What You Should Know About Hyperlipidemia

What is hyperlipidemia?

Hyperlipidemia is a medical term for abnormally high levels of fats (lipids) in the blood, which include cholesterol and triglycerides.

Although hyperlipidemia can be inherited, it’s most often the result of lifestyle factors, including an unbalanced diet and too little physical activity.

The most common type of hyperlipidemia is high cholesterol. Other forms of hyperlipidemia include hypertriglyceridemia and mixed hyperlipidemia, in which both cholesterol and triglyceride levels are high.

Hyperlipidemia is very common, especially in modern developed countries. It’s also increasing around the world.

In the United States, 94 millionTrusted Source people over age 20 have elevated total cholesterol levels. This amounts to about 50 percentTrusted Source of all U.S. adults.

People with untreated hyperlipidemia are twice as likelyTrusted Source to develop coronary artery disease (CAD) as those with cholesterol levels in the normal range. This can lead to clogged arteries, which can trigger heart attack, stroke, or other serious problems.

Hyperlipidemia is usually quite manageable, though, and these emergency events can often be avoided. The key is an early diagnosis and treatment plan to prevent its progression.

Understanding cholesterol

Cholesterol is a fatty substance that travels through your bloodstream on proteins called lipoproteins.

When you have too much cholesterol in your blood, it can build up on the walls of your blood vessels and form plaque. Over time, plaque deposits grow larger and begin to clog up your arteries. This may lead to:

There are two types of cholesterol, LDL and HDL. You’ve probably heard them called “bad” and “good” cholesterol, respectively.

LDL (“bad”) cholesterol builds up in your artery walls, making them hard and narrow. HDL (“good”) cholesterol cleans up excess “bad” cholesterol and moves it away from the arteries, back to your liver.

Causes and risk factors

Hyperlipidemia is an imbalance of cholesterol in your blood caused by a combination of having too much LDL cholesterol and not enough HDL cholesterol to clear it up.

There are two main classifications of hyperlipidemia: familial and acquired. The familial type stems from genes you inherit from your parents.

The acquired type is the result of:

  • underlying health conditions
  • medications you take
  • lifestyle choices

Acquired hyperlipidemia

Acquired hyperlipidemia is most often the result of certain lifestyle factors. It may also result from medications you take or underlying health conditions.

Lifestyle causes of hyperlipidemia

Lifestyle factors can raise “bad” cholesterol levels and lower “good” cholesterol levels.

According to the American Heart AssociationTrusted Source, the main lifestyle choices that raise your chances of developing high cholesterol levels include:

  • an unbalanced diet
  • insufficient exercise
  • smoking or regular exposure to secondhand smoke
  • overweight or obesity
  • heavy alcohol use (though drinking moderate amounts of red wine may have a positive effectTrusted Source)

Health conditions that contribute to hyperlipidemia

Certain health conditions can also contribute to high cholesterol levels, including:

Other inherited conditions and pregnancy may also contribute to high cholesterol.

Medications that contribute to hyperlipidemia

Your cholesterol levels may sometimes be affected by certain medications, such as:

Beta-blockers rarely affect cholesterol levels, and often not enough to merit stopping the medications.

Familial combined hyperlipidemia

Familial combined hyperlipidemia (or mixed hyperlipidemia) is a type that you can inherit from your parents or grandparents. It causes high cholesterol and high triglyceride levels.

People with familial combined hyperlipidemia often develop high cholesterol or high triglyceride levels in their teens and receive a diagnosis in their 20s or 30s. This condition increases chances of early coronary artery disease and heart attack.

Unlike people with typical hyperlipidemia, people with familial combined hyperlipidemia may experience symptoms of cardiovascular disease early in life, such as:

  • chest pain at a young age
  • heart attack at a young age
  • cramping in the calves while walking
  • sores on the toes that don’t heal properly
  • stroke symptoms, including trouble speaking, drooping on one side of the face, or weakness in the extremities

Signs and symptoms

Hyperlipidemia usually does not show symptoms until it has advanced to the state where people have emergency complications, such as a heart attack or stroke. These can occur when high cholesterol has led to plaque buildup in your arteries that limits or blocks the flow of blood.

A simple blood test will let you and your doctor know your blood cholesterol levels.

The 2018 guidelinesTrusted Source published in the Journal of the American College of Cardiology (JACC) propose that a total blood cholesterol level above 240 milligrams per deciliter (mg/dL) is considered high, while levels above 200 mg/dl are considered elevated. This can vary based on many factors, however.

The CDCTrusted Source recommends that generally, you should get a cholesterol test starting at the age of 20, then:

  • every 5 years if you are at low risk for cardiovascular disease
  • more frequently than every 5 years if you have cardiovascular disease risk factors

Sometimes, tests are appropriate for children and adolescents. The CDC points out that 1 in 5Trusted Source adolescents have high cholesterol in the United States.

Check with your doctor about a cholesterol test for your child if:

  • your family has a history of early heart attacks or heart disease
  • your child has excess weight or obesity
  • your child has diabetes

How it’s diagnosed

Hyperlipidemia has no symptoms, so the only way to detect it is to have your doctor request a blood test called a lipid panel or a lipid profile. Your doctor will use your lipid panel to make a hyperlipidemia diagnosis.

This test determines your cholesterol levels. A healthcare professional will take a sample of your blood and send it to a lab for testing, then get back to you with a full report. Your report will show your levels of:

  • total cholesterol
  • low-density lipoprotein (LDL) cholesterol
  • high-density lipoprotein (HDL) cholesterol
  • triglycerides

Your doctor may ask you to fast for 8 to 12 hours before getting your blood drawn. That means you’ll need to avoid eating or drinking anything other than water during that time. However, recent studies suggest that fasting isn’t always necessary, so follow your doctor’s instructions.

Safe levels of cholesterol can vary from person to person depending on health history and current health concerns and are best determined with your doctor.

Hyperlipidemia treatments

Lifestyle changes are the first line of treatment for hyperlipidemia. If these are insufficient, your doctor may prescribe medications to help manage your high cholesterol.

Lifestyle changes

Lifestyle changes are often key to managing hyperlipidemia at home. Even if your hyperlipidemia is inherited (familial combined hyperlipidemia), lifestyle changes are still an essential part of treatment.

These changes alone may be enough to reduce your risk of complications like heart disease and stroke.

If you’re already taking medications to manage hyperlipidemia, lifestyle changes can improve their cholesterol-lowering effects.

Eat a heart healthy diet

Making changes to your diet can lower your LDL cholesterol levels and increase your HDL cholesterol levels. Here are a few changes you can make:

  • Choose healthier fats. Avoid saturated fats that are found primarily in red meat, bacon, sausage, and full-fat dairy products. Choose leaner proteins like chicken, turkey, and fish when possible. Use monounsaturated fats like olive, avocado, and canola oil for cooking.
  • Cut out the trans fats. Trans fats are found in fried food and processed foods, like cookies, crackers, and other snacks. Check the ingredients on product labels. Skip any product that lists “partially hydrogenated oil.”
  • Eat more omega-3s. Omega-3 fatty acids have many heart benefits. You can find them in some types of fish, including salmon, mackerel, and herring. They can also be found in some nuts and seeds, like walnuts and flaxseeds.
  • Increase your fiber intake. All fiber is heart healthy, but soluble fiber, which is found in oats, bran, fruits, beans, and vegetables, can lowerTrusted Source your LDL cholesterol levels.
  • Learn heart healthy recipes. Check out the American Heart Association’s recipe pageTrusted Source for tips on delicious meals, snacks, and desserts that won’t raise your cholesterol.
  • Eat more fruits and veggies. They’re high in fiber and vitamins and low in saturated fat.

Maintain a healthy-for-you weight

If you have high body weight or obesity, losing weight may help lower your total cholesterol levels.

Losing weight starts with figuring out how many calories you’re taking in and how many you’re burning. For a typical adult, it takes cutting 3,500 calories from your diet to lose about a pound.

You don’t have to start this process alone, though. You can work with a doctor or registered dietitian to create an eating plan that works for you, along with increasing physical activity so you’re burning more calories than you’re eating.

Get active, if you can

Physical activity is important for overall health, weight loss, and cholesterol levels. When you aren’t getting enough physical activity, your HDL cholesterol levels go down. This means there isn’t enough “good” cholesterol to carry the “bad” cholesterol away from your arteries.

You only need 40 minutes of moderate to vigorous exercise 3 or 4 times a week to lower your total cholesterol levels. The goal should be 150 minutes of total exercise each week.

This can look like anything you enjoy doing, but some of the following can help you add exercise to your daily routine:

  • Try biking to work.
  • Take brisk walks with your dog.
  • Swim laps at the local pool.
  • Join a gym (and use it!).
  • Take the stairs instead of the elevator.
  • If you use public transportation, get off a stop or two sooner.

Seek strategies to stop smoking

Smoking lowers your “good” cholesterol levels and raises your triglycerides. Even if you haven’t been diagnosed with hyperlipidemia, smoking can increase your risk of heart disease.

Talk with your doctor about quitting, or try the nicotine patch. Nicotine patches are available at the pharmacy without a prescription.

Medications

If lifestyle changes aren’t enough to treat your hyperlipidemia, your doctor may prescribe medication.

Statins are the first line medication for hyperlipidemia. If you cannot tolerate statins or if they do not reduce your LDL cholesterol enough, mRNA and monoclonal antibody drugs have been developed recently.

Common cholesterol- and triglyceride-lowering medications include:

New medications for high cholesterol

Inclisiran

Inclisiran is a new drug using mRNA technology. It has been approved in Europe but not yet in the United States.

Clinical trials in 2020 showed the drug could cut levels of LDL cholesterol by 50 percent in people who are either intolerant or resistant to standard statin medications.

Inclisiran is the pioneer cholesterol drug in what’s called “small interfering RNA therapy.” This is a type of drug that blocks, or interferes with, the function of an RNA messenger (mRNA). An mRNA is a molecule that carries code for making a particular protein.

In the case of Inclisiran, the drug blocks, or interferes with, the production of an enzyme called PCSK9 (proprotein convertase subtilisin kexin type 9). This enzyme causes problems with the LDL receptors in the liver that are necessary for the uptake of LDL cholesterol by liver cells.

By blocking PCSK9 activity, Inclisiran helps the body reduce the amount of LDL cholesterol. The drug is intended for hyperlipidemia treatment in adults whose high LDL cholesterol persists even while they’re on a maximum tolerated dose of statin therapy.

Bempedoic acid (Nexlitol) and ezetimibe (Nexlizet)

The two drugs Nexlitol and Nexlizet, approved by the FDA in 2020, are the first new non-statin cholesterol drugs approved by the FDA since 2002.

Nexlitol contains bempedoic acid, which has been shown in clinical trials to inhibit cholesterol. It’s designed to be taken in combination with the maximum tolerable dosage of statins.

Nexlizet contains ezetimibe, which lowers cholesterol by preventing the body from absorbing cholesterol from foods. It’s also designed to be taken along with statins.

Both Nexlitol and Nexlizet can cause serious side effects. Your doctor can help you decide if one of these drugs would benefit your treatment plan.

Alirocumab (Praluent)

Praluent (alirocumab) was approved by the FDATrusted Source in 2021 as an add-on treatment for familial hypercholesterolemia. This is a genetic condition that causes severely high cholesterol.

Praluent was originally approved by the FDA in 2015 for treating heart disease and primary inherited hyperlipidemia. It was then the first PCSK9 inhibitor approved by the FDA.

PCSK9 inhibitor drugs work by attaching to the PCSK9 gene to prevent it from degrading LDL receptors in the liver that help lower LDL cholesterol in the body. This differs from the new mRNA drug Inclirisan, in that inhibitors attach to the PCSK9 gene, whereas the mRNA drug prevents PCSK9 from being produced.

Alirocumab, the active drug in Praluent, is a monoclonal antibody. This is a protein synthesized in a laboratory that behaves like antibodies made by the human body.

Praluent comes as a liquid solution in a prefilled pen. You deliver it as an injection every 2 to 4 weeks, which can be done at home. It has a number of reported possible side effects, so be sure to discuss with your doctor whether it would suit your treatment plan.

How to prevent high cholesterol

You can make changes to your lifestyle to prevent high cholesterol or reduce your risk of developing hyperlipidemia:

  • Exercise several days per week, if you can.
  • Eat a diet lower in saturated and trans fats.
  • Include lots of fruits, vegetables, beans, nuts, whole grains, and fish regularly into your diet.
  • Limit red meat and processed meats like bacon, sausage, and cold cuts.
  • Maintain a weight that’s healthy for you.
  • Eat lots of healthy fats, like avocado, almonds, and olive oil.

You may want to try a heart healthy eating plan like the Mediterranean diet, which includes a lot of the nutritious foods mentioned above.

Outlook

People with untreated hyperlipidemia have double the risk of developing coronary heart disease as those with normal-range cholesterol levels. Coronary heart disease can lead to heart attack, stroke, or other serious problems.

Hyperlipidemia is very treatable, however, and complications can often be avoided.

You may be able to prevent complications and manage hyperlipidemia by making lifestyle choices, like:

  • eating a balanced and nutrient-dense diet
  • exercising regularly
  • not smoking
  • maintaining a healthy weight for you

If lifestyle choices are not sufficient, you can talk with your doctor about adding medications such as statins to help bring your cholesterol and triglycerides down to healthy level

 

 


1. 고지혈증이란?

고지혈증이란, 필요 이상으로 많은 지방 성분이 혈액 내에 존재하면서 혈관 벽에 쌓여 염증을 일으키는 것을 말한다. 심혈관계 질환을 일으키는 고지혈증은 총 2가지로 분류된다.

먼저 유전적인 요인으로 인해 발생하는 일차성 고지혈증이 있다. 유전적 결함으로 특정 지질이 증가하여 고지혈증이 발생하는 경우이다. 그리고 생활 습관에 의해 생겨나는 이차성 고지혈증이 있다. 비만이나 술, 당뇨병 등과 같은 원인에 의해서 고지혈증이 생기게 될 수 있다.

2. 고지혈증 증상 및 합병증

대부분의 고지혈증은 특별한 증상이 없이 나타나기 때문에 더욱 위험하다. 오직 혈액검사로만 알 수 있으므로 지속적인 검사가 필수다.

고지혈증이 원인이 되어 어떤 증상이 나타났다면 합병증이 진행된 상태라고 볼 수 있는데, 이러한 고지혈증이 장기간 지속하면 콜레스테롤이 혈관 벽에 쌓여 심혈관질환이나 뇌혈관질환과 같은 합병증이 나타난다. 또한 혈액 내의 중성지방 수치가 높은 경우 췌장염도 발생할 수 있어 더욱 각별한 주의가 필요하다.

3. 고지혈증 예방법

고지혈증의 예방법은 식사 조절과 함께 적절한 운동을 통한 생활 습관 개선이 중요하다. 이상적인 체중을 유지하고 고지혈증 수치를 낮추는 식품들을 섭취하는 것이 좋다.
 

<고지혈증 예방법>

1. 콜레스테롤 수치를 높이는 음식을 멀리한다.

2. 식이섬유가 풍부한 식품을 먹는다.

3. 과도한 음주와 흡연을 삼간다.

4. 적절한 운동을 통해 적정 체중을 유지한다.

4. 고지혈증에 좋은 음식 

기름이 많은 삼겹살, 짠 음식, 패스트푸드 등의 음식은 고지혈증을 더욱 악화시킨다. 신선한 채소를 꾸준히 섭취하고 단백질이 풍부한 음식들과 함께 골고루 먹는 습관을 들여야 한다. 고지혈증에 좋은 음식들 자세히 살펴보자. 
 

▶ 등 푸른 생선(고등어, 참치, 꽁치 등) 

등 푸른 생선에 함유된 오메가3 지방산이 혈액 속 중성지방과 혈압을 낮추는 데 효과적입니다.

▶ 완두콩, 땅콩

완두콩에는 비타민C, 땅콩에는 불포화지방이 들어있어 혈액에 쌓이는 콜레스테롤을 낮추는 데 도움이 됩니다.

▶ 고구마

칼륨이 많이 함유된 고구마는 혈액 속의 나트륨 배출을 도와 혈관 건강을 지켜줍니다. 또한, 섬유질과 비타민 등 영양소가 풍부하여 고지혈증에 좋습니다.

▶ 표고버섯

렌티나신 성분이 있어 피가 굳어 엉키는 혈전 현상에 대항하는 항혈전 작용이 탁월합니다.

5. 고지혈증 운동가이드

규칙적인 운동은 지질을 낮추는 데 효과적이다. 체지방을 감소시키고 혈압을 낮춰 고지혈증 예방 및 치료에 도움이 된다. 하지만 무리하게 운동을 하게 되면 건강에 더 해로울 수 있으니 운동을 시작하기 전 의사와 함께 상의하는 것이 바람직하다.
 

▶ 유산소운동

가벼운 조깅과 속보, 수영, 자전거 타기 등의 유산소 운동은 중성지방 수치를 감소시켜줍니다. 그러나 고령이거나 심혈관계 질환이 있는 경우에는 무리하게 운동을 하게 되면 맥박수 상승이나 저혈압 등 문제가 올 수 있기에 주의하셔야 합니다. 유산소 운동은 일주일에 5일 이상 1회에 30분 이상 하는 것이 좋습니다. 보통의 강도보다 약간 힘들다는 느낌을 유지하며 운동하는 것이 효과적입니다.

▶ 근육운동

근육 운동을 권유 받은 환자라면 1주일에 2회가량 복근 운동, 스쿼트, 플랭크 등의 운동을 꾸준히 하면 좋습니다. 그러나 심하고 무리한 근육 운동은 급사나 실신의 위험이 있어 반드시 의사와 상담하는 것이 필요합니다.

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