Overview

Hyperlipidaemia, also known as high cholesterol or high lipid levels, is a condition characterized by elevated levels of lipids (fats) in the blood, including cholesterol and triglycerides. These fats are essential for various bodily functions but can lead to health problems when present in excessive amounts. Hyperlipidaemia is a significant risk factor for cardiovascular diseases such as heart attack, stroke, and atherosclerosis (hardening of arteries). Often, it develops silently without noticeable symptoms, making routine health checks important for early detection and management.

Causes

Hyperlipidaemia can result from a combination of genetic, dietary, and lifestyle factors. Common causes include:

• Poor Diet: Consuming high amounts of saturated fats, trans fats, and cholesterol increases lipid levels.
• Lack of Physical Activity: Sedentary lifestyles contribute to weight gain and high cholesterol.
• Obesity: Excess body fat, especially around the abdomen, is associated with elevated cholesterol and triglyceride levels.
• Genetic Disorders: Familial hypercholesterolemia is a hereditary condition causing very high cholesterol levels from a young age.
• Diabetes: Uncontrolled diabetes can raise triglyceride levels and lower good cholesterol (HDL).
• Alcohol Consumption: Excessive alcohol intake increases triglycerides.
• Hypothyroidism: An underactive thyroid gland can lead to higher cholesterol levels.
• Certain Medications: Drugs like steroids, beta-blockers, and some diuretics may increase lipid levels.
• Aging: Cholesterol levels tend to rise naturally with age.

Symptoms

Hyperlipidaemia is often called a “silent” condition because it typically does not cause obvious symptoms until it leads to complications. However, in severe cases or genetic conditions, some signs may appear:

• No Early Symptoms: Most individuals feel completely normal despite high lipid levels.
• Xanthomas: Fatty deposits that form yellowish lumps on the skin, elbows, knees, or around the eyes in severe cases.
• Xanthelasma: Yellowish plaques around the eyelids.
• Chest Pain or Angina: Occurs if hyperlipidaemia leads to narrowed coronary arteries.
• Sudden Cardiovascular Events: Heart attacks or strokes may be the first indication of prolonged untreated hyperlipidaemia.

Diagnosis

Hyperlipidaemia is diagnosed through blood tests and clinical evaluation:

• Lipid Profile Test: Measures total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides after fasting.
• Physical Examination: Checking for visible signs like xanthomas or xanthelasma in severe cases.
• Family History: Assessment of any family history of high cholesterol or early heart disease.
• Additional Blood Tests: May include thyroid function tests, blood sugar levels, and liver function tests to rule out secondary causes.
• Risk Assessment: Tools like the ASCVD risk calculator may be used to estimate the 10-year risk of cardiovascular disease.

Treatment

Treatment of hyperlipidaemia focuses on lowering lipid levels to reduce the risk of cardiovascular diseases:

• Lifestyle Modifications:
• Adopting a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins.
• Limiting intake of saturated fats, trans fats, and cholesterol.
• Regular physical activity, such as at least 30 minutes of moderate exercise most days of the week.
• Weight loss for overweight or obese individuals.
• Quitting smoking and reducing alcohol consumption.
• Medications:
• Statins: First-line therapy to lower LDL cholesterol and reduce cardiovascular risk.
• Ezetimibe: Reduces cholesterol absorption in the intestines.
• PCSK9 Inhibitors: Injectable medications used in high-risk or genetic cases.
• Fibrates: Primarily lower triglycerides and can slightly increase HDL cholesterol.
• Niacin: Increases HDL cholesterol but is less commonly used due to side effects.
• Omega-3 Fatty Acids: Help reduce triglyceride levels.
• Regular Monitoring: Routine follow-ups and lipid profile tests to assess treatment effectiveness.

Prognosis

With proper management, the prognosis for hyperlipidaemia is generally good:

• Effective Control: Most individuals can achieve healthy lipid levels with lifestyle changes and medications.
• Reduced Cardiovascular Risk: Treating hyperlipidaemia significantly lowers the risk of heart attacks, strokes, and other cardiovascular events.
• Ongoing Management Required: Since it is a chronic condition, lifelong management is necessary to prevent recurrence.
• Potential for Complications: Untreated hyperlipidaemia can lead to serious health problems, including heart disease and peripheral artery disease.
• Good Quality of Life: With adherence to treatment, individuals can lead active, healthy lives with minimal risk of complications.

Overall, early detection and consistent management of hyperlipidaemia lead to excellent outcomes and a substantial reduction in long-term health risks.