Hyperlipidemia is an abnormally high level of fatty substances called lipids in the blood. Lipids include cholesterol and triglycerides. There are five primary types of hyperlipidemia. The type depends on which lipid in the blood is high. If not treated, high lipids can cause heart disease, hardening of the arteries, or stroke.

Causes

Causes may include:

• A family history of hyperlipidemia

• A diet high in total fat, saturated fat, or cholesterol

• Obesity

• Certain conditions, including:

• • Diabetes

• • Low thyroid

• • Kidney problems

• • Liver disease

• • Cushing's syndrome

• Certain drugs, such as:

• • Hormones or birth control pills

• • Beta-blockers

• • Some diuretics

• • Cortisone drugs

• • Isotretinoin (for acne)

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

Risk factors include:

• Advancing age

• Adult men (any age)

• Postmenopause

• Lack of exercise

• Smoking

• Stress

• Overuse of alcohol

Symptoms

Hyperlipidemia usually does not cause symptoms. Very high levels of lipids in the blood may cause fat deposits in the skin or tendons (xanthomas). Extremely high levels of triglycerides in the blood can cause pain, enlargement, or swelling (inflammation) of abdominal organs such as the liver, spleen, or pancreas (pancreatitis). The most significant consequence of hyperlipidemia involves obstruction of blood vessels throughout the body, particularly those that serve the heart and brain. Individuals with hyperlipidemia are at increased risk of:

• Atherosclerosis (hardening of the arteries)

• Heart attack

• Stroke

Diagnosis

Hyperlipidemia is diagnosed with blood tests that measure the levels of lipids in the blood. The National Cholesterol Education Program advises that adults have their blood lipids checked at least once every five years, starting at age 20.

Testing may consist of a fasting blood test for total cholesterol, LDL (bad cholesterol), HDL (good cholesterol), and triglycerides. Your doctor may recommend more frequent or earlier testing for reasons such as:

• You have a family history of hyperlipidemia.

• You have a risk factor or disease that may cause hyperlipidemia.

• You have a complication that may result from hyperlipidemia.

Treatment

Diet and lifestyle changes can help treat hyperlipidemia. In some cases, a combination of diet and lifestyle changes and medication may be required.

Prevention

To reduce your chance of getting hyperlipidemia:

• Starting at age 20, get regular blood tests for total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides at least once every five years. Get tested earlier or more often if your doctor advises it.

• Eat a diet low in total fat, saturated fat, and cholesterol.

• Don't smoke. If you smoke, quit.

• Drink alcohol in moderation. This means no more than two drinks per day for men or one drink per day for women.

• If you are overweight, lose weight.

• Exercise regularly. If you are unaccustomed to exercise, first check with your doctor.

• If you have diabetes, keep your blood sugar under tight control.

• Since some drugs may contribute to hyperlipidemia, discuss with your doctor potential side effects.

RESOURCES:

American Heart Association
http://www.americanheart.org

Medline Plus
http://medlineplus.gov

Canadian Resources:

Canadian Health Network
http://www.canadian-health-network.ca/

Heart and Stroke Foundation of Canada
http://ww2.heartandstroke.ca/Page.asp?PageID=24

References:

The Merck Manual of Medical Information. 17th ed. Simon and Schuster, Inc; 2000.

National Institutes of Health website. Available at: http://www.nih.gov/.