Hyperlipidemia is a common condition that occurs when there is too much fat in the blood (called lipids). Cholesterol and triglycerides are two types of fats that can build up in the arteries, restricting blood flow and increasing the likelihood of heart disease , stroke, or other health problems.
Many factors can increase your chances of developing hyperlipidemia. While some cannot be avoided (such as a family history), others can be controlled, such as diet and exercise. Many people diagnosed with hyperlipidemia can lower cholesterol and triglyceride levels through healthier diets, more physical activity, and maintaining a healthy weight. Others may need medication to maintain normal lipid levels.
Hyperlipidemia alone won't make you feel bad, so many people don't realize that their cholesterol and triglyceride levels are too high until their doctor diagnoses them through routine lab tests. In rare cases, hyperlipidemia can lead to xanthomas, which are yellowish fatty nodules that form under the skin near the eyes, elbows, arms, buttocks, or knees. Other unusual manifestations include an enlarged liver or spleen, or pale rings around the iris.
High triglyceride levels and high LDL cholesterol levels can increase the risk of stroke and heart attack .
While excess lipids can put you at risk for heart disease, they also play an important role in how your body works. Cholesterol is a type of waxy fat that is made in the body in the liver or absorbed from food. It is a fundamental component for the cells of the body and is vital for the production of hormones and digestive fluids.
Triglycides are a type of fat that provides energy for cell function and alcohol metabolism. They enter the bloodstream from foods that contain fat and from body fat. Triglycerides also come from excess calories, especially carbohydrate calories; calories that the body does not use immediately are converted to triglycerides and stored.
The risk of cardiovascular disease increases when high levels of circulating lipids are combined with low-density lipoproteins (LDL cholesterol, known as 'bad cholesterol') or very low-density lipoproteins (VLDL). LDLs transport cholesterol to tissues, whereas VLDLs primarily transport triglycerides to tissues. Both LDL and VLDL cholesterol contribute to plaque build-up in the arteries. This plaque, made up of fat, cholesterol, calcium, and other substances, strengthens and narrows the arteries .
On the other hand, the cholesterol associated with high-density lipoproteins (HDL cholesterol) is the excess cholesterol that is eliminated from the tissues. For this reason, HDL cholesterol is known as "good cholesterol."
Over time, the buildup of cholesterol-containing plaque can lead to heart attacks, strokes, or blood clots.
Cholesterol and triglyceride levels can be influenced by a wide range of factors, including family history, age, medical conditions, medications, and health-related behavior.
You share a lot with your family members. Your genetic makeup can affect your risks for certain health conditions known to contribute to hyperlipidemia, such as obesity or diabetes. Family can also influence your behavior and choices, especially when it comes to diet and exercise. As a result, if you have a family history of hyperlipidemia, you are also more likely to develop it .
Certain genetic conditions can predispose you to hyperlipidemia, including :
- Combined familial hyperlipidemia . Combined familial hyperlipidemia is the most common genetic disorder that can lead to increased body fat. It causes high levels of cholesterol and triglycerides and is exacerbated by other chronic conditions such as alcoholism, diabetes , and hypothyroidism .
- Familial hypercholesterolemia . This inherited disorder prevents the body from removing LDL cholesterol from the blood, resulting in abnormally high levels of "bad" cholesterol in the body.
- Familial dysbetalipoproteinemia. People with familial dysbetalipoproteinemia have a genetic defect that leads to the accumulation of cholesterol and triglycerides in the blood. Like combined familial hyperlipidemia, certain health problems can make familial dysbetalipoproteinemia worse.
Age and gender
With age, it becomes more difficult for the body to remove excess cholesterol from the blood and it becomes easier for the body to raise its dangerous levels. Someone's gender can also play a role. Men have, on average, less "good" cholesterol than women, and women (especially those under the age of 55) often have less "bad" cholesterol .
The older you get, the more likely you are to be diagnosed with hyperlipidemia, but the younger generation is not immune to this.
In some cases, children with a sedentary lifestyle and poor diet can develop hyperlipidemia. Diabetes, obesity, kidney disease, and certain thyroid conditions can also cause high cholesterol and triglycerides in children and teens .
The presence of certain medical conditions has been shown to increase the risk of abnormal cholesterol and triglyceride levels :
In particular, diabetes can affect your risk of developing high cholesterol levels. While it is not entirely clear why this is the case, some research suggests that high insulin levels can negatively affect cholesterol levels by increasing the amount of "bad" cholesterol and decreasing the amount of "good" cholesterol. This is especially true for people with type 2 diabetes .
Medication can also increase the chance of developing hyperlipidemia. Taking medications such as beta-blockers, diuretics (water pills), certain birth control pills, or certain antidepressants can raise blood cholesterol and triglyceride levels .
Certain lifestyle decisions can affect your cholesterol and triglyceride levels, including what you eat, how often you exercise, and whether you smoke.
- Diet choice: You absorb some cholesterol from certain foods, including foods high in saturated and trans fats. Also, when you consume more calories than you can burn, those extra calories are replaced by triglycerides, which can lead to high blood levels .
- Physical Activity: Low physical activity can lead to weight gain and elevated levels of LDL cholesterol and triglycerides.
- The weight. Being overweight or obese can change the way the body uses cholesterol, resulting in higher blood levels. Being overweight can also lead to high levels of triglycerides that build up in fat cells .
- Smoking: Smoking will not cause an increase in LDL cholesterol, but it can lower HDL cholesterol (the good kind) and damage your arteries and make them harden faster .
- Alcohol consumption: Excessive alcohol consumption increases cholesterol and triglyceride levels .
Hyperlipidemia does not cause any physical signs or symptoms of the disease, so your healthcare provider should rely on blood tests to determine this. The most common way to diagnose high cholesterol is with a lipid panel.
A simple blood test called a lipid panel can be used to monitor your blood cholesterol and triglyceride levels. The test uses a blood test taken after fasting for about 12 hours.
Blood levels that can lead to a diagnosis.
- Total cholesterol is greater than 200 mg / dL (milligrams per deciliter)
- LDL cholesterol above 100 mg / dL
- HDL cholesterol below 60 mg / dL
- Triglycerides greater than 150 mg / dL
If your blood is returning to normal, your healthcare provider may want to test periodically, about every four to six years, to watch for any trends that indicate an increase in cholesterol and triglyceride levels.
Although a total cholesterol level of more than 200 mg / dL generally indicates high cholesterol, your healthcare provider may consider other factors (such as age and medical history) before making a diagnosis based on their findings. Your healthcare provider will then use your results to work with you to set your cholesterol goals and plan your treatment.
Some people can lower cholesterol and triglyceride levels by making some healthy lifestyle changes, such as a better diet and more exercise. Others may also need help with medications. What your healthcare provider recommends will largely depend on your lab results, medical history, and any other risk factors that may affect your cardiovascular health.
Changes in lifestyle
You can lower your cholesterol and triglyceride levels by making lifestyle changes to eat better, exercise more, and maintain a healthy weight. This includes:
- Diet: Limit foods high in saturated or trans fat, such as certain meats, tropical vegetable oils (such as palm oil), and cheese. Choose foods low in fat and unsaturated, such as fruits, vegetables, lean proteins (such as fish), and nuts. If you have high triglycerides, try to eat fewer calories, as the excess calories are converted to triglycerides and stored as fat .
- Training. Staying physically active can help lower blood cholesterol and triglyceride levels. The American Heart Association recommends that you engage in at least 150 minutes of moderate-intensity aerobic exercise each week, or 75 minutes of high-intensity aerobic exercise, preferably spread throughout the week. One study found that 12 weeks or more of aerobic exercise resulted in a drop in triglycerides by more than 3% and in LDL cholesterol by 5% .
- Weightloss. Being overweight or obese can raise blood cholesterol and triglyceride levels. Lowering your body mass index can improve your posture to excrete and recycle lipoproteins more efficiently and prevent lipoprotein build-up. in the bloodstream. Fortunately, the best way to lose weight is through a healthy diet and frequent exercise, which will also help lower cholesterol and triglyceride levels.
- Stop smoking: smoking damages blood vessels and increases the likelihood of fat accumulation. Quitting smoking can significantly reduce your risk of heart attack and stroke.
If you are unable to lower cholesterol and triglycerides through lifestyle changes, your healthcare provider may prescribe cholesterol-lowering medications. These medications often need to be taken over a long period of time and should only be used as directed by a doctor. These are the most common medications used to treat high cholesterol and triglycerides:
- Statins Statins lower LDL cholesterol by lowering the amount of cholesterol made by the liver. In addition, they have other important effects that reduce the risk of cardiovascular disease regardless of their ability to lower cholesterol levels. In fact, statins are the only class of cholesterol-lowering drugs that have been clearly shown in clinical studies to reduce the risk of cardiovascular disease.
- Bile acid sequestrants : These drugs remove bile acids from the body. When the liver tries to compensate by producing more bile, it consumes some of the cholesterol from the bloodstream.
- Niacin (nicotinic acid) . Certain prescription forms of this B vitamin increase HDL cholesterol and also lower LDL cholesterol and triglycerides. However, recent research suggests that niacin cannot significantly reduce heart risk when combined with statins, and in addition, pharmaceutical niacin can pose serious risks. Most healthcare providers no longer prescribe it for cholesterol in people who may be taking statins.
- Fibrates . These drugs mainly reduce the amount of triglycerides in the blood.
- PCSK9 Inhibitors – An injectable drug, this type of drug is a relatively new option available to treat people with familial hypercholesterolemia, which causes high levels of LDL cholesterol. PCSK9 inhibitors are also used for those who cannot reach their target cholesterol levels on statins alone, as well as for people with high cholesterol who cannot tolerate statins.
These medications are typically only prescribed if you have had or are at increased risk of heart attack or stroke, have very high LDL cholesterol (more than 190 mg / dL), or have certain risk factors such as diabetes in combination with levels of LDL cholesterol above 70 mg / dL. However, just over half of the people who need these drugs get them.
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Hyperlipidemia can greatly increase your chances of serious heart problems, including a heart attack and stroke. While some risk factors (like your genes or family history) are out of your control, there are many things you can do to lower your cholesterol and triglyceride levels if they are already high.
Because people with hyperlipidemia often do not have any symptoms, it is important to ask your healthcare provider about routine screening tests and how often to get tested based on your current or past health condition.