Hyperlipidemia / High Cholesterol

Hyperlipidemia, commonly known as high cholesterol, is a condition characterized by elevated levels of lipids (fats) in the blood, including cholesterol and triglycerides. Cholesterol exists in several forms: low-density lipoprotein (LDL or "bad" cholesterol) which deposits in artery walls and contributes to plaque buildup, high-density lipoprotein (HDL or "good" cholesterol) which helps remove excess cholesterol from the bloodstream, and very low-density lipoprotein (VLDL) which carries triglycerides. High cholesterol typically causes no symptoms and is often discovered only through routine blood tests, though severely elevated levels can sometimes cause physical signs such as yellowish deposits around the eyes (xanthelasma) or on tendons (xanthomas). The condition develops due to a combination of genetic factors (familial hypercholesterolemia), diet high in saturated fats and trans fats, obesity, lack of physical activity, smoking, diabetes, hypothyroidism, and certain medications. Diagnosis is made through a lipid panel blood test that measures total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides, typically after an 8-12 hour fast for the most accurate results. High cholesterol is a major risk factor for atherosclerosis (hardening and narrowing of the arteries), which can lead to serious complications including coronary artery disease, heart attack, stroke, and peripheral artery disease. Treatment begins with lifestyle modifications including adopting a heart-healthy diet (such as the Mediterranean diet) that limits saturated fats, trans fats, and dietary cholesterol while emphasizing fruits, vegetables, whole grains, and healthy fats, increasing physical activity to at least 150 minutes of moderate exercise per week, achieving and maintaining a healthy weight, quitting smoking, and limiting alcohol consumption. When lifestyle changes alone are insufficient to reach target cholesterol levels, medications are prescribed including statins (the most effective and commonly used drugs for lowering LDL cholesterol), ezetimibe (which blocks cholesterol absorption in the intestine), PCSK9 inhibitors (injectable medications for very high cholesterol or statin intolerance), bile acid sequestrants, fibrates (primarily for high triglycerides), and niacin. Treatment goals are individualized based on overall cardiovascular risk, with more aggressive LDL targets (below 70 mg/dL or even below 55 mg/dL) recommended for people with existing heart disease, diabetes, or very high risk factors. Regular monitoring through repeat lipid panels is essential to assess treatment effectiveness and adjust therapy as needed, with most patients requiring lifelong management to maintain healthy cholesterol levels and reduce cardiovascular risk.

Hyperlipidemia / High Cholesterol

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