September is National Cholesterol Awareness Month: Learn About Hyperlipidemia

What is hyperlipidemia?

Hyperlipidemia is a medical term for abnormally high levels of lipids in the blood. There are two major types of lipids found in the blood: triglycerides and cholesterol.

Triglycerides are made when your body accumulates and stores the extra calories it doesn’t need for energy. They also come directly from your diet in foods such as red meat and whole-fat dairy. A diet high in processed sugar, fructose, and alcohol increases triglycerides.

Cholesterol is produced naturally in your liver because every cell in your body uses it. Just like triglycerides, cholesterol is also found in fatty foods like eggs, red meat, and cheese.

Hyperlipidemia is more commonly known as high cholesterol. High cholesterol can be either inherited, or from the result of unhealthy lifestyle choices.

Consequences of too much cholesterol

Cholesterol is just fat that travels through your bloodstream on proteins called lipoproteins. Too much cholesterol in your blood, 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, which can lead to heart disease, heart attack, and stroke.

Diagnosing hyperlipidemia

Hyperlipidemia has no symptoms, therefore in order to detect it your doctor will need to perform a blood test called a lipid panel. This test determines your cholesterol levels. Your doctor 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

Generally, a total cholesterol level above 200 milligrams per deciliter is considered high. However, safe levels of cholesterol can vary from person to person depending on health history and current health concerns, and are best determined by your doctor. Your doctor will use your lipid panel to make a hyperlipidemia diagnosis.

Who is at risk for Hyperlipidemia?

There are two types of cholesterol, LDL and HDL. 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. Hyperlipidemia is caused by having too much LDL cholesterol in your blood and not enough HDL cholesterol to clear it up.

Unhealthy lifestyle choices can raise “bad” cholesterol levels and lower “good” cholesterol levels. If you’re overweight, eating lots of fatty foods, smoking, or not getting enough exercise, then you’re at risk.

The following is a list of lifestyle choices that can cause you to be at risk for high cholesterol such as:

  • eating foods with saturated and trans fats
  • eating animal protein, like meat and dairy
  • not getting enough exercise
  • not eating enough healthy fats
  • obesity
  • large waist circumference
  • smoking
  • drinking alcohol excessively

The following comorbidities can cause you to be more likely to develop hyperlipidemia such as:

  • kidney disease
  • diabetes
  • polycystic ovary syndrome
  • pregnancy
  • underactive thyroid
  • inherited conditions

How to treat and manage hyperlipidemia at home

Lifestyle changes are the key to managing hyperlipidemia at home. These changes alone may be enough to reduce your risk of complications like heart disease and stroke. If you’re already taking medications, lifestyle changes can improve their cholesterol-lowering effects.

Eat a heart-healthy diet

Switching to a balanced diet can lower your “bad” cholesterol levels and increase your “good” cholesterol levels. Here are a few changes you can make:

  • Choose healthy fats. Avoid saturated fats that are found primarily in red meat, bacon, sausage, and full-fat dairy products. Choose lean proteins like chicken, turkey, and fish when possible. Switch to low-fat or fat-free dairy. And use monounsaturated fats like olive 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 flax seeds.
  • Increase your fiber intake. All fiber is heart-healthy, but soluble fiber, which is found in oats, brain, fruits, beans, and vegetables, can lower your LDL cholesterol levels.
  • Eat more fruits and veggies. They’re high in fiber and vitamins and low in saturated fat.

 

Lose weight

If you’re overweight or obese, losing weight can help lower your total cholesterol levels. Even 5 to 10 pounds can make a difference.

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

To lose weight, adopt a low-calorie diet and increase your physical activity so that you’re burning more calories than you’re eating. It helps to cut out sugary drinks and alcohol, and practice portion control.

Get active

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 5 times a week to lower your total cholesterol levels. The goal should be 150 minutes of exercise total each week. Any 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.
  • Take the stairs instead of the elevator.
  • If you use public transportation, get off a stop or two sooner.

 

Quit smoking

Smoking lowers your HDL “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 to your doctor about quitting. 

Hyperlipidemia pharmacotherapy

If your lifestyle modification fails you, your doctor may start you on cholesterol lowering medications like:

  • Statins, such as:
    • atorvastatin (Lipitor)
    • fluvastatin (Lescol XL)
  • bile-acid-binding resins, such as:
  • cholestyramine (Prevalite)
  • colesevelam (WelChol)
  • cholesterol absorption inhibitors, such asezetimibe (Zetia)
  • injectable medications, such as alirocumab(Praluent) or evolocumab (Repatha)
  • fibrates, like fenofibrate (Fenoglide, Tricor, Triglide) or gemfibrozil (Lopid)
  • niacin (Niacor)
  • omega-3 fatty acid supplements
  • other cholesterol-lowing supplements

Natural progression of hyperlipidemia

Left untreated, hyperlipidemia will likely lead to coronary heart disease. Heart disease is a condition in which plaque builds up inside the heart arteries. Hardening of the arteries, called atherosclerosis, happens when plaque builds up on the walls of arteries. Over time, plaque buildup narrows the arteries and can block them completely, preventing normal blood flow. This can lead to heart attack, stroke, or other problems.

Therefore, the easiest way to avoid this catastrophe is by operating lifestyle modifications such as:

  • Exercise several days per week.
  • Eat a diet low in saturated and trans fats.
  • Include lots of fruits, vegetables, beans, nuts, whole grains, and fish regularly into your diet. (The Mediterranean diet is an excellent heart-healthy eating plan.)
  • Stop eating processed meats like bacon, sausage, and cold cuts.
  • Drink skim or low-fat milk.
  • Maintain a healthy weight.
  • Eat lots of healthy fats, like avocado, almonds, and olive oil

Gracia Pierre-Pierre, MD CAQSM