What is hyperlipidemia dyslipidemia

Treatment involves dietary changes, exercise, and lipid-lowering drugs. See also Overview of Lipid Metabolism Overview of Lipid Metabolism Lipids are fats that are either absorbed from food or synthesized by the liver. Triglycerides TGs and cholesterol contribute most to disease, although all lipids are physiologically important There is no natural cutoff between normal and abnormal lipid levels because lipid measurements are continuous.

Consequently, there are no numeric definitions of dyslipidemia; the term is applied to lipid levels for which treatment has proven beneficial. Proof of benefit is strongest for lowering elevated low-density lipoprotein cholesterol LDL levels.

In the overall population, evidence is less strong for a benefit from lowering elevated TG and increasing low high-density lipoprotein cholesterol HDL levels.

HDL levels do not always predict cardiovascular risk. For example, high HDL levels caused by some genetic disorders may not protect against cardiovascular disorders, and low HDL levels caused by some genetic disorders may not increase the risk of cardiovascular disorders.

Although HDL levels predict cardiovascular risk in the overall population, the increased risk may be caused by other factors, such as accompanying lipid and metabolic abnormalities, such as hypertriglyceridemia, rather than the HDL level itself. Dyslipidemias were traditionally classified by patterns of elevation in lipids and lipoproteins Fredrickson phenotype—see table Lipoprotein Patterns Lipoprotein Patterns Fredrickson Phenotypes Dyslipidemia is elevation of plasma cholesterol, triglycerides TGs , or both, or a low high-density lipoprotein cholesterol level that contributes to the development of atherosclerosis.

A more practical system categorizes dyslipidemias as primary or secondary and characterizes them by. This system does not take into account specific lipoprotein abnormalities eg, low HDL or high LDL that may contribute to disease despite normal cholesterol and TG levels.

Both primary and secondary causes contribute to dyslipidemias in varying degrees. For example, in familial combined hyperlipidemia, expression may occur only in the presence of significant secondary causes. Primary causes are single or multiple gene mutations that result in either overproduction or defective clearance of triglycerides and LDL, or in underproduction or excessive clearance of HDL see table Genetic Primary Dyslipidemias Genetic Primary Dyslipidemias Dyslipidemia is elevation of plasma cholesterol, triglycerides TGs , or both, or a low high-density lipoprotein cholesterol level that contributes to the development of atherosclerosis.

The names of many primary disorders reflect an old nomenclature in which lipoproteins were detected and distinguished by how they separated into alpha HDL and beta LDL bands on electrophoretic gels. A sedentary lifestyle with excessive dietary intake of total calories, saturated fat, cholesterol, and trans fats. Trans fats are polyunsaturated or monounsaturated fatty acids to which hydrogen atoms have been added; they are used in some processed foods and are as atherogenic as saturated fat.

Diabetes mellitus Diabetes Mellitus DM Diabetes mellitus is impaired insulin secretion and variable degrees of peripheral insulin resistance leading to hyperglycemia. Early symptoms are related to hyperglycemia and include polydipsia Chronic kidney disease Chronic Kidney Disease Chronic kidney disease CKD is long-standing, progressive deterioration of renal function.

Symptoms develop slowly and in advanced stages include anorexia, nausea, vomiting, stomatitis, dysgeusia Hypothyroidism Hypothyroidism Hypothyroidism is thyroid hormone deficiency. It is diagnosed by clinical features such as a typical facial appearance, hoarse slow speech, and dry skin and by low levels of thyroid hormones Primary biliary cirrhosis Primary Biliary Cholangitis PBC Primary biliary cholangitis PBC; formerly known as primary biliary cirrhosis is an autoimmune liver disorder characterized by the progressive destruction of intrahepatic bile ducts, leading Drugs, such as thiazides, beta-blockers, retinoids, highly active antiretroviral agents, cyclosporine , tacrolimus , estrogen and progestins, and glucocorticoids.

It is more common among children and has both primary and secondary Diabetes is an especially significant secondary cause because patients tend to have an atherogenic combination of high TGs; high small, dense LDL fractions; and low HDL diabetic dyslipidemia, hypertriglyceridemic hyperapo B. Patients with type 2 diabetes are especially at risk. The combination may be a consequence of obesity, poor control of diabetes, or both, which may increase circulating free fatty acids FFAs , leading to increased hepatic very-low-density lipoprotein VLDL production.

Diabetic dyslipidemia is often exacerbated by the increased caloric intake and physical inactivity that characterize the lifestyles of some patients with type 2 diabetes. Women with diabetes may be at special risk of cardiac disease as a result of this form of dyslipidemia. Dyslipidemia itself usually causes no symptoms but can lead to symptomatic vascular disease, including coronary artery disease Overview of Coronary Artery Disease Coronary artery disease CAD involves impairment of blood flow through the coronary arteries, most commonly by atheromas.

Clinical presentations include silent ischemia, angina pectoris, acute The most common triggers are gallstones and alcohol intake.

The severity of acute pancreatitis is Very high triglyceride levels can also cause hepatosplenomegaly, paresthesias, dyspnea, and confusion.

High levels of LDL can cause arcus corneae and tendinous xanthomas at the Achilles, elbow, and knee tendons and over metacarpophalangeal joints. Other clinical findings that occur in patients with high LDL eg, in familial hypercholesterolemia include xanthelasma lipid rich yellow plaques on the medial eyelids.

Xanthelasma can also occur in patients with primary biliary cirrhosis Primary Biliary Cholangitis PBC Primary biliary cholangitis PBC; formerly known as primary biliary cirrhosis is an autoimmune liver disorder characterized by the progressive destruction of intrahepatic bile ducts, leading Patients with the homozygous form of familial hypercholesterolemia may have arcus corneae, tendinous xanthomas and xanthelasma plus planar or tuberous xanthomas.

Planar xanthomas are flat or slightly raised yellowish patches. Tuberous xanthomas are painless, firm nodules typically located over extensor surfaces of joints. Patients with severe elevations of TGs can have eruptive xanthomas over the trunk, back, elbows, buttocks, knees, hands, and feet. Extremely high lipid levels also give a lactescent milky appearance to blood plasma. Symptoms can include paresthesias, dypsnea, and confusion. Dyslipidemia is suspected in patients with characteristic physical findings or complications of dyslipidemia eg, atherosclerotic disease.

Physical signs of dyslipidemia such as tendon xanthomas, which are pathognomonic for familial hypercholesterolemia. Onset of premature atherosclerotic disease men 55 years, women 60 years. Dyslipidemia is diagnosed by measuring serum lipids. Total cholesterol, triglycerides, and HDL cholesterol are measured directly. TC and HDL cholesterol can be measured in the nonfasting state, but most patients should have all lipids measured while fasting usually for 12 hours for maximum accuracy and consistency.

Total and HDL cholesterol can be measured in the nonfasting state, but most patients should have all lipids measured while fasting usually for 12 hours for maximum accuracy and consistency. Testing should be postponed until after resolution of acute illness because TG and lipoprotein a levels increase and cholesterol levels decrease in inflammatory states. Lipid profiles can vary for about 30 days after an acute myocardial infarction MI ; however, results obtained within 24 hours after MI are usually reliable enough to guide initial lipid-lowering therapy.

Direct measurement may be useful in some patients with elevated TGs, but these direct measurements are not routinely necessary. Patients with premature atherosclerotic cardiovascular disease, cardiovascular disease with normal or near-normal lipid levels, or high LDL levels refractory to drug therapy should have Lp a levels measured. Lp a levels may also be directly measured in patients with borderline high LDL cholesterol levels to determine whether drug therapy is warranted.

Apo B measurement includes all atherogenic particles, including remnants and Lp a. Tests for secondary causes of dyslipidemia should be done in most patients with newly diagnosed dyslipidemia and when a component of the lipid profile has inexplicably changed for the worse. It refers to excess levels of LDL cholesterol and triglycerides in the blood. Hypothyroidism, a high fat diet, and being overweight contribute to high cholesterol.

However, some types of hyperlipidemia have genetic causes. Regular physical activity and a diet rich in healthful fats can improve the balance of cholesterol in the blood and help a person prevent related health problems.

Blood lipids are fatty substances, such as triglycerides and cholesterol. When a person's levels are too high or low, they have dyslipidemia. It can…. The liver has many roles, one being to make cholesterol while another is to remove excess amounts. Healthy cholesterol levels are essential for the…. Eating a healthy diet is one way to keep cholesterol levels in check. Learn which foods to avoid and which to prioritize to maintain healthy….

Pure hypercholesterolemia is a form of high cholesterol that parents pass down to their children in their genes. Find out more here. High cholesterol is a risk factor for heart attacks and coronary heart disease, because it builds up in the arteries, narrowing them. It does not…. What to know about hyperlipidemia. Medically reviewed by Dr. Payal Kohli, M. What is hyperlipidemia? Latest news Scientists identify new cause of vascular injury in type 2 diabetes.

Adolescent depression: Could school screening help? Related Coverage. Dyslipidemia: Everything you need to know. How are liver function and cholesterol production linked? The body may deposit excess fat in blood vessels and Lifestyle, genetics, disorders such as low thyroid hormone levels or kidney disease , drugs, or a combination can contribute.

Atherosclerosis can result, causing angina, heart attacks, strokes, and peripheral arterial disease. Cholesterol is an essential component of cell membranes, of brain and nerve cells, and of bile, which helps the body absorb fats and fat-soluble vitamins.

The body uses cholesterol to make vitamin D and various hormones, such as estrogen , testosterone , and cortisol. The body can produce all the cholesterol that it needs, but it also obtains cholesterol from food. Some types of fatty acids are made by the body, but others must be obtained from food. Lipoproteins Lipoproteins: Lipid Carriers The body needs fats for growth and energy. They carry fats, such as cholesterol and triglycerides, which cannot circulate freely in the blood by themselves.

There are different types of lipoproteins see table Lipoproteins: Lipid Carriers Lipoproteins: Lipid Carriers The body needs fats for growth and energy. Levels of lipoproteins and therefore lipids, particularly low-density lipoprotein LDL cholesterol, increase slightly as people age. Levels are normally slightly higher in men than in women, but levels increase in women after menopause. The increase in levels of lipoproteins that occurs with age can result in dyslipidemia.

The risk of developing atherosclerosis Atherosclerosis Atherosclerosis is a condition in which patchy deposits of fatty material atheromas or atherosclerotic plaques develop in the walls of medium-sized and large arteries, leading to reduced or Atherosclerosis can affect the arteries that supply blood to the heart causing coronary artery disease Overview of Coronary Artery Disease CAD Coronary artery disease is a condition in which the blood supply to the heart muscle is partially or completely blocked.

The heart muscle needs a constant supply of oxygen-rich blood. The coronary Most often, doctors use the term peripheral arterial disease to describe poor circulation Therefore, having a high total cholesterol level also increases the risk of having a heart attack Acute Coronary Syndromes Heart Attack; Myocardial Infarction; Unstable Angina Acute coronary syndromes result from a sudden blockage in a coronary artery.

This blockage causes unstable angina or heart attack myocardial infarction , depending on the location and amount Having a low total cholesterol level is generally considered better than having a high one.

A high level of LDL bad cholesterol increases the risk. A high level of HDL good cholesterol is not usually considered a disorder because it decreases the risk of atherosclerosis. Whether high triglyceride levels increase the risk of a heart attack or stroke is uncertain. For people with high triglyceride levels, the risk of heart attack or stroke is increased if they also have a low HDL cholesterol level, diabetes Diabetes Mellitus DM Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar glucose levels to be abnormally high.

Urination and thirst are Major causes are diabetes and high blood pressure A high level of HDL—the good—cholesterol may be beneficial and is not considered a disorder. A level that is too low increases the risk of atherosclerosis. Lipoprotein a is a combination of LDL with an additional protein attached to it. High levels are inherited. Lipoprotein a is not affected by diet or most lipid-lowering drugs. It usually only needs to be measured once. Both primary and secondary causes contribute to dyslipidemia in varying degrees.

For example, a person with a hereditary hyperlipidemia may have even higher lipid levels if the person also has secondary causes of hyperlipidemia. Primary causes involve gene mutations that cause the body to produce too much LDL cholesterol or triglycerides or to fail to remove those substances.

Some causes involve underproduction or excessive removal of HDL cholesterol. Primary causes tend to be inherited and thus to run in families. Hereditary disorders occur when parents pass the defective genes that cause these disorders on to their children. There are different People can also inherit a tendency for HDL cholesterol to be unusually low. Consequences of primary dyslipidemias can include premature atherosclerosis Atherosclerosis Atherosclerosis is a condition in which patchy deposits of fatty material atheromas or atherosclerotic plaques develop in the walls of medium-sized and large arteries, leading to reduced or Peripheral arterial disease Overview of Peripheral Arterial Disease Peripheral arterial disease results in reduced blood flow in the arteries of the trunk, arms, and legs.

Symptoms depend Stroke Overview of Stroke A stroke occurs when an artery to the brain becomes blocked or ruptures, resulting in death of an area of brain tissue due to loss of its blood supply cerebral infarction and symptoms that Very high triglyceride levels can cause pancreatitis Overview of Pancreatitis Pancreatitis is inflammation of the pancreas.

The pancreas is a leaf-shaped organ about 5 inches about 13 centimeters long. It is surrounded by the lower edge of the stomach and the first In people who have a genetic disorder that causes high triglyceride levels such as familial hypertriglyceridemia or familial combined hyperlipidemia , certain disorders and substances can increase triglycerides to extremely high levels. Examples of disorders include poorly controlled diabetes Diabetes Mellitus DM Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar glucose levels to be abnormally high.

Examples of substances include excessive alcohol consumption and use of certain drugs, such as estrogens taken by mouth , that increase triglyceride levels.

Symptoms can include fatty deposits eruptive xanthomas in the skin on the front of the legs and back of the arms, an enlarged spleen and liver, abdominal pain, and a decreased sensitivity to touch due to nerve damage.

These disorders can cause pancreatitis Overview of Pancreatitis Pancreatitis is inflammation of the pancreas. Limiting fat intake to less than 50 grams a day can help prevent nerve damage and pancreatitis. Losing weight and not drinking alcohol can also help. Lipid-lowering drugs may be effective. From a dietary standpoint, the best way to lower your cholesterol is reduce your intake of saturated fat and trans fat.

Reducing these fats means limiting your intake of red meat and dairy products made with whole milk. Choose skim milk, low-fat or fat-free dairy products instead. It also means limiting fried food and cooking with healthy oils, such as vegetable oil. A heart-healthy diet emphasizes fruits, vegetables, whole grains, poultry, fish, nuts and nontropical vegetable oils, while limiting red and processed meats, sodium and sugar-sweetened foods and beverages.

Many diets fit this general description. Department of Agriculture and the American Heart Association are heart-healthy approaches. Such diets can be adapted based on your cultural and food preferences. A sedentary lifestyle lowers HDL cholesterol. Physical activity is important. At least minutes of moderate-intensity aerobic exercise a week is enough to lower both cholesterol and high blood pressure.

And you have lots of options: brisk walking, swimming, bicycling or even yard work can fit the bill. Worse still, when a person with unhealthy cholesterol levels also smokes, risk of coronary heart disease increases more than it otherwise would.

Smoking also compounds the risk from other risk factors for heart disease, such as high blood pressure and diabetes.