Treatment for High Blood Cholesterol Levels (Hyperlipidemia)

high cholesterol (Hyperlipidemia)
Medically reviewed by Dr. Ola Tarabzuni

Overview

In hyperlipidemia, lipid levels, including cholesterol and triglycerides, are high. It is a major cause of atherosclerosis and coronary heart disease. Therefore, if you or someone you know suffers from this condition, it is essential to treat it immediately. Read this article to learn more about symptoms, causes, diagnosis, prevention, and treatment options.

What is Hyperlipidemia?

A high cholesterol level is known as hyperlipidemia. It is also known as dyslipidemia, which means excess lipids (fats) in your blood. It is a common problem increasing all around the world.

If you have a high cholesterol level in your blood, your arteries become blocked, causing damage to the organs that receive insufficient blood flow. This may lead to:

  • heart disease
  • stroke
  • heart attack
  • peripheral artery disease

Overview of Lipids and Their Role in the Body

Lipids are chemical elements in our body that help with some of their functions. Our body makes fatty or waxy substances that do not dissolve in water. For example, cholesterol is a lipid in the blood. The body needs it to help us take in fats and vitamins and produce hormones.

There are two types of lipids:

  • Low-density lipoprotein (LDL): It is also known as bad cholesterol because our liver makes very low-density lipoproteins, which take triglyceride from our liver to other cells. When these low-density lipoproteins drop off triglycerides and cholesterol, they become denser and become Low-density lipoprotein or bad cholesterol. It can stick to the arteries and clog them like a large truck that broke down and blocked a traffic lane. 
  • High-density lipoprotein (HDL) is good cholesterol because it removes cholesterol from the blood and carries it back to the liver. It clears the way for your blood to get through your blood vessels. It also fights inflammation, blood clots, heart disease, and oxidation.

Function:

Different lipids have different functions. These include:

  • Triglycerides send and store energy.
  • Steroid hormones perform various psychological functions.
  • Bile salts from cholesterol help to digest fat.
  • Fatty acids metabolize to create energy.
  • Phospholipids and cholesterol make cell membranes. Phospholipids are like gatekeepers that allow cells to regulate what enters and exits.
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Prevalence of Hyperlipidemia

Hyperlipidemia is a common medical condition that affects millions of people worldwide. Hyperlipidemia is more prevalent in men than women and generally increases with age. According to the World Health Organization (WHO), hyperlipidemia is estimated to affect approximately 39% of adults worldwide. In the United States, the  American Heart Association (AHA) estimates that about 94 million adults have total cholesterol levels above 200 mg/dL, which is considered high. Of these, approximately 28 million have total cholesterol levels above 240 mg/dL, which is regarded as very high. 

Cardiovascular disease is the world’s leading cause of death, and hyperlipidemia is a significant risk factor for it. According to estimates, 4.4 million people die from high cholesterol each year.

Types of Lipid Disorder

Lipid disorders refer to conditions affecting the body’s fat metabolism. As a result of these disorders, abnormal lipids (fat molecules) levels can increase the risk of heart disease, stroke, and diabetes. The following are a few of the most common lipid disorders:

  1. Hypercholesterolemia: 

Hypercholesterolemia occurs when blood cholesterol is abnormally high. Cholesterol is a type of lipid essential for the body to function properly. Too much cholesterol can cause plaque in the arteries, increasing heart disease and stroke risk. Treatment for Hypercholesterolemia typically involves a heart-healthy diet, physical activity, and quitting smoking. 

  1. Hypertriglyceridemia

This is a type of hyperlipidemia in which there is an abnormally high level of triglycerides in the blood. When the levels of triglycerides become too high, it can increase the risk of various diseases related to heart and pancreatitis. Hypertriglyceridemia is usually treated by modifying your lifestyle, reducing sugar and refined carb intake, and drinking less alcohol.

  1. Familial Hypercholesterolemia: 

This genetic disorder causes high blood LDL cholesterol levels, increasing heart disease risk. LDL cholesterol, which is sometimes called “bad” cholesterol, contributes to plaque buildup in the arteries, increasing heart disease and stroke risk. Mutations cause FH in one of several genes that are involved in the metabolism of cholesterol. An affected person has a 50% chance of passing the mutated gene to each of their children due to the autosomal dominant inheritance pattern.

  1. Mixed Dyslipidemia:  

In mixed dyslipidemia, low-density lipoprotein cholesterol (LDL) is elevated along with triglycerides, while high-density lipoprotein cholesterol (HDL) is low. It is sometimes called atherogenic dyslipidemia since it can increase the risk of atherosclerosis (hardening and narrowing of arteries) and cardiovascular disease. The development of mixed dyslipidemia can be attributed to lifestyle factors such as saturated and trans fat intake, inactivity, and smoking.

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Symptoms and Complications

Hyperlipidemia has no prominent symptoms but may eventually lead to other conditions and symptoms. However, if it leads to CHD (coronary heart disease) or atherosclerosis, symptoms in adults can include the following:

  • Chest pain or pressure (angina)
  • Blood vessels blockage in the brain or heart
  • High blood pressure
  • Heart attack
  • Heart disease
  • Stroke

With hyperlipidemia, you can experience severe complications, such as:

  • Chest pain: Chest pain and pressure from angina may occur when the arteries are blocked, resulting in reduced blood flow to your heart.
  • Coronary artery disease (CAD): is a common type of heart disease that may result in a heart attack. Coronary artery damage can lead to this condition.
  • Heart attack: Hyperlipidemia can cause a heart attack due to coronary artery disease or plaque completely blocking blood flow to the heart.
  • Peripheral artery disease (PAD): Our peripheral arteries supply blood to the limbs. When plaque limits blood flow in these arteries, it may cause symptoms such as leg numbness or weakness, swelling, and pain.
  • Stroke: When blood clots are formed, they block the blood flow to your brain, resulting in a stroke.

Causes of Hyperlipidemia 

Different hyperlipidemia causes include:

  • Smoking.
  • Drinking too much alcohol.
  • Food that has a lot of saturated or trans fats.
  • Being stressed.
  • Inherited genes that make your cholesterol levels unhealthy.
  • Being overweight.

A few medical conditions can also affect your cholesterol level in the blood. These include:

  • Liver disease
  • Pancreas disease
  • Multiple myeloma
  • Polycystic ovary syndrome (PCOS)
  • Hypothyroidism
  • Chronic kidney disease
  • Diabetes
  • Lupus
  • Sleep apnea
  • HIV

Lifestyle causes of hyperlipidemia

Lifestyle factors can cause “bad” cholesterol levels or the “good” ones.

According to research, the leading lifestyle choices that may result in developing high cholesterol levels are:

  • an unbalanced diet
  • insufficient exercise
  • smoking or passive smoking
  • being overweight or obese
  • heavy alcohol consumption

Medicines you take may sometimes affect your cholesterol levels, such as:

  • birth control pills
  • diuretics
  • corticosteroids
  • antiretrovirals used for HIV treatment
  • beta-blockers

Medical Conditions

Several medical conditions can cause hyperlipidemia. These conditions can include the following:

  • Familial Hypercholesterolemia
  • Familial combined hyperlipidemia
  • Diabetes mellitus
  • Hypothyroidism
  • Nephrotic syndrome
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Hyperlipidemia Diagnosis and Testing

Hyperlipidemia has no symptoms, so a lipid panel or profile blood test can only diagnose it. Your healthcare provider will use your lipid panel to make a hyperlipidemia diagnosis.

This test determines your cholesterol levels. Your doctor will take your blood sample for testing, then get back to you with a full report. Levels of the following will be shown in your report:

  • The amount of cholesterol in the blood
  • low-density lipoprotein cholesterol
  • high-density lipoprotein (HDL) cholesterol
  • triglycerides

Your healthcare provider may recommend you fast for 9 to 12 hours before getting your blood drawn. That means you’ll have to avoid eating or drinking anything other than water during that time. However, it is only sometimes necessary.

Normal cholesterol levels can vary from one person to another depending on health history and current health conditions and are best determined by your doctor.

Treatments and Management for High Cholesterol

Lifestyle changes

Lifestyle changes are often considered the best way to manage hyperlipidemia at home. Even if you have familial combined hyperlipidemia, lifestyle changes are still significant in treating hyperlipidemia.

These changes can reduce your risk of complications like heart problems and stroke.

If you’re already taking medications to control your cholesterol level, a few lifestyle changes can improve it.

  • Eat a heart-healthy diet.

Changing your diet can lower your Low-density lipoprotein cholesterol levels and increase your High-density lipoprotein cholesterol levels. 

  • Choose healthier fats. Avoid saturated fats in butter, ghee, bacon, lamb, and other full-fat dairy products. Choose lighter proteins like chicken, eggs, and fish when possible. Use monounsaturated fats like olive, safflower, and sesame oil for cooking.
  • Cut out the trans fats. Trans fats are present in fried and processed foods, like baked goods, cakes, pies, etc. Always check the ingredients on labels before buying the product. Avoid products that list “partially hydrogenated oil.”
  • Eat more omega-3s. It has many heart benefits. You can find them in flax seeds, cod liver oil, nuts and seeds, and some types of fish, including salmon, mackerel, and herring. 

Get active, if you can

Physical activity is essential for overall health, weight loss, and cholesterol levels. 

Forty minutes of moderate to vigorous exercise can balance the cholesterol levels in your blood. Some of the following can help you add activity to your daily routine:

  • Try biking to work.
  • Take brisk walks.
  • Swimming
  • Join a gym.
  • Use the stairs instead of the elevator.
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Hyperlipidemia Medication:

Your healthcare provider may prescribe medication if lifestyle changes aren’t enough to treat hyperlipidemia.

Statins are the first-line medication for hyperlipidemia. Some of them are mentioned below:

  • Statins, such as:
  • atorvastatin 
  • lovastatin 
  • pitavastatin 
  • pravastatin 
  • rosuvastatin 
  • simvastatin 
  • Bile-acid-binding resin drugs, such as:
    cholestyramine (Prevalite)
    Colestid
    colestipol (Colestid)
  • Cholesterol absorption inhibitors, such as Triacylglycerol.
  • injectable alternatives to statins, such as PCSK9 inhibitor or evolocumab (Repatha)
  • fibrates, such as Clofibrate (Atromid-S), Fenofibrate 
  • niacin (Niacor)
  • omega-3 fatty acid supplements
  • other cholesterol-lowering supplements

Surgical Treatment 

Partial ileal bypass (PIB) surgery is one of the safest, most effective methods for reducing plasma cholesterol levels, lipids, and lipoproteins, particularly in patients with heterozygous familial Hypercholesterolemia. This procedure also applies to treating sitosterolemia, a rare genetic disorder where plant sterols are absorbed abnormally high. Following PIB, circulating plasma and low-density lipoprotein (LDL) cholesterol fall markedly, while high-density lipoprotein (HDL) cholesterol rises.

Hyperlipidemia Prevention  

Changes to your lifestyle can reduce your risk of developing hyperlipidemia:

  • Vigorous exercise several days per week.
  • Cut out saturated and trans fats in your diet.
  • Regularly include fruits, vegetables, beans, nuts, whole grains, and fish.
  • Avoid red meat and processed meats like bacon, pork, and cold cuts.
  • Maintain a healthy weight.
  • Eat many healthy fats, like avocado, nuts, and olive oil.

If you have a health history of heart disease or high blood cholesterol that indicates you could have Familial Hypercholesterolemia, you might be referred to a genetic counselor. In addition to helping you better understand the likelihood that you or your family members have Familial Hypercholesterolemia, genetic counseling can help you decide whether to undergo genetic testing for the disease. If you choose to get testing, genetic counseling can help you understand what your test results mean.

Risk Factors for Hyperlipidemia

Hyperlipidemia (high cholesterol) that is left untreated can allow plaque to collect inside your body’s blood vessels (atherosclerosis) which can bring on hyperlipidemia complications that include:

  • Heart attack.
  • Stroke.
  • Coronary heart disease.
  • Carotid artery disease (CAD).
  • Cardiac arrest.
  • Peripheral artery disease.
  • Microvascular disease

Hypercholesterolemia vs. Hyperlipidemia

Hyperlipidemia is above normal lipid levels in your blood, including LDL and triglycerides. It can show no symptoms and is sometimes only detected through a lipid panel, whereas Hypercholesterolemia is above-average LDL or total cholesterol levels in your blood. It doesn‘t include triglycerides.

Both conditions are dangerous to health and well-being. Unhealthy lifestyles can lead to hyperlipidemia and Hypercholesterolemia.

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When to Consult a Doctor?

The American Heart Association recommends checking your cholesterol levels once every 4 to 6 years, starting from 20 years of age. Individuals with risk factors, such as a family health history of heart disease, smoking, diabetes, etc., should consider going more often. Speak to your healthcare provider to understand what is better for you. It is essential to consult a doctor for hyperlipidemia to get a correct diagnosis, receive personalized treatment, be monitored continuously, and prevent complications. Keeping your lipid levels under control and maintaining good cardiovascular health can be achieved through regular checkups and follow-up appointments. Monitoring hyperlipidemia is necessary to ensure effective treatment and identify any lipid level changes. Your doctor can monitor your lipid levels regularly to ensure they stay within a healthy range.

FAQs about Hyperlipidemia Answered by Your Doctors Online Team

Is hyperlipidemia the same as high cholesterol?

A person with hyperlipidemia has a high level of lipids in the blood. Since cholesterol is also a lipid, high cholesterol is also called hyperlipidemia or lipid disorder.

Which strategy would help improve your blood lipid profile?

You can improve your blood lipid profile by eating a low-fat diet, exercising regularly, and quitting smoking.

How to lower cholesterol and triglycerides?

A diet rich in fruits and vegetables, regular physical activity, losing weight, and limiting alcohol intake can help lower cholesterol and triglycerides.

How long does it take to lower cholesterol?

It usually takes 6 to 8 weeks for cholesterol-lowering drugs to modify LDL levels. Depending on the individual, it may take longer, usually about three months or even longer.

Can high cholesterol be reversed?

It is often possible to manage high cholesterol effectively, but it may not be fully reversible. Changing your lifestyle, such as eating healthier, exercising more, losing weight, and quitting smoking, can reduce cholesterol levels.

How to manage high cholesterol?

Choosing foods that are low in saturated fat and trans fat and high in fiber, exercising regularly, quitting smoking, and limiting alcohol consumption can help improve your cholesterol levels.

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