Everything you need to know about hyperlipidemia

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?

Hyperlipiedmia cholesterol

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 vitamin storage.

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.


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.


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.


To determine if and when medications are needed, a physician will look at:

  • the patient’s lipid profile
  • their risk factors
Statins hyperlipidemia
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.


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.


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.


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 III increases the risk of early-onset cardiovascular and peripheral artery disease.

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.

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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.

An unhealthful 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.


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.