What is Hyperlipidemia?

Hyperlipidemia refers to several conditions in which high amounts of lipids (fats) are present in the bloodstream. Hyperlipidemia can be caused by genetics, lifestyle, or a combination of the two and is contributing factor in atherosclerosis.

Types of lipids in the blood

High density lipoproteins (HDL) – Often called “good cholesterol,” HDL picks up excess cholesterol in the blood and carries it back to the liver, where it is broken down and removed from the body.

Low density lipoproteins (LDL) – LDL carries cholesterol and deposits it in
body tissues to be used for cell repair or for energy. Often called “bad cholesterol,” high levels of LDL circulating in the blood may increase the risk of heart disease.

Very low density lipoproteins (VLDL) – High levels of VLDL in the blood may mean that there is too much triglyceride in the body, which is associated with heart disease and low levels of HDL.

Types of Hyperlipidemia Conditions

High cholesterol – levels of the harmful LDL carrier of cholesterol are more than 130 milligrams per deciliter (mg/dL).

Dyslipidemic syndrome – a group of risk factors that increases the risk of developing CHD. Dyslipidemic syndrome is identified by the presence of three or more of the following symptoms:

  • Abdominal obesity (a waist circumference more than 40 inches in men, more than 35 inches in women)
  • Triglyceride level over 150 mg/dL
  • HDL level less than 40 mg/dL in men, or less than 50 mg/dL in women
  • Blood pressure higher than 130/85 millimeters of mercury
  • Fasting glucose level between 110 and 125 mg/dL

Primary elevated triglycerides – in this condition, LDL cholesterol may be normal, the HDL cholesterol is often low, and the triglyceride level is high, often as high as 1500 mg/dL.

Primary low-HDL syndromes – a diminished level of HDL, often less than 35 mg/dL, which can lead to heart disease even in the absence of high total cholesterol.

Diagnosing Hyperlipidemia

Since there are no symptoms associated with hyperlipidemia it’s recommended that people have blood tests to measure their lipid levels every five years after the age of 20.

Treatment Options

Lowering the LDL cholesterol levels is the primary target of lipid therapy. health care providers usually first recommend that people make changes in their diet
and exercise habits. This is often referred to as making therapeutic lifestyle
changes (TLC).

  • Smokers should quit immediately
  • Maintain a healthy weight
  • Exercise regularly
  • Saturated fat should make up less than 7 percent of total daily calories for a person with hyperlipidemia
  • Total fat should make up 25 to 35 percent of daily calories
  • Cholesterol eaten should be less than 200 mg per day
  • Eat more soluble fiber (found in oats, peas, beans, and some fruits) – 20 and 30 g per day
  • Eat more plant stanols or sterols (substances found in nuts, vegetable oils, corn and rice) 

Other foods to eat more of to help control cholesterol include:

  • Fish (cold-water fish, including mackerel, sardines, tuna, cod, salmon, and halibut) contains omega-3 fatty acids that may lower triglycerides
  • Soybeans (found in tofu, miso soup, soy nuts, and most meat substitutes) contain a powerful antioxidant that can lower LDL
  • Psyllium (a source of soluble fiber found in over-the-counter laxatives made from seed grain husks) helps absorb water and cholesterol from the intestines and may improve the ratio of HDL to LDL 

If lipid levels do not improve after three months of lifestyle changes your health care provider may consider adding medication, such as:

  • Statins (lower levels of LDL and triglycerides by preventing the liver from manufacturing cholesterol)
  • Bile acid sequestrants (block reabsorption of bile, the digestive liquid that allows fats to be absorbed by the body)
  • Fibrates (lower cholesterol and triglycerides in the blood)
  • Niacin (Nicotinic acid, Vitamin B5 – appears to decrease the breakdown of triglycerides in the liver, preventing fat storage and decreasing LDL)
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