do
not offer good nutritional value should be restricted or eliminated.
Regular servings of fish,
nuts, and legumes are recommended. When oil is used, it should be olive oil, or
another oil rich in monounsaturated fats.
Weight
Being overweight is a risk
factor for hyperlipidemia and heart disease.
Losing weight can help reduce
LDL, total cholesterol, and triglyceride levels. It can also boost HDL, which
helps to remove the bad cholesterol out of the blood.
Physical activity
A lack of physical activity is
a risk factor for heart disease.
Regular exercise and activity
helps lower LDL, raise HDL, and encourage weight loss.
At least 30 minutes of
physical activity is recommended at least 5 days a week. Brisk walking is an
effective and easy option.
Not smoking
Smoking triggers many problems
that contribute to heart disease.
It promotes plaque buildup on
the walls of the arteries, increases LDL levels, and it encourages the
formation of blood clots and inflammation.
Quitting smoking will result in higher
HDL. This may be one reason why the risk of cardiovascular disease falls after
stopping.
The risk of heart and artery
problems later in life can be greatly reduced by strictly following any
recommended diet and treatment plan.
While unchecked hyperlipidemia
can greatly increase the risk of a stroke or heart attack, lipid levels can be
easily managed.
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