Can Dyslipidemia Be Treated?

Dyslipidemia is defined as an abnormally high level of lipids (fats) or lipoproteins (fat-carrying proteins) in the blood. It is caused by an imbalance in lipids, which include cholesterol (both low-density lipoprotein and high-density lipoprotein cholesterol) and triglycerides.

• If your total cholesterol level is less than 200 mg/dL (5.17 mmol/L), it is considered normal.
• A total cholesterol level in the range of 200 to 239 mg/dL (5.17 to 6.18 mmol/L) is considered borderline high.
• Total cholesterol levels of 240 mg/dL (6.21 mmol/L) or higher are considered high.

Cholesterol is a wax-like substance found in your bloodstream. Although your body requires cholesterol to build healthy cells, high cholesterol levels can increase your risk of heart disease.

High cholesterol can cause fatty deposits in your blood vessels. These deposits eventually grow, making it difficult for sufficient blood to flow through your arteries. These can cause damage or rupture unexpectedly to form a clot, resulting in a heart attack or stroke.

Initial treatment focuses on diet and lifestyle changes, with the possibility of including lipid-lowering medications to lower your cholesterol and triglyceride levels if your condition is more severe.

A healthy diet, weight loss, and exercise are all examples of lifestyle changes that can help you lower your cholesterol. These include:

• Exercise.
• Quit smoking.
• Sleep at least eight hours every night.
• Keep your stress level under control.
• Eat healthy foods.
• Limit your alcohol intake.
• Lose a few pounds to reach your optimum weight.

Statins are commonly used to treat high cholesterol in people who require medication. Statins are a type of medication that reduces the amount of bad cholesterol in your blood. 

• Your doctor may prescribe a different medication if:
• You are unable to take a statin.
• You require another medication, in addition to a statin.
• You have familial hypercholesterolemia, a genetic condition that causes your bad (low-density lipoprotein) cholesterol level to be abnormally high.

If you have elevated triglycerides, your doctor might prescribe:

• Fibrates.
• Niacin.
• Omega-3 fatty acid supplements.

Treatment also includes communication from the prescribing doctor and, if necessary, the pharmacist to avoid any potential side effects or interactions from the prescribed medications. People with dyslipidemia should be monitored yearly or more frequently, as determined by their primary care physician, to track the progression of the disease.

Dyslipidemia may be divided into two distinct categories depending on the cause:

• Primary (genetic) dyslipidemia
• Secondary (environmental) dyslipidemia

The primary causes of dyslipidemia, which involve gene mutations that alter lipid production, include the following:

• Familial hyperapobetalipoproteinemia: Occurs when normal low-density lipoprotein (LDL) cholesterol is paired with high LDL apolipoprotein B.
• Familial combined hyperlipidemia: The most common inherited dyslipidemia. It increases blood fats, which cause heart attack and stroke.
• Familial hypertriglyceridemia: A condition in which the liver produces an excess of very low-density lipoprotein.

The secondary causes of dyslipidemia include lifestyle choices and other medical conditions. Some of the most common causes of secondary dyslipidemia include:

• Alcohol intake
• A diet high in saturated fat, cholesterol, and trans fats
• Hypothyroidism
• Diabetes
• Polycystic ovary syndrome
• Chronic kidney disease
• Smoking

Foods that contain cholesterol, saturated fat, and trans fats can all increase your blood cholesterol level. These are some examples:

• Egg yolk and cheese
• Processed and fried foods
• Ice cream
• Cakes and pastries
• Red meat

Not exercising regularly can lead to weight gain and elevated cholesterol levels. Moreover, your cholesterol tends to increase as you age. 

Dyslipidemia can be inherited. People who inherit the condition may develop an extremely high level of cholesterol. That means they are more likely to have a heart attack, even when they are young.

Many systemic diseases can cause dyslipidemia; here are some examples:

• Psoriasis
• Depression
• Chronic pain
• Crohn's disease
• Pediatric alopecia areata
• Chronic kidney disease
• Inflammatory bowel disease
• Chronic obstructive pulmonary disease

Diabetes, chronic renal failure, nephrotic syndrome, hypothyroidism, age, and a sedentary lifestyle are all common causes of dyslipidemia. Certain drugs, such as beta-blockers, thiazide diuretics, estrogen-progestin contraceptives, and antiretrovirals, can lead to dyslipidemia.

In most cases, dyslipidemia does not have any symptoms. Therefore, it is essential to monitor the levels of the different lipids in your blood. In some cases, dyslipidemia can lead to more serious conditions that do have symptoms, such as heart disease and pancreatitis. 

Rarely, dyslipidemia can lead to:

• Arcus senilis (fatty deposits in the iris of the eye, which appear as a white ring on the edge of the iris)
• Xanthoma (which appears as painless nodules around the joints)
• Xanthelasma (which appears as yellow lesions, commonly on and around the eyes)

Most people who have dyslipidemia are unaware of their condition at first. You cannot feel it, but it may affect you someday.

Cholesterol, triglycerides, and other fats can clog your arteries. This narrows the blood vessels, making blood flow more difficult, which may increase your blood pressure.

The buildup can also lead to the formation of a blood clot. A heart attack can occur if a blood clot breaks free and travels to your heart. It can cause a stroke if it gets to your brain.

Various experts have created lipid screening guidelines, which include the "lipid profile," which measures cholesterol and triglyceride levels. Guidelines differ on when doctors should begin screening for dyslipidemia and how frequently they should do so.

Dyslipidemia is diagnosed through a blood test that measures the following:

• High-density lipoprotein cholesterol
• Low-density lipoprotein cholesterol
• Triglyceride levels
• Total cholesterol: a combination of the other three numbers

According to the American Heart Association, adults aged (or older than) 20 years should have their cholesterol checked every four to six years. You may be required to fast for 9 to 12 hours before the test.

A total cholesterol level of 200 mg/dL or higher is considered abnormal. To determine whether your specific test numbers are high and what to do about them, your doctor will consider factors such as your age, consumption of alcohol and tobacco, and family history of heart problems.