Dyslipidemia

Dyslipidemia is a condition that refers unhealthy levels of fat (lipid) in your blood. Blood contains 3 main types of lipid: HDL, LDL, and triglycerides.

Dyslipidemia can be the elevation of a person’s plasma cholesterol, triglycerides, or both, or a low HDL cholesterol level that contributes to the development of atherosclerosis – a hardening of the arteries. Dyslipidemia can be caused by genetics or lifestyle habits.

CausesBoth primary (genetic) and secondary (lifestyle) causes contribute to dyslipidemias in varying degrees.

Primary causes are gene mutations that result in either the overproduction or ineffective clearance of triglycerides and LDL, or in the underproduction or excessive clearance of HDL.

Secondary causes of dyslipidemia include:

  • A sedentary lifestyle
  • Excessive intake of saturated fat, cholesterol, and trans fats
  • Diabetes
  • Excessive alcohol consumption
  • Chronic kidney disease
  • Hypothyroidism
  • Primary bilary cirrhosis and other cholestatic liver diseases
  • Drugs such as thiazides, beta-blockers, retinoids, highly active antiretroviral agents, cyclosporine, tacrolimus, estrogen and progestins, and glucocorticoids

SymptomsYou could have dyslipidemia and never know it. Like high blood pressure, high cholesterol doesn’t have obvious symptoms. It’s often discovered during a routine blood test.

While dyslipidemia itself usually causes no symptoms, it can lead to cardiovascular disease, including coronary artery disease, stroke, and peripheral arterial disease – which can be symptomatic.

High LDL cholesterol levels are associated with coronary artery disease (blockage in the arteries of your heart), and peripheral artery disease, (blockage in the arteries of your legs). Coronary heart disease can lead to chest pain and eventually a heart attack, and the main symptom of peripheral artery disease is leg pain when walking.

Diagnosis Your doctor will perform a simple blood test that checks for LDL, HDL, and triglycerides, to reveal whether your levels are high, low, or in a healthy range. These numbers can change from year to year, so it’s important to get annual blood work. If you take medications for dyslipidemia, your doctor may want you to have more frequent blood tests.

Primary lipid disorders are suspected when patients exhibit:

  • Physical signs of dyslipidemia
  • Premature atherosclerotic disease (before age 60)
  • A family history of atherosclerotic disease
  • Serum cholesterol > 240 mg/dL (> 6.2 mmol/L)

TreatmentThe most commonly used medication to treat dyslipidemia is a statin. Statins help reduce LDL levels by interfering with cholesterol production in the liver.

Your doctor may also prescribe other cholesterol medications. They may be taken in addition to a statin or in place of a statin, and include:

  • ezetimibe (Zetia)
  • fibrates, like fenofibrate (Fenoglide)
  • PCSK9 inhibitors

Lifestyle changes may be able to help you get your cholesterol and triglyceride levels under control, including:

  • Dietary changes – consuming less saturated fat and refined sugar, adding more fruits, vegetables, lean proteins, and whole grains
  • Reducing your alcohol consumption
  • Daily exercise
  • Weight loss