This is an abbreviated version of the complete article.*
||Physicians use the term hyperlipidemia to describe several conditions in which high concentrations of lipids (fats) exist in the bloodstream.
||Hyperlipidemia in the blood can be caused by genetics, lifestyle, or a combination of both.
||Atherosclerosis, which is the buildup of fatty streaks and cholesterol-laden plaque in the walls of the body's arteries, can result from hyperlipidemia.
||Lifestyle changes are the first choice for treating hyperlipidemia.
Lipid is the scientific term for fats in the blood. Like vitamins and minerals, certain fats are useful to the body as an energy source and to help build cells and hormones. Several types of fatty acids exist in the human body including:
Abnormally high levels of these lipids in the blood can accelerate a process called atherosclerosis (hardening of the arteries), which is the buildup of fatty streaks and cholesterol-laden plaque in the walls of the arteries. Physicians diagnose coronary heart disease (CHD) and peripheral artery disease (PAD) when the accumulation of plaque in a coronary or peripheral artery grows large enough to obstruct blood flow in the heart muscle or leg.
- Cholesterol-esters; and
Like any fat, lipids do not dissolve in water, which is a prime component of both cells and blood. For cholesterol and fatty acids to be carried in the blood and used in cells, the body must use a kind of protein to carry the lipids through the blood and into the cells. These protein-bound fats are called lipoproteins. The lipoprotein classes include:
- High density lipoproteins (HDL);
- Low density lipoproteins (LDL); and
- Very low density lipoproteins (VLDL).
Other forms of hyperlipidemia include familial hypercholesterolemia and familial hypertriglyceridemia.
- Primary elevated cholesterol, commonly known as high cholesterol;
- Metabolic syndrome;
- Primary elevated triglycerides; and
- Primary low-HDL syndromes.
CAUSES AND RISK FACTORS
Elevated levels of lipids in the blood can be caused in part by a diet high in fat and cholesterol, but other factors, including other conditions and lifestyle, can contribute to acquired hyperlipidemia. Conditions that contribute to hyperlipidemia include:
Controllable, lifestyle-related risk factors associated with hyperlipidemia include:
- Diabetes mellitus;
- Nephrotic syndrome;
- Certain medications (anabolic steroids, beta blockers, diuretics, or oral contraceptives);
- Chronic liver disease;
- Pregnancy; and
- Chronic renal failure.
However, the patient cannot control other risk factors, which include:
- High blood cholesterol;
- Low HDL cholesterol;
- High blood pressure;
- Excessive alcohol consumption; and
- Physical inactivity.
Some people suffer from lipid disorders that are a combination of genetic problems and lifestyle factors.
- Age (45 years or older for men; 55 years or older for women); and
- Family history of early heart disease.
There are no symptoms associated with hyperlipidemia. Therefore, the National Cholesterol Education Program recommends that people have blood tests to measure their lipid levels every 5 years beginning at age 20.
Therapeutic lifestyle change. When LDL levels are high enough to add to the risk for CHD, physicians usually recommend people first change their diet and exercise habits. Diet changes include:
Other foods that can help control cholesterol include:
- Limiting saturated fats;
- Increasing intake of soluble fiber found in oats, peas, beans, and certain fruits; and
- Increasing intake of plant stanols or sterols, found in nuts, vegetable oils, corn, and rice.
Another change people can make is to add or increase psyllium in their diet. Psyllium is a source of soluble fiber found in certain over-the-counter laxatives.
- Cold-water fish, such as mackerel, sardines, and salmon; and
- Soy, such as tofu and soy nuts.
Smokers should quit immediately after finding out they have hyperlipidemia.
Increased physical activity is another component of lifestyle changes, but because each person's health condition and tolerance for exercise is different, there is not a set amount of exercise that will benefit cholesterol levels. As a general guideline, however, physicians recommend exercising aerobically for 20 to 30 minutes, 5 times each week.
Weight management can affect blood LDL levels. The amount of weight a person should lose varies according to each person's current target, and ideal weight.
Medication. If lipid levels do not improve after 3 months of lifestyle changes, or in cases where a person has CHD or blood lipid levels that are thought to be genetically determined, physicians may consider adding medication to lifestyle changes. Drugs for hyperlipidema include:
- Bile acid sequestrants;
- Fibrates; and
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